BVA9500615 DOCKET NO. 93-02 821 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Diego, California THE ISSUES 1. Entitlement to service connection for hearing loss. 2. Entitlement to service connection for a chronic lung disorder. 3. Entitlement to an increased (compensable) rating for hemorrhoids. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Michael E. Kilcoyne, Counsel INTRODUCTION The veteran had more than 20 years of active military service, retiring therefrom in February 1974. The current appeal arises from a July 1991 rating action by the aforementioned regional office (RO) with which the veteran disagreed in August 1991. After appropriate appellate development, the matter was referred to the Board. REMAND The veteran's service medical records show that he was treated for pneumonia in March 1965, for viral bronchitis in December 1965 and for pneumonia and atelectasis in January 1969. He contends that he incurred a chronic lung disability in service. During the examination conducted for VA purposes in connection with the current, x-rays revealed marked elevation of the right hemidiaphragm and hypoventilatory changes in the lungs. A pulmonary function study revealed a severe restrictive defect. However, no pulmonary diagnosis was entered and no opinion was rendered as to the relationship between this condition and the findings noted in service. With respect to his hearing loss, the record shows that the veteran was diagnosed to have a mild low frequency sensorineural hearing loss and a severe high frequency loss during examination for VA purposes in April 1991. The veteran's service medical records show that an old inflammatory process of the left tympanic membrane with mild scarring was noted during an examination conducted in March 1967 and that he sustained superficial abrasions to the right retro-auricular area after a mortar round detonated adjacent to him in December 1967. The recent examiner did not render any opinion regarding whether the current disability may be related to findings and incidences noted during service. In particular, it has been argued that the current disability of the ears is the result of noise trauma sustained during service as a result of serving with an artillery unit. The record also shows that in his substantive appeal, the veteran stated that when he was hospitalized during 1990 and 1991, he received treatment that could be relevant to the issues on appeal. The record does not reflect that any attempt has been made to obtain the records from those hospitalizations. The VA has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107. This duty includes obtaining relevant medical records, conducting examinations which take into account the records of prior medical treatment and obtaining opinions as to whether there is any possible relationship between the veteran's in-service problems and any current disabilities affecting the same anatomical areas. See Littke v. Derwinski, 1 Vet.App. 90 (1991), Green v. Derwinski, 1 Vet.App. 121 (1991) and Wilson v. Derwinski, 2 Vet.App. 16 (1991). From this record, it appears that there are additional relevant records which have not been associated with the claims file and that the most recent VA examination was conducted without the benefit of the all the relevant prior treatment records. Thus, both further evidentiary development and examination is necessary in this case in order to ensure that an equitable disposition is obtained. Accordingly, this appeal is Remanded to the RO for the following actions: 1. The veteran should be asked to identify the names and addresses of those places at which he has received treatment for hearing loss, a lung disorder and hemorrhoids since his retirement from service. After obtaining any appropriate authorization from the veteran, the RO should obtain copies of all records of treatment identified including those from Scripps Memorial Hospital Encinita, P.O. Box 230817, Encinitas, CA 92023; Scripps Memorial Hospital, 9888 Genesee Ave. La Jolla, CA 92037 and Dr. Hanson, 9844 Genesee Ave. Suite 109, La Jolla, CA 92037. 2. After the preceding development has been accomplished, the veteran should be scheduled for special pulmonary, audiological and rectal examinations, the purpose of which is to determine the nature and extent of any pulmonary disorder, hearing loss and disability due to hemorrhoids. All indicated tests and studies should be performed and the examinations should be conducted in accordance with the pertinent provisions of the VA Physician's Guide for Disability Evaluation Examinations. The claims folder must be made available to the examiners in order for them to be familiar with the veteran's pertinent history. The pulmonary examiner is requested to offer an opinion as to whether any current pulmonary disorder may be related to the pulmonary conditions treated in service. The audiological examiner should set forth an opinion as to the etiology of the hearing loss to specifically include an opinion as to whether the hearing loss was the result of noise trauma sustained in service. The bases upon which these opinions rest should be set forth. Upon completion of the above, the RO should review the evidence and enter its determination. 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. 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) (1993).