BVA9501163 
DOCKET NO.  93-10 623     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUES

1.  Entitlement to an increased rating for a left knee disorder,
currently evaluated as 30 percent disabling.

2.  Entitlement to an increased rating for a low back disorder,
currently evaluated as 20 percent disabling.

3.  Entitlement to service connection for hearing loss.

REPRESENTATION

Appellant represented by: AMVETS

WITNESS AT HEARING ON APPEAL

The appellant

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

REMAND

The veteran had active service from February 1942 to February
1946 and from July 1950 to November 1952.  This appeal arises
from a December 1991 rating decision of the St. Petersburg,
Florida, Regional Office (RO).

A review of the record demonstrates that evidentiary development
is incomplete.  The veteran has been receiving ongoing treatment
for the disabilities at issue at the Bay Pines VA medical center.
Complete medical records should be obtained from that facility.
In addition, the RO should obtain the veteran's service medical
records for his second period of enlistment, as well as records
from the Thomas Jefferson Hospital in Philadelphia for treatment
received in the mid-1950's as these records may be pertinent to
his claim for entitlement to service connection for hearing loss.

The duty to assist also includes, when appropriate, the duty to
conduct a thorough and contemporaneous examination of the veteran
that takes into account the records of prior medical treatment.
Green v. Derwinski, 1 Vet.App. 121 (1991).  This is to ensure
that the evaluation of a disability is a fully informed one.  The
November 1991 VA orthopedic examination is inadequate to evaluate
the veteran's increased rating claims.  In view of the foregoing,
following the gathering of all available records, the veteran
should be afforded VA orthopedic and neurology examinations to
determine the nature and extent of all disability of the left
knee and low back.

Under the circumstances of this case, the Board finds that
further assistance is required.  Accordingly, the case is
REMANDED to the RO for the following actions:

1.  The RO should contact the National
Personnel Records Center and obtain the
veteran's service medical records for his
second period of enlistment from July 1950
to November 1952.  Once obtained, those
records should be associated with the
claims folder.

2.  The RO should contact the veteran and
obtain the names and addresses of all
health care providers where he has received
treatment for the disabilities at issue.
Thereafter, the RO should obtain legible
copies of all records which have not
already been obtained, to include those
from the Bay Pines VA medical center from
April 1991 to the present; and from the
Thomas Jefferson Hospital in Philadelphia
for the mid-1950's.  Once obtained, all
records must be associated with the claims
folder.

3.  Following completion of above
developments, the veteran should be
afforded VA orthopedic and neurology
examinations to determine the nature and
extent of all disability of the left knee
and low back.  All indicated tests, to
include x-rays, should be accomplished.  It
is imperative that the physicians review
the entire claims folder prior to the
examinations.  All disability should be
evaluated in relation to its history, with
emphasis upon the limitation of activity,
to include employability, imposed by the
disabling conditions in light of the whole
recorded history.  The orthopedic exami-
nation report should include complete range
of motion studies for the left knee and low
back.  The report should also indicate if
there is ankylosis of the left knee, and if
so, the examiner should report the degree
of the angle at which the knee is fused.
The neurology report should indicate the
nature and severity of any recurring
attacks of intervertebral disc syndrome.

4.  When the above developments have been
completed, the case should be reviewed by
the RO.  The claim for entitlement to
service connection for hearing loss should
be considered on both a direct and
secondary basis.  If the decision remains
adverse to the veteran in any way, he and
his representative should be furnished with
a supplemental statement of the case which
includes consideration of all applicable
Diagnostic Codes for evaluation of the low
back disorder, to include 5292, 5293, and
5295.  They should then be afforded a
reasonable opportunity to respond.

Thereafter, subject to current appellate procedures, the case
should be returned to the Board for further appellate
consideration, if appropriate.  The veteran need take no action
until he is further informed.  The purpose of this REMAND is to
obtain additional information and to ensure due process of law.
No inference should be drawn regarding the final disposition of
the claim as a result of this action.

          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).