BVA9504067 
DOCKET NO.  93-09 928     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Phoenix,
Arizona

THE ISSUES

1..  Entitlement to service connection for traumatic arthritis of
the entire spine.

2.  Entitlement to service connection for a gastrointestinal
disorder.

3.  Entitlement to service connection for hypertension.

4.  Entitlement to an increased rating for bilateral knee
arthritis with osteochondroma of the left distal femur, currently
evaluated
as 20 percent disabling.

5.  Entitlement to an increased rating for a psychiatric
disorder, currently evaluated as 10 percent disabling.

6.  Entitlement to an increased (compensable) evaluation for
residuals of frozen feet.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Michael E. Kilcoyne, Counsel

INTRODUCTION

The veteran had active military service from August 1942 to
September 1945.  He was a prisoner of war (POW) of the German
government from June 1944 to May 1945.

The matters on appeal arise from an October 1991, decision by the
aforementioned regional office (RO).  The veteran disagreed with
that decision in June 1992, and after further appellate
development, the case was forwarded to the Board.

REMAND

The record reveals that in connection with a VA examination
conducted in July 1992, the RO requested that the examining
physician confirm or rule out the presence of traumatic arthritis
in the veteran's spine.  The report of that examination revealed
the presence of degenerative joint disease in the cervical and
thoracic spine segments and the presence of an osteophyte at L3.
However, the examiner did not set forth whether or not any of
these findings were of traumatic origin.  The veteran has
reported injuries to his spine while a POW.

With respect to his claim for service connection for a
gastrointestinal disorder, the record shows that following an
examination conducted for VA purposes in March 1991, the veteran
was diagnosed to have stomach problems, the symptoms of which
were consistent with irritable bowel syndrome.  However,
following VA examination conducted in July 1992, the veteran was
diagnosed to have recurrent mild diarrhea.  No attempt has been
made to reconcile these diagnoses.

Regarding the evaluation of the veteran's psychiatric disorder,
he indicated in a February 1993 letter to the RO that following a
1993 automobile accident, his psychiatric symptoms increased in
severity.  The veteran also referred to VA medical records which
he believed would substantiate his contention.  The evidence does
not show that any attempts to obtain those records have been
undertaken.

The VA has a duty to assist the veteran in the development of
facts pertinent to his claim.  38 U.S.C.A. § 5107 (West 19991).
This duty requires that VA base disability determinations upon
the most complete evaluation of the claimant's condition that can
feasibly be constructed and obtaining opinion's regarding whether
current disability may be related to service.  See Schafrath v.
Derwinski, 1 Vet.App. 589 (1991) and Moore v. Derwinski, 1
Vet.App. 401 (1991).  It has also been held that the fulfillment
of the statutory duty to assist includes the conduct of a
thorough and contemporaneous medical examination which takes into
account the records of prior medical treatment, so that the
evaluation of the claimed disability will be a fully informed
one.  Green V. Derwinski, 1 Vet.App. 121 (1991).  Moreover, when
an examination report does not contain sufficient detail, it is
incumbent upon the rating board to return the report as
inadequate for rating purposes.  38 C.F.R. § 4.2.

In this case, the Board is unable to determine the precise nature
of any stomach disorder that the veteran experiences or whether
the degenerative changes in his spine may be considered to be of
traumatic origin.  In addition, the record does not show that any
attempt has been made to obtain treatment records which the
veteran believes would support his contention that his
psychiatric disorder has increased in severity.  In view of this,
further development and evaluation is necessary in order to
ensure an equitable disposition of the veteran's appeal is
obtained.  Although additional delay is regrettable, this case is
Remanded to the RO for the following:

1.  The RO should associate with the claims
file, copies of all treatment records
relating to the veteran from the Prescott,
Arizona VA Medical Center dated after May
1992.

2.  Next, the veteran should be scheduled
for special gastrointestinal, orthopedic and
psychiatric examinations, the purpose of
which is to determine the nature and extent
of any digestive and psychiatric disability
present as well as the nature and extent of
any disability of the spine.  These
examinations should be conducted in
accordance with the pertinent provisions of
the VA Physician's Guide for Disability
Evaluation Examinations and all indicated
tests and studies should be performed.  The
claims folder must be made available to the
examiners prior to examination to ensure
that the evaluations are conducted in the
context of the veteran's pertinent history.
The gastrointestinal examiner is requested
to specifically state whether the veteran
has irritable bowel syndrome and the
orthopedic examiner, after taking a detailed
medical history with respect to all spinal
injuries, is requested to offer his opinion
as to whether the veteran has traumatic
arthritis of the spine.  The psychiatric
examiner must assign a Global Assessment of
Functioning Score consistent with the
American Psychiatric Association's
DIAGNOSTIC AND STATISTICAL MANUAL FOR MENTAL
DISORDERS (3d ed. rev., 1987), and explain
what the assigned score represents.  A
complete rationale for any opinion expressed
must be provided.

3.  Following completion of the foregoing,
the RO must review the claims folder and
ensure that all of the foregoing development
actions have been conducted and completed in
full.  If any development is incomplete,
including if the requested examinations do
not include all test reports, special
studies or opinions requested, appropriate
corrective action is to be implemented.
Upon completion of the above, the RO should review the evidence
and enter its determination with respect to service connection
for arthritis of the spine, service connection for a stomach
disorder and the evaluation of the veteran's psychiatric
disorder.  If any decision remains adverse to the veteran, he and
his representative should be provided with a supplemental
statement of the case and given an opportunity to respond to it
before the case is returned to the Board for further review.

No action is required of the veteran until he is further informed
and the matters regarding service connection for hypertension and
entitlement to increased ratings for frozen feet and a bilateral
knee disorder are held in abeyance pending the development
requested by this Remand.

          C. W. SYMANSKI
          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).