BVA9502495 
DOCKET NO.  89-44 783     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Los Angeles,
California

THE ISSUE

Entitlement to service connection for a renal disability, claimed
as secondary to malaria (including treatment of malaria).

REPRESENTATION

Appellant represented by: Disabled American Veterans

INTRODUCTION

The veteran served on active duty from November 1942 to November
1945.

This matter came before the Board of Veterans' Appeals (Board) on
appeal from a June 1989 rating decision from the Los Angeles,
California, Regional Office (RO).  The Board entered a decision
in April 1990.  That decision was vacated and remanded by the
United States Court of Veterans Appeals.  [citation redacted].

The Board remanded the case in June 1992, and the case was
returned for further appellate consideration.

REMAND

In June 1992, the Board remand the case, requesting that specific
questions be answered.  Following examination, in July 1994, a
Department of Veterans Affairs urologist answered the questions.
However, the examiner noted, twice, that an opinion from a
nephrologist was in order.  Although the regional office referred
the file to a nephrologist, there is no indication that the
nephrologist was asked the appropriate questions; and the
response of the nephrologist did not comply with the intent of
the remand.

This case has been the subject of a remand by the United States
Court of Veterans Appeals.

The case is not ripe for appellate consideration.  Accordingly,
the case is remanded for the following:

1.  The veteran is to be informed that
there was noncompliance with the VA remand
request regarding the opinion from his
doctor.  The veteran's doctor did not state
the basis of the opinion that malaria or
medication for malaria contributed to the
current renal insufficiency.  If the
veteran wants such opinion included in the
record, he should obtain the opinion from
the doctor.  The veteran is to be informed
that his statements as to what the doctor
told him does not comply with the remand.

2.  The veteran should be examined by a
nephrologist.  The claims file must be made
available to the examiner for review.  The
nephrologist should comment on the
following: (1) Based upon the record, when
was renal insufficiency first manifest?
(2) What is the correct diagnosis?  (3)
Based upon the examiner's expertise, is
there any relationship between the
veteran's current renal disorder and the
veteran's malaria or medication prescribed
for the malaria?  The examiner is requested
to detail the reasons for the opinions.  If
possible, appropriate medical authorities
should be cited.

3.  The veteran should be informed that if
he has additional competent opinions in
support of the claim, such should be
provided.

If, upon completion of the above action, the claim remains denied,
the case should be returned to the Board after compliance with all
requisite appellate procedures.  No action on the veteran's part
is required until he receives further notice.

          H. N. SCHWARTZ
          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).