BVA9502865 DOCKET NO. 93-10 715 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUES 1. Entitlement to an increased (compensable) evaluation for a scar as a residual of a shrapnel wound of the left knee. 2. Entitlement to service connection for arthritis of the left knee. REPRESENTATION Appellant represented by: Military Order of the Purple Heart ATTORNEY FOR THE BOARD Robert E. O'Brien, Counsel REMAND The veteran had active service from April 1944 to March 1946. This case comes before the Board of Veterans' Appeals (Board) on appeal from a January 1993 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California. The veteran and his representative essentially maintain that he has developed arthritis of the left knee secondary to the shrapnel wound he sustained to the knee during World War II service. Unfortunately, records pertaining to treatment of the veteran for a shrapnel wound he sustained to the left knee in service are not of record. Indeed, the only mention in the service medical records of the wound is the report of physical examination done at the time of service separation in March 1946. Notation was made that the veteran had sustained a shrapnel wound to the left knee on May 11, 1945, while stationed with the 1st Marine Division in Okinawa. At that time he complained of a slight clicking in the left knee. Otherwise, the knee was asymptomatic. On examination there was observed a small one- quarter inch, healed shrapnel wound of the left knee. Post service, the veteran was accorded an examination by VA in May 1952. The veteran reported that his left knee became stiff and tender in bad weather. An X-ray study of the left knee at that time was described as regular, with no anatomical or pathological variations from normal. On clinical examination there was observed a one-half inch scar over the mid-patellar region which was slightly adherent and contracted. VA outpatient records dated in 1992 indicate probable degenerative joint disease of the left knee. On a visit in April 1992, it was indicated the knee would be X-rayed. The report of any X-ray study which might have been done is not of record. In his substantive appeal dated in April 1993, the veteran expressed dissatisfaction with the way the RO considered his claim. He pointed primarily to the failure of the RO to address a number of regulations he believed applied to his situation. The Board notes the veteran has not received a VA examination for his service-connected disability for many years. In view of the foregoing, and recognizing its duty to assist the veteran in the development of facts pertinent to his claim, as mandated by 38 U.S.C.A. § 5107(a), the case is REMANDED to the RO for the following actions: 1. The RO should contact the veteran and request that he provide the names and addresses of any health care providers who treated him for his service-connected left knee disability in the years following service, and specify the approximate dates of treatment, if possible. Then, after any necessary authorization is obtained from the veteran, the RO should obtain copies of any treatment records identified by the veteran. 2. The RO should ask the veteran to provide a statement containing as much detail as possible regarding the incident in service when he sustained the shrapnel wound to the left knee. He should be asked to provide specific details of the event. Based on any information obtained, the RO should take appropriate steps to help secure any records regarding treatment to which the veteran refers. 3. Thereafter, a VA orthopedic examination should be arranged to determine the extent and severity of the veteran's shrapnel wound residuals of the left knee. The claims folder should be made available to the examiner for review. The examination should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. The examiner, after reviewing pertinent data in the claims folder and eliciting from the veteran a detailed history of the left knee injury and all subsequent symptoms, should set forth detailed findings regarding impairment attributable to the shrapnel wound. Active and passive range of motion of the left knee, in terms of degrees, with a comparison of the opposite side, should be reported. Any portion of the arcs of motion which are painful should be so designated, and any pain or tenderness of the scar should be noted. The examiner should comment on the etiology of any arthritis identified, specifically on the degree of probability that the arthritis is related to the shrapnel wound of the knee. Thereafter, if the benefit sought on appeal is not granted to the veteran's satisfaction, the RO should issue a supplemental statement of the case and the veteran and his representative should be given the applicable time in which to respond. Thereafter, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran until he is notified by the RO. GARY L. GICK 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 deter- mination. 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) (1993).