BVA9508157 
DOCKET NO.  91-17 063     )       DATE
          )
          )

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

THE ISSUES

1.  Entitlement to service connection for degenerative disc
disease of the lumbosacral spine.

2.  Entitlement to a total disability evaluation based on
individual unemployability due to service-connected disabilities.

REPRESENTATION

Appellant represented by: Paralyzed Veterans of America,
Inc.

ATTORNEY FOR THE BOARD

James A. Frost, Associate Counsel

REMAND

The veteran served on active duty from June 1973 to June 1975 and
from June 1977 to July 1978.

This appeal arose from a rating decision in December 1990 by the
Department of Veterans Affairs (VA) Regional Office (RO) in
Phoenix, Arizona.  In August 1991 the Board of Veterans' Appeals
(the Board) remanded the case to the RO.  The case was returned
to the Board in April 1992.

By a decision of July 2, 1992, the Board denied entitlement to:
Service connection for degenerative disc disease of the
lumbosacral spine; increased ratings for lumbosacral strain and
bilateral hearing loss; and a total disability rating based on
individual unemployability due to service-connected disabilities
(TDIU). The veteran appealed the Board's aforementioned decision
to the United States Court of Veterans Appeals (the Court) which
affirmed so much of the Board's July 2, 1992, decision as denied
increased ratings for lumbosacral strain and hearing loss and
vacated so much of the Board's decision as denied entitlement to
service connection for degenerative disc disease of the
lumbosacral spine and TDIU.
[citation redacted].

The Court directed that the veteran should be allowed the
opportunity to undergo a comprehensive medical examination to
determine the cause of degenerative disc disease of the
lumbosacral spine.  In this connection, the Board notes that
there appears to be a question as to whether degenerative disc
disease of the lumbosacral spine was proximately due to or the
result of service-connected lumbosacral strain or whether disc
pathology is attributable to postservice heavy construction labor
and/or an intercurrent back injury sustained in a motor vehicle
accident in September 1984.

Through his representative, the veteran has previously alleged
that rating decisions in May 1976, August 1976, May 1977 and
September 1978, which denied entitlement to service connection
for hypertension, were clearly and unmistakably erroneous.  The
veteran's representative has recently also asserted that service
medical records from the veteran's second period of service
constitute new and material evidence which warrants reopening the
claim of entitlement to service connection for hypertension.
Also, on the veteran's behalf, his representative has asserted a
claim of entitlement to an effective date earlier than March 8,
1983, for the award of service connection for tinnitus and the
assignment of a compensable evaluation for tinnitus.  These
claims are not inextricably intertwined with the current appeal
and are referred to the RO for appropriate consideration.

This case is REMANDED to the RO for the following:

1.  The RO should request that the veteran
identify each physician and medical
facility, VA or non-VA, which has rendered
medical treatment to him since October
1991.  The RO should attempt to obtain
copies of all such clinical records.

2.  The RO should schedule the veteran for
an orthopedic examination to be conducted,
because of the question of medical
causation presented in this case, by a
specialist in that field.  It is imperative
that the examiner review the medical
records in the veteran's claims file prior
to the examination.  The examiner should
determine the nature and current
symptomatology of the veteran's back
disability.  The examiner should offer an
opinion as to the etiology of degenerative
disc disease of the lumbosacral spine.
Specifically, the examiner should offer an
opinion as to whether degenerative disc
disease of the lumbosacral spine is
attributable to service-connected
lumbosacral strain or to the veteran's post
service participation in heavy construction
labor or to an injury sustained in a motor
vehicle accident in 1984 or to a
combination of such causes or to some other
cause or causes.

Following completion of these actions, the RO should review the
evidence and determine whether the veteran's claims of
entitlement to service connection for degenerative disc disease
of the lumbosacral spine and TDIU may now be granted.  The RO
should also adjudicate all other pending claims.  If the decision
remains adverse to the veteran, he and his representative should
be provided with an appropriate supplemental statement of the
case and an opportunity to respond thereto.  The case should then
be returned to the Board for further appellate consideration.
The purposes of this REMAND are to comply with the Court's order
and to obtain clarifying medical information.  By this REMAND the
Board intimates no opinion, legal or factual, as to the ultimate
disposition of the appeal.  No action is required of the veteran
until he receives further notice.

          ALBERT D. TUTERA
          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) (1994).