BVA9503330 DOCKET NO. 93-08 207 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Pittsburgh, Pennsylvania THE ISSUES 1. Entitlement to service connection for weakness of the hands secondary to burn scars of the hands. 2. Entitlement to service connection for memory loss. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD J.W. Engle, Counsel REMAND Review of the record reveals that the appellant's representative, in the VA Form 1-646, Statement of Accredited Representation dated in March 1993, requested that this case be returned to the Pittsburgh, Pennsylvania, Department of Veterans Affairs Regional Office (VARO) for medical development with respect to the appellant's claim to service connection for weakness of the hands secondary to his service-connected burn scars of the hands. It is argued that the appellant has not been recently evaluated by VA pursuant to the provisions of Littke v. Derwinski, 1 Vet. App. 90 (1990), and that the appellant should be afforded an examination to determine the etiology of the weakness of the hands. Our review of the record reveals that the relationship between weakness of the hands and the service-connected burn scars of the hands cannot be adequately evaluated based upon the evidence currently of record. The service medical records reflect complaints of weakness in the hands in August 1945, shortly after the appellant sustained his injuries as the result of enemy bombardment. In January 1947 on VA examination, the examiner noted that the appellant had muscle spasms and pain in both hands following exertion. However, the record is then silent with regard to pertinent complaints until June 1963 when the appellant was seen by VA on an outpatient basis. At that time, the appellant reported complaints of tension and inability to open his fingers. It was further noted that the appellant worked with power tools which vibrated "quite a bit" and that there were no objective findings on examination. During VA hospitalization from September 21, 1964 to October 29, 1964 the appellant reported complaints of cramps and weakness in both hands with the use of power tools at work. He noted that the symptoms disappear with rest and indicated that the symptoms began after he started his job in March 1963. Subsequent VA outpatient treatment reports dated from 1965 to 1968 noted complaints of hand weakness and that the appellant was dropping objects and in June 1965 a diagnostic assessment of muscular weakness of unknown etiology was noted. In December 1969 on VA examination the appellant reported complaints of weakness of both hands with use and that he had difficulty holding on to things. He indicated that he began to notice symptoms after he started using mechanical equipment at work in 1963. There were no objective findings with regard to the complaints of hand weakness. Subsequent examination reports dated from 1970 to 1992 noted complaints of hand weakness and in June 1985 a VA EMG study revealed findings suggestive of an early stage of right carpal tunnel syndrome. In April 1991 the appellant reported that he had symptoms of cramping and mild incoordination since the war. However, examination revealed no evidence of nerve compression, either cervical or peripheral. In June 1992 the appellant was again examined by VA. However, the appellant's complaints of weakness in the hands were not addressed and it was noted by the VA examiner that the appellant had an appointment with the Rehabilitative Medicine Service in July 1992 and they would be better able to assess the appellant complaints of weakness in his hands. Review of the July 1992 VA outpatient treatment reports reflect findings associated with the appellant's nonservice-connected left shoulder complaints and only make reference to complaints of occasional episodes of dropping objects from his hands. In view of the above, the undersigned concludes that additional medical development is necessary to provide an adequate record upon which to render a fair decision regarding the appellant's claim to service connection for weakness of the hands secondary to his service-connected burn scars of the hands. Accordingly, this case is REMANDED for the following action: 1. The appellant should be scheduled for a VA neurological examination in an effort to determine the presence and etiology of a disorder manifested by weakness of the hands. The claims folder must be made available to the examiner for review before the examination. 2. The examiner's attention is directed to the service medical records dated in April and August 1945 regarding the injuries the appellant sustained to his hands, as well as the January 1947 VA examination report and the 1964 VA hospitalization report. The examiner is requested to provide an opinion as to the nature and etiology of the appellant's complaints of hand weakness and to comment on the relationship, if any, to the service-connected burn scars of the hands. The examination report should be associated with the claims folder. Consideration of the appellant's claim to service connection for memory loss is deferred until completion of the requested development. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action unless otherwise notified. C.P. RUSSELL Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1994).