BVA9502881 
DOCKET NO.  93-11 310     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Muskogee,
Oklahoma

THE ISSUE

Entitlement to an increased evaluation for tinea pedis and
onychomycosis of the left hand and left foot, currently evaluated
as 10 percent disabling.

WITNESS AT HEARING ON APPEAL

Appellant and his spouse

ATTORNEY FOR THE BOARD

Robert E. O'Brien, Counsel

INTRODUCTION

The veteran had active service from October 1956 to October 1958.

This case comes before the Board of Veterans' Appeals (Board) on
appeal from a July 1992 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma.

REMAND

At a personal hearing held before a hearing officer at the RO in
August 1992, the veteran stated that he was being seen for his
service-connected skin disorder at the VA Outpatient Clinic in
Tulsa, Oklahoma, about every 3 to 6 months.  He stated he was
most recently seen at the clinic on May 12, 1992.  The report of
that visit is not of record.  In fact, there are no reports of
record regarding any visits since 1991 apart from a rating
examination by a VA dermatologist in November 1992.  The
veteran's medications were adjusted and he was to return in two
months.

In an April 1993 statement the veteran asked that he be accorded
another examination.  He stated that the November 1982
examination was "not a very good exam" and he added he was not
examined by a dermatologist.  The Board notes that the report of
the examination reflects that the examination was indeed
conducted by a dermatologist, but neither that report or other
evidence of record, including the testimony at a hearing at the
RO in August 1992, reveals any information as to the effects of
the veteran's skin disorder on employment.  The VA compensation
system and the percentage ratings represent average impairment in
earning capacity resulting from diseases and injuries and their
residual conditions in civil occupations.  38 C.F.R. § 4.1
(1994).  Data from the effects of service-connected disability on
employment are also necessary for consideration of an extra-
schedular rating under 38 C.F.R. § 3.321 (b)(1) (1994).

VA has a duty to assist the veteran in the development of facts
pertinent to his claim under 38 C.F.R. § 3.103(a) (1993).  The
United States Court of Veterans Appeals (Court) has held that
fulfillment of the VA's duty to assist the veteran includes
providing him with a thorough and contemporaneous medical
examination.  Littke v. Derwinski, 1 Vet.App. 92 (1990).

In light of the foregoing, 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
had treated him for his service-connected
skin disorder in the recent past 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.  The VA Outpatient Clinic in
Tulsa, Oklahoma, should also be contacted
and asked to provide complete clinical
records for any treatment of the veteran
since 1991.

2.  Thereafter, a special dermatologic
examination should be arranged for the
veteran for the purpose of ascertaining the
current nature and extent of dermatologic
symptomatology.  The examination should be
conducted in accordance with the VA
Physician's Guide for Disability Evaluation
Examinations (1985).  A detailed work
history should be reported, particularly
any time lost from work due to the
veteran's service-connected skin disorder.
A comprehensive examination, including
unretouched color photographs of the areas
affected, should be performed and all
findings should be reported in detail, with
attention to the history of the veteran's
disability.  The claims folder, or copies
of all pertinent records, must be made
available to the examiner for review in
connection with the examination.

3.  Thereafter, the RO should readjudicate
the veteran's claim for an increased rating
for his skin disorder, taking into account
his contention to have the disability rated
on the basis of disfigurement and with
consideration of the effects of the
disability on employment.

If the benefit sought on appeal is not granted to the veteran's
satisfaction, the RO should issue a supplemental statement of the
case which address all aspects of the veteran's claim.  After the
applicable period of time in which to respond, subject to current
appellate procedures, the case should be returned to the Board
for further appellate 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.

          CHARLES E. HOGEBOOM
          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 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).