BVA9503861 
DOCKET NO.  93-12 534     )       DATE
          )
          )

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

THE ISSUE

Entitlement to a rating in excess of 20 percent for a left
shoulder disorder, currently classified as Hill-Sachs deformity
of the humeral head with partial tear of rotator cuff and
associated degenerative changes.

REPRESENTATION

Appellant represented by: The American Legion

ATTORNEY FOR THE BOARD

Michele M. Florack, Associate Counsel

INTRODUCTION

The veteran had active duty from August 1975 to August 1978.

Upon review of this case, the Board of Veterans' Appeals (Board)
notes that the veteran seeks entitlement to service connection
for a knee disorder and a back disorder, secondary to the
service-connected left shoulder disorder.  These particular
issues have not been developed for appellate review and are
referred to the Regional Office (RO) for appropriate action.

In the substantive appeal, the veteran also appeared to be
claiming that the effective date for the grant of the 10 percent
evaluation for the left shoulder disorder, which was awarded in
July 1985,  should have been August 11, 1978.  This matter is
likewise referred to the RO for appropriate disposition.

REMAND

The Board finds that the veteran's claim for an increased rating
for a left shoulder disorder is "well grounded" or plausible
within the meaning of 38 U.S.C.A. § 5107(a) (West 1991).  The
Department of Veterans Affairs (VA) therefore has a duty to
assist the veteran in the development of facts pertinent to his
claim.  38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103,
3.159 (1994).  That duty includes obtaining medical records and
medical examinations where indicated by the facts and
circumstances of the case.  Littke v. Derwinski, 1 Vet.App. 90
(1990).

In this case, a review of the medical evidence reveals that there
is some discrepancy as to which shoulder represents the veteran's
major extremity, a critical factor in this increased rating
determination.  In VA examination dated in June 1985, the veteran
was noted to be right handed.  In VA examination dated in October
1992, the veteran was noted to be left handed.  In reports of
medical history completed in July 1975 and July 1978, the veteran
indicated he was right handed.  The Board is also of the view
that additional medical evaluation of the service-connected left
shoulder disability would be in order.

Therefore, to ensure that VA has met its duty to assist the
appellant in developing the facts pertinent to the claim, the
case is REMANDED to the RO for the following development:

1.  The veteran should be afforded a VA
orthopedic examination to determine the
nature, extent, and severity of his
service-connected left shoulder disability
(Hill-Sachs deformity of the humeral head
with partial tear of rotator cuff and
associated degenerative changes.)  All
indicated studies should be performed in
accordance with the Physicians' Guide for
Disability Evaluation Examinations,
including X-rays, loss of strength and
range of motion testing, should be
performed.

2.  Range of motion studies should be
reported in degrees for shoulder abduction,
forward elevation, and rotation of the left
shoulder.  Pain on motion and functional
loss should be discussed.  The orthopedist
should identify the veteran's major
extremity.  In addition, the examiner
should be asked  to state (i) whether the
veteran's left arm has limitation of motion
to 25 degrees from the side;  (2) whether
his left arm has limitation of motion
midway between the side and shoulder level;
and (3) whether his arm has limitation of
motion at the shoulder level.  The claims
folder should be made available to the
examiner for review before the examination.

When the above-requested development is completed, the case
should again be reviewed by the RO.  If the veteran's claim
remains denied, the veteran and his representative should be
furnished an appropriate supplemental statement of the case.
After they have had an adequate opportunity to respond, the case
should be returned to the Board for further appellate review, if
in order.  The purpose of this REMAND is to obtain clarifying
data.

          JOHN E. ORMOND
          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).