BVA9500669 
DOCKET NO.  93-06 954     )       DATE
          )
          )

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

THE ISSUE

Entitlement to an increased evaluation for lumbosacral strain,
currently evaluated as 20 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Carolyn Wiggins, Associate Counsel

INTRODUCTION

The veteran served on active duty from January 1968 until
December 1971.

This appeal arises from a February 1992 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Phoenix, Arizona which denied an increased evaluation for
lumbosacral strain.

The veteran is service-connected for lumbosacral strain.  Current
clinical findings have included L-5 radiculopathy.  Diagnostic
studies have shown degenerative disc disease of the lumbar spine.
The veteran has maintained that he is having increasing pain and
difficulty due to his service connected lumbosacral strain.  It
appears to the Board that the veteran has an inferred claim for
secondary service connection for degenerative disc disease of the
lumbosacral spine.  The RO appears to have considered all low
back manifestations when rating the low back disability, but has
not expressly conceded that degenerative disc disease is part and
parcel of the service connected disability or rated the
disability under the criteria for intervertebral disc syndrome.
The claim for secondary service connection for lumbar disc
disease is inextricably intertwined with the claim for an
increased rating for lumbosacral strain.  Harris v. Derwinski,
1 Vet.App. 180 (1991).

REMAND

VA has a duty to assist the veteran in the development of all
facts pertinent to his claim.  38 U.S.C.A. § 5107 (a) (West
1991); 38 C.F.R. § 3.103(a) (1993).  The United States Court of
Veterans Appeals has held that the duty to assist the veteran in
obtaining available facts and evidence to support his claim
includes obtaining pertinent evidence that applies to all
relevant facts.  Littke v. Derwinski, 1 Vet.App. 90 (1990).  This
duty also includes providing additional examinations by a
specialists when recommended or indicated.  Hyder v. Derwinski,
1 Vet.App. 221 (1991).  To ensure that VA has met its duty to
assist the appellant in developing the facts pertinent to the
claim, the case is REMANDED to the regional office (RO) for the
following development:

1.  The RO should obtain the names and
addresses of all medical care providers who
treated the veteran for a low back disorder
since October 1992.  The RO should also
request that the veteran supply the
complete name and address of the private
physician in Tennessee he stated was
treating him in an October 1992 VA Social
and Industrial Survey.  After securing the
necessary releases, the RO should obtain
these records.

2.  The veteran should be afforded VA
orthopedic and neurologic examinations to
determine the nature, severity and etiology
of low back disability.  The orthopedic
examiner should specifically note range of
motion of the lumbar spine, any listing of
the spine, whether there is a positive
Goldthwaite's sign, any loss of lateral
motion with osteo-arthritic changes and any
narrowing or irregularity of joint space or
any of the above with abnormal mobility on
forced motion.  Each examiner should give
an opinion as to whether or not any lumbar
radiculopathy or lumbar disc disease found
on examination was caused by, represents a
progression of, or is related to, the
service connected lumbosacral strain.  The
claims folder should be made available to
each examiner for review before the
examination.

3.  Inasmuch as the issue of service
connection for degenerative disc disease is
deemed to be "inextricably intertwined"
with the issue of an increased evaluation
for lumbosacral strain, when the above
development is completed, the RO should
adjudicate both issues.  The appellant and
representative should then be provided
notice of the determination and of his
appellate rights.  If a timely notice of
disagreement is filed on the secondary
service connection issue, the appellant and
representative should be furnished with an
appropriate statement of the case and given
time to respond thereto.

The case should then be returned to the Board for further
appellate review.

          NANCY I. PHILLIPS
          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.

NOTICE OF APPELLATE RIGHTS:  Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals within
120 days from the date of mailing of notice of the decision,
provided that a Notice of Disagreement concerning an issue which
was before the Board was filed with the agency of original
jurisdiction on or after November 18, 1988.  Veterans' Judicial
Review Act, Pub. L. No. 100-687, § 402 (1988).  The date which
appears on the face of this decision constitutes the date of
mailing and the copy of this decision which you have received is
your notice of the action taken on your appeal by the Board of
Veterans' Appeals.