BVA9507407 
DOCKET NO.  93-11 459     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Philadelphia,
Pennsylvania

THE ISSUE

Entitlement to an increased rating for residuals of a shell
fragment wound to the right calf, currently evaluated as 10
percent disabling.

REPRESENTATION

Appellant represented by: Paralyzed Veterans of America,
Inc.

WITNESSES AT HEARING ON APPEAL

Appellant and his wife

ATTORNEY FOR THE BOARD

P. M. Lynch, Associate Counsel
INTRODUCTION

The veteran's active military service extended from December 1967
to December 1970.

This matter comes before the Board of Veterans' Appeals (Board)
on appeal from a November 1991 rating decision by the Department
of Veterans Affairs (VA) Regional Office (RO) in Philadelphia,
Pennsylvania which continued a 10 percent rating for residuals of
a shell fragment wound to the right calf.

The Board notes that the veteran filed a claim for entitlement to
service connection for post traumatic stress syndrome (PTSD) in
December 1992.  That issue has not been developed for appellate
consideration and is not currently on appeal.  It is referred to
the RO for action deemed appropriate.

REMAND

The veteran's claim is "well grounded" within the meaning of
38 U.S.C.A. § 5107(a) (West 1991).  That is, he has presented a
claim which is plausible.  However, for the reasons that follow,
it appears that the statutory duty to assist the veteran mandated
by 38 U.S.C.A. § 5107(a) has not yet been fully met.

The veteran contends that the RO erred in denying his claim for
an increased rating for residuals of a shell fragment wound to
the right calf.  The veteran's most recent VA examination was
conducted in December 1992.  In reviewing the examination report,
it is noted that no range of motion measurements were reported
with respect to the veteran's right lower extremity.  Injuries to
muscles of the calf are evaluated on the basis of limitation of
motion.  The United States Court of Veterans Appeals (Court) has
held that range of motion studies should be reported in detail
under the provisions of the Physician's Guide for Disability
Evaluation Examinations, IB 11-56, March 1, 1985.  See Littke v.
Derwinski, 1 Vet.App. 90 (1990).  It is not sufficient to merely
state that there was a "limited range of motion" or "full range
of motion."  Therefore, the veteran should be afforded a special
VA orthopedic examination and range of motion measurements with
respect to his right lower extremity should be reported in
detail.

It is further contented that the veteran should be granted a
separate evaluation for the painful scar resulting from his
service-connected shell fragment wound.  The question of whether
or not the veteran is entitled to a separate rating for his
disability was not decided by the RO.  It appears, however, that
such a question is "inextricably intertwined' with the issue
currently one appeal.  The resolution of that issue could have a
negative or positive impact on the final rating to be assigned
for the veteran's residuals of shell fragment wound.

The United States Court of Veterans Appeals (Court) has held that
it would not review appeals in a piecemeal fashion, and that a
decision on a given claim for an increased rating is not a final
order when an "inextricably intertwined" question remains
undecided and pending.  See Harris v. Derwinski, 1 Vet.App. 180
(1991).

During the personal hearing in December 1992, the veteran
testified that he has been receiving treatment at the local VA
clinic on a regular basis.  Inasmuch as the case is being
remanded, the RO should make attempt to obtain any records of
treatment since 1992.

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 contact the veteran and
request that he provide the names and addresses
of all health care providers which have treated
him for residuals of a shell fragment wound to
his right calf since his discharge from service.

2.  After securing the necessary releases, the
RO should obtain all treatment reports and
hospital treatment folders from any private
health care providers listed by the veteran that
are not already on file.  The RO should also
obtain all VA treatment records that are not
already on file.  If any records are not
available, that fact and the reason(s) should be
annotated in the claims folder.

3.  The veteran should be afforded an
examination by a VA orthopedist.  The report
of examination should include a detailed
account of all manifestations of residuals of
a shell fragment wound to the right calf
found to be present.  All necessary tests and
x-rays should be conducted and the examiner
should review the results of any testing
prior to completion of the report.  Special
attention should be given to the presence or
absence of pain, any limitation of motion,
instability and weakness.  Of note, range of
motion measurements of the veteran's right
lower extremity should be reported in detail.
The examiner should specifically report any
findings with respect to propulsion, plantar
flexion of the foot; stabilizing arch;
flexion of the toes; and flexion of the knee.
The examiner must also assess any loss of
strength or endurance of the muscle groups
involved as compared to the sound side.  The
claims folder must be made available to and
reviewed by the examiner prior to the
examination.  The orthopedist should provide
complete rationale for any conclusions
reached.

4.  The RO should review the examination
report and determine if it is adequate for
rating purposes and in full compliance with
this remand.  If not, the report should be
returned to the examiner for corrective
action.

5.  Finally, the RO should formally
adjudicate whether the veteran is entitled
to a separate disability rating for the
scar associated with his shell fragment
wound.

Once the foregoing has been accomplished, and if the benefits are
not granted to the satisfaction of the veteran, both the veteran
and his representative should be furnished a supplemental
statement of the case covering all the pertinent evidence, law
and regulatory criteria.  They should be afforded a reasonable
period of time in which to respond.

Thereafter, the case should be returned to the Board for further
appellate consideration.  The veteran needs to take no action
until so informed.  The purpose of this REMAND is assist the
veteran and to obtain clarifying information.

          JOAQUIN AGUAYO-PERELES
          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).