BVA9506165 
DOCKET NO.  92-11 504     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Oakland,
California

THE ISSUE

Entitlement to an increased rating for postoperative appendectomy
with residual small bowel obstruction, currently rated 10 percent
disabling.

REPRESENTATION

Appellant represented by: Jeffrey Wood, Attorney

INTRODUCTION

The veteran served on active duty from September 1978 to
September 1983.  This matter came before the Board of Veterans'
Appeals (Board) on appeal from a March 1990 rating decision of
the San Francisco, California, Regional Office (RO) of the
Department of Veterans Affairs (VA).  An April 1992 rating
decision granted a 10 percent rating, and the veteran continued
his appeal.  The Board denied an increased rating in May 1994,
and the veteran appealed to the United States Court of Veterans
Appeals (Court).  A January 1995 Order of the Court vacated the
Board's decision (as to this issue) and remanded the case to the
Board to comply with the parties' Joint Motion for Remand and for
Stay of Further Proceedings.  That motion, based on VA medical
evidence which was extant but not on file at the time of the
Board decision, calls for readjudication of the issue.

REMAND

Because the above-mentioned evidence (VA outpatient record of May
1993) has not been considered by the RO, and the veteran has not
waived his right to such consideration, the case must be returned
to the RO for further adjudication.  38 C.F.R. § 20.1304(c)
(1994).  The veteran's attorney has submitted additional medical
evidence (Santa Cruz Medical Clinic, Feb. - Dec. 1993; Health
Analysis, Inc., Aug. 1993; Cynthia Reynolds, M.D., Nov. 1994) and
identified additional issues which must also be addressed by the
RO.  Therefore, the case is remanded to the RO for the following
actions:

1.  Copies of all relevant treatment
records should be obtained from Cynthia
Reynolds, M.D.; the Santa Cruz Medical
Clinic (post- Dec. 1993); Health Analysis,
Inc. (post-Aug. 1993); and VA sources
(post- Jan. 1992).

2.  Copies of all medical evidence
supporting the Social Security
Administration's reported award of
disability benefits should be obtained.

3.  The veteran should be afforded special
VA psychiatric and gastrointestinal
examinations.  The psychiatric examiner
should offer an opinion, based on the
entire record, as to whether it is at least
as likely as not that the veteran has
developed a psychiatric disability as the
result of pain from his service-connected
postoperative appendectomy with residual
small bowel obstruction.  The
gastrointestinal examiner should determine
the source of the veteran's abdominal pain,
and state whether it is at least as likely
as not that the veteran's pain is the
result of his service-connected
postoperative appendectomy with residual
small bowel obstruction.

4.  The RO should readjudicate the issue of
an increased rating, both on a schedular
and extraschedular basis, as well as the
newly raised issues of secondary service
connection for a psychiatric disorder and a
total disability rating based on individual
unemployability.

After RO review, if any issue remains denied, a supplemental
statement of the case should be provided to the veteran and his
attorney, and they should be given an opportunity to respond
before the case is returned to the Board for further review.

          J. E. DAY
          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).