BVA9501213 
DOCKET NO.  93-12 354     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUE

Entitlement to an increased rating for right knee disorder,
currently evaluated as 10 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

INTRODUCTION

The veteran had active service from November 1972 to August 1976.
This appeal arises from a December 1992 rating decision of the
St. Petersburg, Florida, Regional Office (RO).  The Board notes
that in March 1992 the veteran raised the issue of entitlement to
service connection for a back disorder as being proximately due
to or the result of a service connected disability; however, as
that issue is not inextricably intertwined with the issue
currently on appeal, it is referred to the RO for appropriate
consideration.

REMAND

The Department of Veterans Affairs (VA) has a duty to assist the
veteran in the development of facts pertaining to his claim.  38
U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993).  The
Court has held that the duty to assist includes obtaining
available records which are relevant to the claimant's appeal.
The duty to assist is neither optional nor discretionary.  Littke
v. Derwinski, 1 Vet.App. 90 (1990).  A review of the record
demonstrates that evidentiary development is incomplete.  In
October 1992, the veteran requested that the RO obtain medical
records to support his claim from the Riviera VA outpatient
clinic, Northern Michigan Hospital, and Midland Hospital.  In
addition, the veteran indicated that he had received treatment
from a private physician, and on a VA outpatient basis on October
23, 1992.  Complete medical records should be obtained from the
referenced sources.

The duty to assist also includes, when appropriate, the duty to
conduct a thorough and contemporaneous examination of the veteran
that takes into account the records of prior medical treatment.
Green v. Derwinski, 1 Vet.App. 121 (1991).  This is to ensure
that the evaluation of a disability is a fully informed one.
Although the veteran has failed to appeal for two VA rating
examinations, it is requested that a further examination be
scheduled.  The Board notes that the veteran indicated that he
was unable to appear for the July 1992 examination due to
unavoidable reasons, and it appears that he may not have received
notice of the second examination in November 1992 due to a change
in address.  The latest medical evidence, a September 1992 VA
orthopedic notation, shows medial laxity of the right knee and
the veteran was recommended for physical therapy and a knee
brace.  The veteran contends that right knee disability is
progressively debilitating.  In view of the foregoing, following
the gathering of all available records, the veteran should be
afforded VA orthopedic and neurology examinations to determine
the nature and extent of all disability of the right knee.

Under the circumstances of this case, the Board finds that
further assistance is required.  Accordingly, the case is
REMANDED to the RO for the following actions:

1.  The RO should contact the veteran and
obtain the names and addresses of all
health care providers where he has received
treatment for his right knee in recent
years.  Thereafter, the RO should obtain
legible copies of all records which have
not already been obtained to include those
from Northern Michigan Hospital from 1981,
Midland Hospital from 1979, and Riviera VA
outpatient clinic from 1989 to the present.
Once obtained, all records must be
associated with the claims folder.

2.  Following completion of above
development, the veteran should be afforded
VA orthopedic and neurology examinations to
determine the nature and extent of all
disability of the right knee.  All
indicated tests, to include x-rays, should
be accomplished.  It is imperative that the
physicians review the entire claims folder
prior to the examinations.  All disability
should be evaluated in relation to its
history, with emphasis upon the limitation
of activity, to include employability,
imposed by the disabling condition in light
of the whole recorded history.  The
orthopedic examination report should
include complete range of motion studies
for the knee, and indicate whether there is
evidence of recurrent subluxation or
lateral instability, or frequent episodes
of locking, pain and effusion of the knee
joint.

3.  When the above developments have been
completed, the case should be reviewed by
the RO.  If the decision remains adverse to
the veteran in any way, he and his
representative should be furnished with a
supplemental statement of the case.  They
should then be afforded a reasonable
opportunity to respond.

Thereafter, subject to current appellate procedures, the case
should be returned to the Board for further appellate
consideration, if appropriate.  The veteran need take no action
until he is further informed.  The purpose of this REMAND is to
obtain additional information and to ensure due process of law.
No inference should be drawn regarding the final disposition of
the claim as a result of this action.

          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 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) (1993).