BVA9502599 DOCKET NO. 93-07 490 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUE Entitlement to an increased rating for arteriosclerotic heart disease with a postoperative quadruple coronary artery bypass and hypertension, (hypertensive heart disease), currently evaluated as 30 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Richard F. Williams, Counsel INTRODUCTION The veteran served on active duty from April 1943 to March 1946 and from January 1947 to June 1965. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 1991 decision by the Department of Veterans Affairs (VA), Chicago, Illinois, Regional Office (RO), which assigned a temporary one-year schedular total rating for the veteran's hypertensive heart disease (after he underwent quadruple coronary artery bypass graft surgery), from April 7, 1991, through May 1992, and a 30 percent rating thereafter. 38 C.F.R. § 4.104, Code 7017-7005 (1993). The veteran disagrees with the assignment of the 30 percent rating. He canceled a hearing scheduled at the RO in November 1992. REMAND The veteran's claim is well-grounded, meaning it is not inherently implausible, and a review of the file reveals there is a further duty to assist him in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103, 3.159 (1993). In his written arguments in March 1993, the representative expressed dissatisfaction with the most recent VA compensation examination, pointing out, in part, that no stress or tolerance test was performed and that an electrocardiogram report referred to by the examiner is not on file. It also appears that the file lacks the report of X-ray study of June 1991 referred to in the history portion of the VA examination. Accordingly , after reviewing the file, it is my judgment that another examination is indicated. Littke v. Derwinski, 1 Vet.App. 90, 92 (1991); Green v. Derwinski, 1 Vet.App. 121, 123, 124 (1991); Caffery v. Brown, 6 Vet.App. 377, 381 (1994). Further, the statutory duty to assist requires VA to obtain all relevant medical records, the existence of which has been called to its attention. Ivey v. Derwinski, 2 Vet.App. 320 (1992); Murincsak v. Derwinski, 2 Vet.App. 363 (1992). Hence, the case is REMANDED to the RO for the following actions: 1. The RO should ask the veteran, with the assistance of his representative, to prepare a detailed list of all sources (VA or other) of examination and treatment for his hypertensive heart disease, including the report of X-ray study of June 1991 from Loyola University Medical Center and electrocardiogram report from Joliet Medical Group in February 1992. Names and addresses of the medical providers, and dates of examination and treatment, should be listed. After obtaining any needed release forms from him, the RO should directly contact the medical providers and obtain the records. 38 C.F.R. § 3.159. 2. After the above information has been obtained and added to the record, the veteran should be scheduled for a special VA cardiology examination to determine the severity of his service-connected arteriosclerotic heart disease with status- post coronary artery bypass graft surgery and hypertension. A detailed history should be obtained, including the duration and frequency of any anginal attacks. The clinical evaluation should include standing, sitting and supine blood pressure readings. All indicated studies should be accomplished. Findings should include whether there is marked enlargement of the heart, confirmed by roentgenogram, or the apex beat beyond the midclavicular line, sustained diastolic hypertension, diastolic blood pressure of 120 or more, which may later have been reduced, or dyspnea on exertion. The examiner should indicate whether the veteran's cardiac status precludes more than light manual labor. The claims file must be made available to the cardiologist for review prior to the examination. Thereafter, the claim should be reviewed by the RO. If the veteran is dissatisfied with the decision, he and his representative should be issued a supplemental statement of the case and given an opportunity to respond. Then the case should be returned to the Board. M. CHEEK 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).