BVA9505955 
DOCKET NO.  93-11 354     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Houston, Texas

THE ISSUE

Entitlement to service connection for the cause of the veteran's
death.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

Heather J. Harner, Associate Counsel

REMAND

The veteran served on active duty from April 1941 to January
1946.

The evidence of record shows that the veteran died on August [redacted]
1989, after he was involved in an automobile collision.
According to the police report, a witness observed the veteran
pass out behind the wheel of his moving car.  The car then veered
into a parked car.  Upon impact, the veteran's neck and head hit
the steering wheel and the windshield, breaking the veteran's
neck and causing internal brain injuries.  Upon arrival at the
hospital, the veteran's blood alcohol content tested at 208
milligrams/deciliter(mg/dl).  He was treated in the shock room of
the Ben Taub Hospital but died eight days later.  The hospital
report contains final diagnoses of brain death, diffuse brain
injury, and malignant intracranial hypertension.  The death
certificate lists the immediate cause of death as a broken neck
and pontine hemorrhage.  According to the instructions of the
veteran's widow, no autopsy was performed.

At the time of the veteran's death, service connection was in
effect for hypertensive cardiovascular disease, rated as 20
percent disabling.  Service connection was not in effect for any
other disability.  It is contended that, since the terminal
hospital report contains a diagnosis of intracranial
hypertension, and since the veteran was service-connected for
hypertension, his service-connected disability contributed to
cause his death.  The Board further notes that the terminal
hospital report of record contains additional findings concerning
hypertension.  Neither the Board nor the regional office can use
its own medical knowledge in the adjudication of a claim.  The
claim must be decided on the evidence of record, but additional
development can be undertaken to supplement the record.

For the appellant to prevail on her claim, she must show that the
veteran's fatal accident was due to disability incurred in or
aggravated by service or that a disorder of service origin
contributed substantially or materially to cause death.  For a
service-connected disability to be considered the cause of death,
it must singly or with some other condition be the immediate or
underlying cause, or be etiologically related to the veteran's
death.  For a service-connected disability to constitute a
contributory cause, it is not sufficient to show that it casually
shared in producing death, but rather a causal connection must be
demonstrated.  38 U.S.C.A. § 1310 (West 1991); 38 C.F.R. § 3.312
(1994).

The records of the veteran's terminal hospitalization which are
currently contained in the claims file indicate that additional
records may be available.  To ensure that the Department of
Veterans Affairs (VA) has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the regional office (RO) for the following development:

1.        After securing the necessary release from
the appellant, the RO should obtain the
complete records of the veteran's
terminal hospitalization at Ben Taub
Hospital from August 17, 1989 to August
[redacted] 1989, including all records of
treating and consulting physicians,
nursing notes, and lab reports, including
reports of CAT scans and X-rays.

2.        After the development requested above has
been completed to the extent possible,
the RO should again review the record.
Additional development should be
undertaken to determine if there was a
relationship between the veteran's
service-connected hypertension and the
references to hypertension found in the
terminal hospital records, and,
consequently, whether the veteran's
service-connected disability contributed
substantially or materially to cause his
death.  If any benefit sought on appeal,
for which a notice of disagreement has
been filed, remains denied, the appellant
and her representative should be
furnished a supplemental statement of the
case and given the opportunity to respond
thereto.

Thereafter, the case should be returned to the Board if in order.
The purpose of this remand is to assist the appellant in the
development of her claim.  The Board intimates no opinion as to
the ultimate outcome of this case.  The appellant need take no
action unless otherwise notified.

_______________________
          WILLIAM J. REDDY
          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).