BVA9506406 
DOCKET NO.  93-10 130     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Waco, Texas

THE ISSUES

1.  Entitlement to service connection for a multiple joint
orthopedic disability, secondary to service-connected rheumatic
heart disease.

2.  Entitlement to service connection for pes planus.

3.  Entitlement to an increased evaluation for rheumatic heart
disease, currently rated as 10 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESSES AT HEARING ON APPEAL

The veteran and his wife

ATTORNEY FOR THE BOARD

John D. Nachmann, Associate Counsel

INTRODUCTION

The veteran had active service from January 1953 to June 1957.

This matter comes before the Board of Veterans' Appeals (Board)
on appeal from rating decisions of November 1991 and October 1992
by the Department of Veterans Affairs (VA) Waco, Texas, Regional
Office (RO).

REMAND

During his May 1992 personal hearing, the veteran testified that
he experienced pain and swelling in several of his joints.  The
evidence that has been associated with the veteran's claims file
indicates that he has made similar claims for a number of years
for which he has been examined on several occasions. Upon
examination in April 1966 and March 1969, x-rays did not reveal
any arthritis in the veteran's joints, particularly in the
elbows, knees, and feet.  In March 1971, the veteran was found to
have transient pain and occasional swelling in multiple joints
that was characterized as possible low-grade arthritis.
Nevertheless, x-rays obtained in 1973 did not reveal the presence
of any arthritis.

More recently, the veteran was diagnosed with mild to moderate
degenerative joint disease and osteoarthritis secondary to his
service-connected rheumatic fever during an October 1991 VA
orthopedic examination.  During an October 1991 VA medical
examination, however, the examiner concluded that the veteran's
problems were likely due to arthritis and were not connected to
his service-connected rheumatic heart disease.  The Board notes
that although the veteran was diagnosed with arthritis during
both of the October 1991 examinations, the required radiographic
evidence was not obtained to support these diagnoses.  See
38 C.F.R. § 4.71a, Diagnostic Code 5300 (1994).

Therefore, in order to give the veteran every consideration with
respect to the present appeal, it is the Board's opinion that
further development of the case is warranted.  Accordingly, this
case is REMANDED for the following actions:

The veteran should be afforded a special
rheumatologic examination in order to
ascertain the nature and severity of his
multiple joint orthopedic disability.  All
studies deemed appropriate by the examiner,
including x-rays, should be accomplished.
The examiner should render an opinion as to
the degree of probability, if any, that the
veteran's multiple joint orthopedic
disability is proximately due to or the
result of his service-connected rheumatic
heart disease.  The claims file or copies
of all pertinent records contained therein
should be made available to the examiner
prior to and during the examination for a
complete study of the case.

After completion of the requested development, the case should be
reviewed by the RO.  If the determination remains adverse to the
veteran, the case should be returned to the Board after
compliance with the provisions for processing appeals, including
the issuance of a supplemental statement of the case and
provision of the applicable time period for response thereto.
The Board will defer full consideration of all issues on appeal
pending completion of the above-requested development.

The purpose of this REMAND is to obtain additional development,
and the Board does not intimate any opinion as to the merits of
the case, either favorable or unfavorable, at this time.  No
action is required of the veteran until he is notified.

          JACQUELINE E. MONROE
          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).