BVA9502723 
DOCKET NO.  93-07 510     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Paul,
Minnesota

THE ISSUE

Entitlement to an increased rating for a left knee disability,
currently rated 20 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Mark J. Swiatek, Counsel

REMAND

The veteran had active duty from June 1941 to September 1945.
This matter comes before the Board of Veterans' Appeals (Board)
on appeal from a May 1992 rating action by the Department of
Veterans Affairs (VA) Regional Office (RO) in St. Paul,
Minnesota.

The veteran asserts, in essence, that his left knee disability
warrants a higher rating.  The Board observes that the current
claim does not include a thorough and contemporaneous medical
examination of the left knee to permit an informed decision.  In
May 1992, a VA examination was accomplished, but the record shows
that the veteran was confined to a wheel chair and that the
examiner was unable to conduct a complete examination.  When the
veteran was seen in December 1992 at a VA Medical Center, he was
able to walk at least some distance with a cane, but he was
considered to be a candidate for a total knee replacement and was
scheduled to return to the clinic in six months.

Further, the Board observes that the issue of secondary service
connection for a left fibula fracture has been reasonably raised
in this appeal in connection with the increased rating claim.  In
essence, the veteran has asserted that the fracture was sustained
in a fall caused when his left knee gave out.  The VA is required
to adjudicate those issues which are reasonably raised by a
liberal reading of the documents and testimony submitted by a
claimant and any inextricably intertwined issues prior to a final
Board decision.  See, EF v. Derwinski, 1 Vet.App. 324 (1991);
Harris v. Derwinski, 1 Vet.App. 180 (1991).

To ensure that the VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the (RO) for the following development:

1.  The RO should obtain all VA treatment
records for the veteran's left lower
extremity since December 1992 and
associated all such records with the claims
folder.

2.  The RO should also assist the veteran
in obtaining any other records from medical
care providers who treated the veteran
recently for his left knee disability and
the fracture of the left fibula since
November 1991.

3.  The veteran should then be afforded a
VA orthopedic examination to determine the
current severity of his service-connected
left knee disability.  The claims folder
should be made available to the examiner
for review in connection with the
examination.  All functional impairment
should be reported to provide for accurate
and informed adjudication of the veteran's
claim.  The examiner should also be
requested to give an opinion, based upon a
review of the material in the claims file,
as to degree of probability, if any, that
the left fibula fracture was caused by the
service-connected left knee disability.
The examiner should also provide the
rationale for any opinion offered.

4.  After the development requested above
has been completed to the extent possible,
the RO should again review the claim for an
increased rating for a left knee
disability.  The RO should also adjudicate
the claim for secondary service connection
for a fracture of the left fibula.

The veteran and his representative should then  be furnished a
supplemental statement of the case and given the applicable time
to respond thereto. Thereafter, the case should be returned to
the Board, if in order.  The  Board intimates no opinion as to
the ultimate outcome of this case.  The appellant need take no
action unless otherwise notified.

          CHARLES E. HOGEBOOM
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 Improvement 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).