BVA9503756 DOCKET NO. 93-10 079 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Denver, Colorado THE ISSUES 1. Entitlement to service connection for a neurologic disorder of the neck, back, and upper and lower extremities. 2. Entitlement to service connection for a chronic urinary tract infection and a bladder disorder. 3. Entitlement to an increased evaluation for right knee chondromalacia and residuals of a meniscectomy, currently rated at 20 percent. 4. Entitlement to an increased evaluation for sinusitis, currently rated at 10 percent. 5. Entitlement to an increased (compensable) evaluation for migraine headaches. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD C. M.. Flatley, Counsel INTRODUCTION The veteran had active service from January 1966 to October 1973. By a February 1992 rating decision, the evaluation assigned for the veteran's service-connected right knee disability was increased from 10 percent to 20 percent. By a December 1992 rating decision, a 10 percent evaluation was assigned for sinusitis. The issues for consideration herein are listed based on a clarification by the veteran in his notice of disagreement which was received in July 1992. REMAND Review of the record indicates that the veteran has submitted a well-grounded claim. 38 U.S.C.A. § 5107(a) (West 1991). The Department of Veterans Affairs (VA) therefore has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet.App. 78, 81-82 (1990). In this regard, we initially note that the clinical data of record refer to a neck injury sustained by the veteran prior to active service. The veteran asserts that a neurologic disorder, including of the neck, was sustained in service. He also alleges that his headaches are neurologic in origin rather than migraine and that his bladder disorder is of neurologic origin. Pertinent complaints were recorded in service and again several years after discharge from service. The Board is of the opinion that any available medical records referable to the veteran's pre-service injury, including a 6-day hospitalization subsequent to a football injury, and an clinical data recorded shortly after separation from service, may prove helpful in the evaluation of the veteran's claim. See Crowe v. Brown, No. 93-550 (U.S. Vet. App. Dec. 20, 1994). Upon review of the Social Security Administration's exhibit list, it appears that certain medical records, particularly the earliest records used in the Administration's determination, are not included in the veteran's file. The Board notes that the veteran submitted those records deemed pertinent to his current claim. It may be helpful, however, to obtain the remaining records upon which the Social Security determination was based. The veteran's representative has argued that the issue of entitlement to service connection for osteoarthritis of the cervical spine should be addressed rather than a neurologic disorder of the neck. It is asserted that the cervical osteoarthritis and "neurological impingement" currently shown had their onset in service. The United States Court of Veterans Appeals (Court) has held that when an issue raised on appeal, but not developed, may impact upon a fully developed issue, further action with regard to the recently raised issue may be appropriate. Harris v. Derwinski, 1 Vet.App. 180 (1991). The Board concludes that development of the issue of service connection for osteoarthritis and postoperative disc disease of the cervical spine is appropriate. We also note that, after referring to his unemployability in his substantive appeal, the veteran claimed that a "100%" rating was warranted, based, at least in part, on his service-connected disabilities; the method by which the veteran wishes to obtain a total rating is unclear. As the veteran's claim may be considered inextricably intertwined with his increased rating claim, the matter should be adjudicated. See Holland v. Brown, 6 Vet.App. 443 (1994). The veteran's appeal includes a claim for increased compensation involving the right knee, sinusitis, and headaches. The most recent evidence of record regarding sinusitis shows that the veteran underwent surgical intervention in February 1992; abbreviated follow-up entries are of record. The veteran argues that the surgery provided little or no relief of symptomatology. The Board concludes that current clinical data may assist in the evaluation of his service-connected disabilities. Upon review of the record, the Board is of the opinion that, in order to fully assist the veteran in the development of his case and extend to the veteran every equitable consideration, additional development is warranted. This case is therefore REMANDED for the following: 1. After any necessary information and authorization are obtained from the veteran, duplicates of any pertinent pre-service clinical data, as noted above, as well as any pertinent clinical data recorded shortly after service regarding the disabilities for which service connection is sought, should be obtained; outstanding clinical data used by the Social Security administration in the determination as to the veteran's disability, duplicates of any post-1991 treatment, VA or private, inpatient or outpatient, associated with the veteran's service-connected right knee disability, sinusitis, or headaches, should also be obtained by the RO and incorporated into the claims folder. 2. Special VA orthopedic and ear, nose, and throat examinations should be scheduled to determine the extent and severity of the veteran's right knee postoperative meniscectomy with chondromalacia and sinusitis, respectively. Each examination should be conducted in accordance with Chapter 1, Section II, paragraphs 1.11 through 1.13 of the VA's Physician's Guide for Disability Evaluation Examinations; the special examinations should be conducted in accordance with the pertinent provisions of Chapters 2 and 3, respectively, of the of the VA's Physician's Guide. All indicated studies should be conducted. The examination report should include a full description of the veteran's symptoms, clinical findings, and associated functional impairment. All findings should be recorded in detail, including range of motion of the veteran's right knee, recorded in degrees. A comprehensive report, which represents consideration of the aforementioned factors, as well as the history of the veteran's disability, should be provided. The veteran's claims folder, or duplicates of pertinent portions thereof, should be provided to the examiners for review prior to the examinations. 3. A descriptive account regarding the nature and extent of his service-connected migraine headaches, including reference to any remedial measures, should be obtained from the veteran and associated with his claims folder. The veteran should also be requested to clarify the avenue by which he wishes to pursue a total rating. 4. The veteran should then be scheduled for a special VA neurologic examination to determine the nature and probable etiology of his claimed neurologic disorder of the neck, back, and upper and lower extremities and the current severity of his migraine disorder. The examination should be conducted in accordance with all pertinent provisions of the Physician's Guide. The veteran's claims folder should be available to, and reviewed by, the examining physician in conjunction with the examination. The tests or studies deemed necessary for a thorough assessment should be conducted. All findings should be reported in detail. The examiner should comment specifically on the appropriate diagnosis and probable etiology of the claimed "neurologic disorder of the neck, back, and upper and lower extremities" and on the severity of the migraine headache disorder, including the descriptive account provided by the veteran. 5. The veteran should also be scheduled for a VA urologic examina- tion to determine the nature and probable etiology of any urinary tract and/or bladder disorder(s) he may have. His claims folder should be available to, and reviewed by, the examiner prior to the examination. Any tests or studies deemed necessary for an accurate assessment should be conducted. 6. The RO should then review the veteran's claim and should also adjudicate the issues of entitlement to service connection for osteoarthritis and postoperative disc disease of the cervical spine and a total rating. Any additional pertinent law, regulations, and Court decisions should be considered, including Schafrath v. Derwinski, 1 Vet.App. 589 (1991). If the veteran's claims remain in a denied status, he and his representative should be provided with a supplemental statement of the case, which includes any additional pertinent law and regulations and a full discussion of action taken on the veteran's claim, consistent with the Court's instruction in Gilbert v. Derwinski, 1 Vet.App. 49 (1990). Reasonable response time should be allowed. The case should then be returned to the Board, if in order, after compliance with customary appellate procedures. No action is required of the veteran until he is so informed. The Board intimates no opinion as to the ultimate decision warranted in this case, pending completion of the requested development. GEORGE R. SENYK 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).