BVA9503680 
DOCKET NO.  89-26 916     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in San Juan,
Puerto Rico

THE ISSUES

1.  Entitlement to an increased rating for duodenal ulcer
disease, currently rated 10 percent disabling.

2.  Entitlement to an increased rating for the veteran's service-
connected scars, right shoulder, right upper arm, right hand,
right side of face, left side of head, and bruised right eye,
currently rated 10 percent disabling.

REPRESENTATION

Appellant represented by: Public Advocate for Veterans
Affairs, Puerto Rico

ATTORNEY FOR THE BOARD

P. B. Werdal, Associate Counsel

INTRODUCTION

The veteran served on active duty from December 1953 to November
1955.

This matter came before the Board of Veterans' Appeals (Board) of
the Department of Veterans Affairs (VA) on appeal from a decision
dated August 19, 1987, from the San Juan, Puerto Rico, Regional
Office (RO), denying an increased (compensable) rating for the
veteran's service-connected duodenal ulcer.  The notice of
disagreement was received in September 1987.  The statement of
the case was sent to the veteran in December 1987.  The
substantive appeal was received in January 1988.  In a rating
decision dated August 18, 1988, the Chicago, Illinois, Regional
Office denied the veteran's claims for service connection for a
right arm disability.  A notice of disagreement regarding that
claim was received in April 1989.  A statement of the case was
sent to the veteran by the RO in June 1989.  A document accepted
as a substantive appeal was received in July 1989.

This matter was previously before the Board and was remanded in
February 1990.  In a rating decision dated April 12, 1990, the
veteran's service-connected duodenal ulcer was assigned a 10
percent rating, and his claim for service connection for
residuals of a right arm injury, characterized as scars, right
shoulder, right upper arm, right hand, right side of face, left
side of head, and bruised right eye, was granted and the
disability assigned a 10 percent rating.

The Board observes that the veteran seeks service connection for
schistosomiasis, and for a psychiatric disability he alleges is
secondary to one or both of his service-connected disabilities.
Each of those claims were previously denied (in February 1960 and
October 1986, respectively), and the denials were not appealed.
Accordingly, the veteran must first reopen those claims before
they can be reviewed on the merits.  Those claims are not
inextricably entwined with the claims certified on appeal, so
Harris v. Derwinski, 1 Vet.App. 180 (1991), does not require the
Board defer appellate review of the issues certified on appeal at
this time.  The Board refers those claims to the RO for
appropriate action.

REMAND

Service connection was afforded the veteran for scars, right
shoulder, right upper arm, right hand, right side of face, left
side of head, and bruised right eye in April 1990.  Although
there is medical evidence in the claims folder that pertains to
the scars, there is no current information regarding the "bruised
right eye" that was included by the RO in the disability rated
under Diagnostic Codes 7800-7805.  As a result, it is not clear
to the Board what the disability attributed to a bruised right
eye is, whether the veteran suffers symptoms and manifestations
of that disability, or what those symptoms and manifestations
are, if any.  In addition, at page 4 of the transcript of the
hearing conducted in August 1992 the veteran reported that
doctors told him that the vision in his right eye is affected by
the injury that left the scar near his right eye:  it is not
clear that those assertions have been addressed by the RO.

In addition, the Board notes that in the VA Form 21-4138,
Statement in Support of Claim, dated in August 1992 the veteran
claims he is entitled to service connection for gastritis.  That
claim has not been developed and adjudicated.  The United States
Court of Veterans Appeals has held that a claim is not ready for
appellate review if an intertwined claim is not yet ready for
appellate review.  Harris v. Derwinski, 1 Vet.App. 180 (1991).
The Board believes that the veteran's claim of service connection
for gastritis may be inextricably entwined with his claim for an
increased rating for duodenal ulcer, and defers action on the
claim for an increased rating until the service connection claim
for gastritis has been addressed by the RO.

While this appeal was at the Board, the veteran submitted a
document written in Spanish.  The document has not been
translated to English, so its contents are not known to the Board
at this time.  However, because the matter on appeal must be
remanded to address other issues, the Board asks that the
document received January 25, 1995, be translated and any issues
raised in that document, such as a claim for nonservice-connected
pension benefits, should be developed and adjudicated.

The VA has a duty to assist in the nonadversarial process of
claims adjudication.  38 U.S.C.A. § 5107 (West 1991); 38 C.F.R.
§ 3.103(a) (1994).  Under the circumstances of this case,
additional development is necessary.  Accordingly, this matter is
REMANDED for the following action:

1.  The RO should add to the claims folder
a description of the disability identified
in the April 1990 rating decision as
bruised right eye, and the source of the
claim for the disability.  The items of
evidence considered by the RO regarding
that disability should be identified.

2.  The RO should contact the veteran and
his representative and obtain a list of the
names and addresses of the non-VA
physicians who have treated the veteran for
his service-connected disabilities, and for
his gastritis, as well as the approximate
dates those care providers treated those
conditions.  Copies of treatment records
from those care providers should be
obtained and associated with the claims
folder.

3.  The veteran and his representative
should also be asked to identify all VA
facilities at which the veteran has
received treatment, either inpatient or
outpatient.  Copies of records from those
facilities should be obtained, and those
records not already in the claims folder
should be associated with the claims
folder.

4.  The veteran should be afforded special
VA examinations that provide information
necessary to ascertain whether the veteran
has a disability resulting from the bruised
right eye identified in paragraph one, and
whether he has gastritis.  The etiology of
each of

those disabilities should be identified,
and the symptoms and manifestations, if
any, of each disability should be
identified.  All findings must be legibly
written in detail.  All examiners must be
provided with the veteran's complete
medical record, including the documents
obtained in response to paragraphs two and
three above, prior to examining the
veteran.

5.  The RO should develop and adjudicate
the veteran's claim of service connection
for gastritis.  If that matter is not
resolved to his satisfaction, he and his
representative must be informed of the
decision and provided appellate rights.

6.  The RO should obtain a translation from
Spanish to English of the document received
January 25, 1995, and the English
translation should be associated with the
claims file.  Any issues raised in that
document, such as a claim for nonservice-
connected pension benefits, should be
developed and adjudicated.

Following completion of that action, if the claims for an
increased rating of the veteran's service-connected scars, right
shoulder, right upper arm, right hand, right side of face, left
side of head, and bruised right eye are not resolved to the
appellant's satisfaction, he and his representative should be
provided with a supplemental statement of the case that
summarizes the relevant evidence, and contains a citation to and
discussion of the applicable laws and regulations, the reasons
and bases for the decision, and a discussion of the application
of the laws and regulations to the evidence.  All claims in
appellate status should be certified as such and returned to the
Board.  The purpose of this REMAND is to assist the veteran in
developing his claim.  No action is required of him until further
notice.  The Board expresses no opinion, either factual or legal,
as to the ultimate

determination warranted in this case pending completion of the
requested action.

          EUGENE A. O'NEILL
          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) (1994).