BVA9500277 
DOCKET NO.  93-04 037     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Nashville,
Tennessee

THE ISSUE

Entitlement to an increased (compensable) evaluation for
hemorrhoid disorder.

ATTORNEY FOR THE BOARD

Nadine W. Benjamin,  Counsel

INTRODUCTION

The veteran had more than 21 years of active service, ending in
January 1973.  This appeal comes to the Board of Veterans'
Appeals (Board) on appeal from an August 1992 decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Nashville, Tennessee.

During the course of this appeal, the issue of entitlement to
service connection for lipids arose.  In November 1992, the RO
determined that while the condition of lipids was only a finding,
a diagnosis of hypertension was shown, and service connection for
hypertension was granted as secondary to the veteran's service-
connected diabetes mellitus.  In his December 1992 substantive
appeal, the veteran referred to treatment for high lipids and
hypertension.  In a January 1993 letter, after receiving further
explanation via a supplemental statement of the case, he reported
that he had been unaware that service connection had been granted
for hypertension, and that one of the reasons he had requested
service connection for lipids was to have his high blood pressure
medication supplied by VA.  He further noted that his latest
prescriptions were paid by VA.  The RO has accepted that letter
as a withdrawal of the claim for service connection for lipids.

REMAND

The veteran was examined by VA in August 1992, and he complained
of persistent bloody bowel movements.  It was reported that he
was being followed by the medical service and that he was noted
to be anemic secondary to chronic rectal bleeding.  Examination
showed internal hemorrhoids and evidence of some mild bleeding.
Corrective surgery was accomplished by VA in September 1992, when
a proctosigmoidoscopy and a hemorrhoidectomy were performed.  It
was noted that he tolerated the surgery well and was discharged
after a few days.  He was to return for follow-up.

In an October 1992 letter which was accepted as the veteran's
notice of disagreement, he stated that he had blood loss, pain
and external tags.  He reported that the results of his surgery
were very poor.  In October 1992 the veteran refused to allow a
rectal examination by VA due to asserted pain.  In his January
1993 statement, he indicated that since his operation, he has
been unable to control gas or bowel movements.

The Board is of the opinion that additional development is
necessary prior to making a determination in this case.  In view
of the foregoing, the case is hereby REMANDED to the RO for the
following development:

1.  The RO should verify the veteran's
complete dates of service.

2.  The RO should contact the veteran and
request that he identify the names,
addresses and approximate dates of
treatment for all VA and non-VA health care
providers who have treated him for his
hemorrhoids in recent years.  With any
necessary authorization from the veteran,
the RO should attempt to obtain copies of
pertinent treatment records identified by
the veteran which are not currently of
record, including any pertinent VA
outpatient treatment records re surgical
follow-up.

3.  Thereafter, the veteran should be
afforded a special VA examination to
determine the current severity of his
service-connected hemorrhoids.  All
indicated studies should be performed and
all manifestations of current disability
should be described in detail.  The claims
folder should be made available to the
examiner for review prior to the
examination.  The need for such evaluation
should be stressed to the veteran.

4.  Then, the RO should undertake any other
indicated development and readjudicate the
issue of entitlement to an increased
evaluation for the veteran's service-
connected hemorrhoids.

If the benefit sought on appeal is not granted to the
satisfaction of the veteran, a supplemental statement of the case
should be issued , and the veteran provided an opportunity 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.

          J. J. SCHULE
          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).