BVA9501088 
DOCKET NO.  92-04 523     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Indianapolis,
Indiana

THE ISSUE

Whether new and material evidence has been submitted to reopen a
claim for entitlement to service connection for a heart disorder.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

A. S. Nemeth, Associate Counsel

INTRODUCTION

The veteran's active service extended from December 1942 to
August 1943.

This matter was previously before the Board of Veterans' Appeals
(Board) in February 1993 and at that time, the Board remanded the
case for further development.  The case originally came to the
Board on appeal from adverse rating decisions by the Department
of Veterans Affairs (VA) Regional Office (RO) in Indianapolis,
Indiana, which denied reopening the veteran's claim for service
connection for heart disease.

REMAND

In its February 1993 decision, the Board remanded the veteran's
case so that the RO could assist in further developing the
evidence.  Included in the February 1993 Remand, was the
requirement that VA provide the veteran with a cardiology
examination to determine the nature and severity of his heart
disorder.  The Remand specifically required the examining
physician to render an opinion on "whether any preservice heart
disability underwent an increase in severity during service and
if so, whether the increase in disability was due to the natural
progress of the disease."

The VA cardiology examination was performed in January 1994.  A
copy of the Remand and the claims file were made available to the
examining physician.  However, the examination was not performed
as per the instructions in the Remand.  Specifically, no opinion
was rendered regarding whether or not the veteran's heart
condition increased in severity during service, and if so,
whether that increase was due to the natural progress of the
condition.  This is the primary question regarding whether or not
to grant service connection for the veteran's heart condition.
The case should be remanded so that the examining physician can
render the necessary opinion.  The veteran should be re-examined
if the physician deems it necessary.

All other requirements of the February 1993 Remand have been
performed

In view of the foregoing, it is the opinion of the Board that
this case should be remanded to the RO for the following
development:

1.  The RO should make arrangements for the
physician who examined the veteran in
January 1994 to review the veteran's medical
records, this Remand, and the entire claims
file in order to render an opinion as to the
following:

A.  Did the veteran have a pre-
existing heart disability which
underwent an increase in severity
during service?

B.  If the veteran did have an
increase during service in the
severity of a pre-existing heart
condition, was the increase in
disability due to the natural
progress of the disease?

The physician should provide complete
rationale for all conclusions reached.

2.  The veteran should be re-examined if the
physician deems that an examination is
necessary in order to answer the above
questions.  Likewise, if the physician who
performed the January 1994 examination is
not available, the veteran should be
afforded a VA cardiology examination.  The
report of the examination should include a
detailed account of all manifestations of
the disorder found to be present.  The
report must also include the examiner's
opinions on the questions posed above.  All
necessary tests should be conducted and the
examiner should review the results of any
testing prior to completion of the report.
The claims folder and a copy of this Remand
must be made available to and be reviewed by
the examiner prior to the examination.  The
examiner should provide complete rationale
for all conclusions reached.

3.  The RO should review the examiner's
report and
determine if it is adequate for rating
purposes and in compliance with this Remand.
If not, the report should be returned for
corrective action.

Following completion of these actions, the RO should review the
veteran's claim.  If the decision remains unfavorable, the
veteran and his representative should be provided with a
supplemental statement of the case and be afforded a reasonable
period of time in which to respond.  Thereafter, the case, in
accordance with the current appellate procedures, should be
returned to the Board for completion of appellate review.

No further action on the part of the veteran is required until
further notice.

          JAN DONSBACH
          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).