BVA9502830 
DOCKET NO.  93-09 392     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in No. Little
Rock, Arkansas

THE ISSUES

1.  Entitlement to a rating in excess of 10 percent for residuals
of shell fragment wound to the right (major) arm.

2.  Entitlement to a rating in excess of 10 percent for
tendonitis of the left (minor) shoulder.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

D. B. Weiss, Associate Counsel

REMAND

The veteran had active military service from June 1967 to July
1970.  In July 1967, he sustained a shell fragment wound to his
right upper arm or shoulder area.

The veteran's substantive appeal contains a claim for a total
rating based on individual unemployability.  This issue was not
developed for appellate review and is not inextricably
intertwined with the instant appeal.  Therefore, it is referred
to the regional office (RO) for action to include development and
adjudication of this claim.

The veteran contends that diminished strength is as important as
limited range of motion and that his bilateral upper extremity
strength is so diminished that the currently assigned rating are
inadequate.

A longitudinal review of the veteran's claims file reveals
indications that inquiry should be directed to whether the
veteran has a muscle group injury in his right upper arm
secondary to his shell fragment wound.  These indications have
included right arm with radiculitis of the right musculocutaneous
nerve, disparity in circumference of the right arm and left just
below the elbow, decreased strength and grip in the right arm and
hand, and giving way on strength testing of the deltoids.
Numerous X-rays have showed retained foreign bodies in the right
arm.  Recent Department of Veterans Affairs (VA) outpatient
treatment, however, has suggested a psychogenic overlay to some
of the upper extremity complaints.  The veteran gave a history of
arthroscopy in 1990 at his most recent VA examination, the
records of which have not been sought.

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

1.  The RO should obtain the names and
addresses of all medical care providers who
treated the veteran for his bilateral upper
extremity disorders since January 1990.
This should include information pertinent
to his left shoulder arthroscopy in 1990
and to any Social Security Administration
disability pension award which may have
been made.  After securing any necessary
release, the RO should attempt to obtain
copies of these records.

2.  Copies of complete VA treatment records
at the Little Rock VA Medical Center and of
treatment records since August 1991 at the
Memphis VA Medical Center should be
obtained and associated with the claims
file.

3.  The veteran's VA vocational
rehabilitation and counseling folders
should also be obtained and associated with
the claims file.

4.  The veteran should be afforded VA
neurological and orthopedic examinations to
determine the severity of his left shoulder
tendonitis and his residuals of shell
fragment wound to the right upper arm, to
include a determination of whether such
residuals include a muscle injury.  If so,
the muscle group involved should be
identified, and relevant grip strength and
arm strength testing should be performed.
Range of motion studies should be recorded
in degrees.  All indicated diagnostic tests
should be performed, including a right
upper arm X-ray and electromyography if
indicated.  A complete history of the
symptoms associated with the right upper
extremity should be taken.  The examiner
should comment on the organicity of
findings.  The claims folder should be made
available to the examiner for review before
the examination.

5.  After the development requested above
has been completed to the extent possible,
the RO should again review the record.  If
any benefit sought on appeal, for which a
notice of disagreement has been filed,
remains denied, the appellant and
representative should be furnished a
supplemental statement of the case and
given the opportunity to respond thereto.

Thereafter, the case should be returned to the Board of Veterans'
Appeals (Board), if in order.  The Board intimates no opinion as
to the ultimate outcome of this case.  The appellant need take no
action until otherwise notified.

          SAMUEL W. WARNER
          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) (1993).