BVA9501542 
DOCKET NO.  93-09 618     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Chicago,
Illinois

THE ISSUE

Entitlement to a compensable evaluation for the residuals of a
shell fragment wound of the right cheek with a retained foreign
body, presently characterized as a scar.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

WITNESS AT HEARING ON APPEAL

The veteran

ATTORNEY FOR THE BOARD

J. Johnston, Associate Counsel
INTRODUCTION

The veteran had more than 21 years of active service, including
periods of active service from August 1967 to July 1970, and from
March 1980 to October 1990.  For service in Vietnam during his
first enlistment, the veteran was awarded the Combat Action
Ribbon and two Purple Heart Medals, among others.

This matter comes before the Board of Veterans' Appeals (Board)
on appeal from a July 1992 rating decision of the Chicago,
Illinois, Department of Veterans Affairs (VA) Regional Office
(RO).  That rating decision granted 10 percent evaluations for
the residuals of a gunshot wound to the right thumb with a fused
interphalangeal joint, and for a shell fragment wound scar to the
sole of the right foot with retained foreign body.  It continued
noncompensable evaluations for the residuals of shell fragment
wounds to the left thigh, to the right posterior thigh, and to
the right anterior chest wall.  That rating decision also granted
service connection for the residuals of a shrapnel wound of the
right cheek with a noncompensable evaluation assigned based upon
a minute, nondisfiguring scar.  The veteran filed a notice of
disagreement only with respect to the issue of entitlement to a
compensable evaluation for the residuals of a shrapnel wound of
the right cheek so that is the only issue presently in appellate
status.

REMAND

In the July 1992 rating decision presently on appeal, the RO
granted service connection for the residuals of a shrapnel wound
to the right cheek.  The only apparent residual considered by the
RO was a scar which it found to be minute and not disfiguring.
The RO relied upon 38 C.F.R. Part 4, Diagnostic Code 7805 (1993),
for scars rated on limitation of function of the part affected,
as the basis for the noncompensable evaluation.  However, during
the April 1991 VA examination and in testimony at a personal
hearing before the RO, the veteran indicated that the retained
foreign body which remained in his face itself was causing pain,
discomfort, itching, headaches and a white drainage from the
right eye.  While photographs of the veteran's right cheek reveal
little to no residual scarring, and while the VA examiner in
April 1991 indicated both that there was "no visible scar" and
that the scar was "minute, not noticeable, not disfiguring," the
veteran has contended that it is the retained foreign body itself
which causes adverse symptomatology.  He has not complained about
a residual scar.

It is not clear from the record whether the RO conducted a
thorough review of the service medical records reflecting
treatment of the initial shell fragment wound of the veteran's
right cheek, which are in microfiche form in the claims folder.
These records indicate that the veteran was injured accidentally
during hand grenade training in Japan in May 1986.  After the
accident, the veteran complained of headaches and blurred vision.
An examination report from later that month said the veteran
complained of temporal pain.  An X-ray study reveals that a
metallic foreign body was lodged posterior to the right maxillary
sinus.  An ear, nose and throat consultation report reflects that
X-rays showed a 3- by 5-millimeter bone density mass in the
posterior aspect of the right maxillary sinus.  In July 1986, the
veteran apparently had problems with capillary bleeding under the
right eye since the shrapnel wound, and the eye dermal area was
darker on the right than the left.  In August 1986, there were
complaints of intermittent suborbital hematuria and complaints of
occipital pressure and tenderness to the injured area.  A right
oblique X-ray confirmed a retained foreign body in the
paratemporal fossa.  An ear, nose and throat examination resulted
in an impression of probable soft tissue injury.

Additional evidentiary development is required prior to final
appellate disposition.  In conjunction with this additional
development, the RO should consider evaluating all clinical
residuals of the shell fragment wound to the right cheek with
retained foreign body, not just the residual scar.  The veteran
has, since service, reported residual pain, discomfort, headaches
and drainage from the right eye during the April 1991 VA
examination and during the personal hearing at the RO.  The
rating decision on appeal, the statement of the case, and the
hearing officer's decision failed to discuss the issue of pain
residual to the wound and failed to discuss the veteran's
credibility in regards to reports of pain.  This is also
necessary.  See Magana v Brown, No. 93-556 (U.S. Vet.App. Dec.
14, 1994).

Because additional development is required prior to final
disposition, the case is REMANDED to the RO for the following:

1.  The veteran should be provided special
VA examinations by an otolaryngologist and
an ophthalmologist.  The claims folder,
should be made available to each examiner
prior to any examination for review in
evaluating the veteran's case.  All special
studies including X-rays should be
performed.  Each examiner should be
requested to provide a legible report
describing all symptomatology residual to
the veteran's shell fragment wound of the
right cheek.  The etiological origin of any
headaches reported should be confirmed.

2.  Following completion of the above
development, the RO should review the
evidence and determine whether the
veteran's claim for an increased evaluation
for the residuals of a shell fragment wound
to the right check with a retained foreign
body may be allowed.  In so doing, the RO
should consider all adverse symptomatology
residual to the wound, not just the scar.
If the benefit sought on appeal is not
allowed, the veteran and his representative
should be provided with an appropriate
supplemental statement of the case and a
reasonable opportunity to respond.

The case should then be returned to the Board for further
appellate review.  The veteran need do nothing until further
notified.

          THOMAS J. DANNAHER
          Member, Board of Veterans' Appeals

(Continued on next page)
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).