BVA9504996 
DOCKET NO.  93-15 446     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Salt Lake City,
Utah

THE ISSUE

Entitlement to service connection for a heart rhythm disorder.

REPRESENTATION

Appellant represented by:  The American Legion

WITNESSES AT HEARING ON APPEAL

Appellant and his wife

ATTORNEY FOR THE BOARD

B. Anderson, Counsel

REMAND

The appellant had active duty from October 1954 to October 1956
and from January 25 to February 13, 1991.  This appeal arises
from a December 1991 rating decision of the Salt Lake City, Utah,
regional office (RO).  In that decision, service connection was
denied for cardiac dysrhythmias or a heart rhythm disorder.

The appellant was admitted to a service department hospital in
January 1991 with the diagnosis of rule out sick sinus syndrome.
The hospital discharge diagnosis was paroxysmal supraventricular
tachycardia.  It is unclear whether all clinical records
associated with this hospitalization have been obtained.   In a
statement dated in September 1991, a private cardiologist
reported that a Bruce protocol showed no evidence of any coronary
artery disease.  In November 1991, Mark Oveson, M.D., reported
that the appellant had been treated for cardiac dysrhythmias with
good control on medication.

The appellant's representative has contended that the Department
of Veterans Affairs (VA) erred in not providing the appellant
with a VA examination.  In this regard, the Board of Veterans'
Appeals (Board) observes that a threshold question to be resolved
is whether the claimed disorder is a "disability."  Brammer v.
Derwinski, 3 Vet.App. 223, 225 (1992).  It is also observed that
determinations of relationship to service and evaluation in the
case of disability due to disease of the heart require accurate
identification of the disease, as an active or residual
condition, with the complete required classification of etiology,
structural lesions, manifestations, and capacity for work.
Moreover, tachycardia, bradycardia, and the various arrhythmias
do not represent generally acceptable diagnoses.  38 C.F.R.
§ 4.100 (1994).  Arrhythmias and conduction abnormalities,
standing alone, represent incomplete diagnoses.  Note preceding
Diagnostic Codes 7010 through 7015, 38 C.F.R. § 4.104 (1994).

Further, the United States Court of Veterans Appeals has recently
held that medical opinion evidence is required with respect to
cases involving whether a disability existed prior to service and
was aggravated by service.  See Crowe v. Brown, No. 93-550 (U.S.
Vet. App. Dec. 20, 1994), a copy of which is attached to this
decision.

To ensure that 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 RO for the following development:

1.  The RO should take appropriate steps to
ensure that all records from the veteran's
active service in 1991, particularly all
available records from Madigan Army Medical
Center, are obtained and associated with
the claims folder.

2.  The appellant should be afforded a VA
cardiology examination to determine the
nature and extent of any current cardiac
abnormalities, especially any claimed heart
rhythm disorder. The claims folder should
be made available to the examiner for
review.  The examiner should be requested
to provide an opinion as to whether the
cardiac abnormalities reported during
service in 1991 were manifestations of a
disease entity.  If so, the examiner should
also provide an opinion with respect to (1)
whether such disorder existed prior to
service, (2) if so, whether the disorder
increased in severity during service, and
(3), whether any such increase was a
natural progression of the disorder.  The
rationale for the opinions reached should
be explained.

3.  The RO should then readjudicate the
claim, to include consideration of Crowe v.
Brown.

Unless the benefit sought on appeal has been granted, the
appellant and his representative should then be furnished a
supplemental statement of the case and given the applicable
opportunity to reply.  Thereafter, the case should be returned to
the Board, if in order.  The Board intimates no opinion as to the
ultimate outcome of this case.  The appellant need take no action
until so notified.

          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) (1994).