BVA9501766 
DOCKET NO.  93-19 143     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in San Diego,
California

THE ISSUE

Entitlement to an increased evaluation for degenerative arthritis
of the knees and elbows, currently evaluated as 10 percent
disabling.

REPRESENTATION

Appellant represented by: Military Order of the Purple
Heart

WITNESS AT HEARING ON APPEAL

Appellant

INTRODUCTION

The veteran served on active duty from May 1948 to February 1950,
July 1966 to December 1968, and October 1971 to July 1981.

REMAND

The issue before the Board of Veterans' Appeals (Board) is
entitlement to an increased evaluation for arthritis of the knees
and elbows.  Our initial review of the claims file has disclosed
that X-ray studies of the veteran's knees have shown arthritis,
but the most recent X-rays of the veteran's elbows, taken in
1981, were not interpreted as showing the presence of arthritis.
In addition, it appears that the Department of Veterans Affairs
(VA) examiner in December 1992 did not use the VA Physician's
Guide for Disability Evaluation Examinations.  Therefore, the
Board is of the opinion that another examination is warranted.

Accordingly, the case is remanded to the regional office (RO) for
the following actions:

1.  After the necessary information and authorization
are obtained from the veteran, copies of all treatment
records for the veteran's knees or elbows, VA or
private, inpatient or outpatient, since December 1992,
should be obtained by the RO and added to the claims
file.

2.  After the foregoing has been accomplished to the
extent possible, the veteran should be scheduled for a
special VA orthopedic examination to determine the
presence and extent of any arthritis of his knees or
elbows.  The examination must include an X-ray study
of the veteran's elbows and the interpreting physician
should be asked to make a specific finding concerning
the presence or absence of arthritis.  The orthopedic
examination must be conducted in accordance with the
VA Physician's Guide for Disability Evaluation
Examinations and the range of motion of each knee and
each elbow should be reported in degrees of arc.  The
examiner should specify the range of motion that is
considered the normal range of motion for most
individuals, and make a specific finding as to whether
any limitation of motion that the veteran may have is
due to joint or periarticular pathology, as opposed to
a range of motion that may be less than what is
considered normal for most individuals, but would be
considered normal for this veteran.  The claims file
must be made available to the examiner for study prior
to the examination.

If, after RO review, the decision is still adverse to the
veteran, a supplemental statement of the case should be issued
and the veteran and his representative afforded an opportunity to
respond.  Thereafter, the case should be returned to the Board
for further appellate consideration.  By this remand, the Board
intimates no opinion as to the ultimate determination warranted
in this case.  No action is required of the veteran until he us
otherwise notified.

          WILLIAM J. REDDY
          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).