BVA9508415 
DOCKET NO.  93-18 382     )       DATE
          )
          )

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

THE ISSUE

Entitlement to an increased evaluation for residuals of a
meniscectomy for removal of torn lateral semilunar cartilage to
the right knee with traumatic arthritis, currently rated as 20
percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

T. Hal Smith, Counsel

INTRODUCTION

The veteran had nearly continuous active duty from September 1954
to August 1968.  This appeal ensued following September 1991 and
September 1992 rating decisions of the Department of Veterans
Affairs (VA) Regional Office (RO) in Waco, Texas, which increased
a 10 percent rating for right knee disability to 20 percent,
effective October 1991.

REMAND

It is asserted that the RO erred in denying a rating in excess of
20 percent for the veteran's service-connected right knee
disorder.  In statements by the veteran, he has asserted that
this disorder has increased in severity to the point that he
needs a total knee replacement.

VA outpatient treatment records from July 1991 through July 1992
show that the veteran was seen for right knee complaints before
and after arthroscopic surgery in August 1991 when he underwent
debridement and partial lateral meniscectomy.  In July 1992, he
complained of recurrent locking of the right knee with severe
pain and frequent mild swelling.  Range of motion was 10 degrees
to 110 degrees.  (38 C.F.R. 4.71 (1994) Plate II provides that
full flexion and extension of the knee is from 0 degrees to 140
degrees.)  Examination was positive for tenderness along the
medial joint line with mild effusion noted.  The examiner's
impression was of severe degenerative joint disease of the right
knee.  The veteran was placed on the list for a total right knee
replacement.

In a March 1993 VA outpatient treatment record, the veteran was
seen for complaints that his right knee was locking up.
Examination, however, did not show instability, crepitus,
erythema or effusion.  A private physician, Steven J. Mackey,  M.
D., reported in February 1993 that X-rays showed severe global
degenerative changes.  He indicated that he had told the veteran
that no surgical procedure short of joint replacement would be of
any benefit.

The 20 percent rating currently in effect for the veteran's right
knee disorder contemplates "moderate" impairment.  For a rating
increase, there must be "severe" impairment.  In an August 1993
statement, a representative, on behalf of the veteran, requested
that the case be remanded for an orthopedic examination to
determine the current degree of knee impairment.

Under the circumstances of this case, we are also of the opinion
that additional development is required.  Accordingly, this case
is REMANDED for the following:

The veteran should be afforded a
comprehensive orthopedic examination, in
order to ascertain the severity of his
current right knee disorder.  All tests
indicated should be performed, and the
examiner should express an opinion as to
the degree of recurrent subluxation and
lateral instability that is present.  The
claims folder should be made available to
the examiner prior to the examination.

Following completion of this action, the RO should review the
evidence and determine whether the veteran's claim may be
granted.  If not, the veteran and his representative should be
provided with an appropriate supplemental statement of the case,
and the case should be returned to the Board for further
appellate consideration.

The veteran need take no action until he is so informed.  The
purpose of this REMAND is to obtain additional medical evidence
and to ensure compliance with due process considerations.

          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 action has been taken in
accordance with the Veterans' Benefits Improvements Act of 1994,
Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and 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).