BVA9500181 
DOCKET NO.  93-08 313     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUES

1.  Entitlement to an increased evaluation for anxiety reaction,
currently evaluated as 30 percent disabling.

2.  Entitlement to an increased evaluation for left knee
disorder, currently evaluated as 10 percent disabling.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

Alice A. Booher, Counsel

INTRODUCTION

The veteran had active service from March 1943 to May 1945.
Service medical records show that he injured his left knee when
he fell while carrying a patient on a litter in Italy in May
1944; service connection is in effect for post-traumatic
arthritis of the left knee, residuals of contusion.

The veteran initially filed his reopened claim for increased
compensation in September 1990.  In several subsequent rating
actions, the Department of Veterans Affairs (VA) Regional Office
(RO) in St. Petersburg, Florida denied his claim for increased
compensation.  A Statement of the Case was prepared in March
1993; the veteran's subsequent VA Form 21-4138 in March 1993
disagreed both with the decision of the RO and the VA examination
findings on which it was made.  To his VA Form 1-9, submitted in
May 1993, the veteran attached a copy of a VA outpatient report
dated in March 1993 relating to his left knee and proposed
surgery.   Thereon, the veteran waived a "personal hearing at the
RO in re: submission of the attached evidence"; he also indicated
that he had been told by the VA physician that the cartilage in
his left knee was no longer evident, that bone was grating on
bone, that he was to be seen again in September 1993 at the
outpatient facility and that thereafter, surgery was proposed.
The veteran indicated that this increased disability had been the
basis for his claim for increased compensation.

The case was certified to the Board of Veterans' Appeals (the
Board) in April 1993, and reviewed by the veteran's
representative, the Veterans of Foreign Wars of the United States
in August 1993.  In October 1993 and March 1994, reports of VA
hospitalization were received by the Board, reflecting that the
veteran underwent a total left knee replacement during an
admission in September and October 1993.  Although there is a
notation in the file that review was needed thereon as the
evidence related to the appellate issues, and although it appears
that the reports were submitted to the Board by the RO, there is
nothing in the file to indicate that either the RO has considered
this evidence as part of any adjudicative action, or that the
veteran has waived RO consideration thereof.

Action by the Board on the veteran's claim for increased
compensation for anxiety reaction will be held in abeyance
pending the other requested development.

REMAND

The veteran has indicated that the VA examination reported in
late 1992 was inadequate, but even it clearly showed that his
left knee was severely disabling, was very unstable and required
the use of a cane.  He indicates that the range of motion
described by the examiner was inaccurate.  He argues that the
outpatient record he himself submitted dated in March 1993
reflects the treating physician's concern over the severity of
his left knee disorder and that as soon as he lost weight, (which
he subsequently did), surgery was scheduled and undertaken.
Finally, he argues that these VA treatment records are pivotal to
his claim for increased compensation.  The veteran's
representative argues that the VA examination findings of
"severe" left knee disability clearly warrant an evaluation in
excess of 10 percent.

In view of the evidence in this case, the case is REMANDED for
the following actions:

1.  The veteran's complete VA outpatient
and inpatient treatment records from the
Tampa Bay VA Medical Center since December
1992, should be acquired and attached to
the claims folder.

2.  The veteran should then be given a
special VA orthopedic examination to
determine the exact nature of his current
left knee disability.  All necessary
laboratory and other testing should be
accomplished.  The claims folder, a copy of
this REMAND, and all evidence obtained
pursuant to this REMAND must be made
available to the examiner prior to
evaluating the veteran's case.

3.  The RO should then review the case with
regard to the entire evidence of record and
with regard to the state of the veteran's
service-connected left knee disorder since
his current claim for increased
compensation was opened.  If the decision
remains adverse, a Supplemental Statement
of the Case should be prepared to include
all pertinent evidence and regulations, and
the veteran and his representative should
be afforded a reasonable opportunity to
respond.

Thereafter, the case should be returned to the Board for further
appellate review.  The veteran need do nothing further until so
notified.

          THOMAS J. DANNAHER
          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) (1993).