BVA9501430 
DOCKET NO.  93-04 324     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Phoenix,
Arizona

THE ISSUE

Entitlement to an increased rating for paroxysmal atrial
fibrillation, currently rated as 10 percent disabling.

ATTORNEY FOR THE BOARD

Michael P. Vander Meer, Associate Counsel

INTRODUCTION

The veteran retired from service in January 1972, after having
served on active duty for a period in excess of 21 years.

This case is before the Board of Veterans' Appeals (Board) on
appeal from an August 1992 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Phoenix, Arizona.

The appeal was received at the Board in February 1993 and
docketed at the Board in March 1993.

REMAND

Based on the report of an August 1972 VA examination, which
reflected diagnoses of chronic anxiety reaction and a history of
paroxysmal atrial fibrillation, a rating decision entered in
October 1972 granted service connection for anxiety reaction,
manifested by multiple psychosomatic complaints associated with
paroxysmal atrial fibrillation, evaluated as 30 percent
disabling.  On an August 1977 VA examination the veteran
indicated he no longer experienced fibrillation, and a rating
decision entered in September 1977 reduced the veteran's
evaluation for anxiety reaction to 10 percent disabling.

On VA examination in June 1992, performed in conjunction with the
veteran's current claim, the veteran alluded to cardiac "attacks"
which were unrelated to stress or anxiety; the diagnosis was
supraventricular tachycardia.  A rating decision entered in
August 1992, from which the current appeal ensued, assigned a
separate 10 percent evaluation for paroxysmal atrial fibrillation
under Diagnostic Code 7099-7012 (1993), and continued the 10
percent rating for anxiety reaction.  When seen for outpatient
treatment at a military facility in February 1993, at which time
the veteran complained of experiencing a recent atrial
tachycardia attack as well as occasional episodes of atrial
fibrillation, the diagnosis was paroxysmal supraventricular
tachyarrhythmias.  Inasmuch as it is unclear whether the veteran
currently has supraventricular tachycardia, as diagnosed on VA
examination in June 1992, and, if so, the etiology thereof, the
Board is of the opinion that a VA examination, as specified in
greater detail below, should be performed before an appellate
determination is made.  Moreover, the RO has not had an
opportunity to review the 1993 clinical evidence.

Accordingly, the case is REMANDED for the following:

1.  The RO should contact the veteran and
request him to identify the names,
addresses, and approximate dates of
treatment for any health care provider(s),
to include Andre Andresian, M.D., as well
as any VA medical facility other than the
VA Medical Center in Tucson, Arizona, who
may possess records pertinent to his claim
in addition to those which have previously
been submitted.  Thereafter, in light of
the response received and after obtaining
any necessary authorization, the RO should
take appropriate action to obtain copies of
any clinical records indicated.  In any
event, the RO should obtain copies of all
clinical records reflecting treatment
rendered the veteran since February 1993 at
Davis-Monthan Air Force Base.

2.  Thereafter, the RO should arrange for
the veteran to undergo a VA examination by
a board certified cardiologist, if
available, to ascertain the nature and
extent of any cardiac abnormality.  If the
veteran is found to have supraventricular
tachycardia, the examiner is further
requested, after reviewing the entire
record, to offer an opinion whether it is
at least as likely as not that such
disorder is related to and/or is a
manifestation of the veteran's service-
connected disability picture.  Any special
diagnostic studies deemed necessary should
be performed.  It is imperative that a copy
of this REMAND be provided to the examiner,
and the claims folder must be made
available to the examiner for review prior
to the examination.  The rationale for all
opinions expressed should be fully
explained.

3.  Then, after undertaking any development
deemed necessary in addition to that
specified above, and in consideration of
the entire record, the RO should
readjudicate the issue on appeal to
include, if warranted, evaluating
tachycardia under the appropriate
Diagnostic Code.  If tachycardia is present
but not felt to be service connected, the
veteran should be notified and told of his
appellate rights.  Should he exercise
these, the RO should respond accordingly.

4.  If the benefit sought on appeal is not
granted to the veteran's satisfaction, he
should be provided a complete Supplemental
Statement of the Case on all issues in
appellate status, and given the opportunity
to respond.

Thereafter, the case should be returned to the Board for further
appellate consideration, if otherwise in order.  In taking this
action, the Board implies no conclusion, either legal or factual,
as to the ultimate outcome warranted.  No action is required of
the veteran until he is notified.

          J. J. SCHULE
          Member, Board of Veterans' Appeals

(CONTINUED ON NEXT PAGE)

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).