BVA9507856 DOCKET NO. 93-17 135 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUES 1. Entitlement to an increased evaluation for status postoperative inguinal hernia repair, currently rated 10 percent disabling. 2. Entitlement to an increased (compensable) evaluation for neuropathy of the left ilio-inguinal nerve. REPRESENTATION Appellant represented by: Georgia Department of Veterans Service WITNESS AT HEARINGS ON APPEAL Appellant ATTORNEY FOR THE BOARD S. L. Kennedy, Counsel INTRODUCTION The veteran served on active duty from July 1979 to May 1982. This appeal arises from an April 1991 rating decision of the Department of Veterans Affairs (VA), Atlanta, Georgia, Regional Office (RO). In that decision, the RO granted service connection for status postoperative left inguinal hernia repair, and assigned a noncompensable disability rating. In a November 1991 rating decision, service connection for neuropathy of the left ilio-inguinal nerve was granted and a noncompensable evaluation was assigned. In a December 1992 rating decision, a 10 percent disability rating was assigned the veteran's service-connected left inguinal hernia. The Board of Veterans' Appeals (Board) notes that at a personal hearing held at the RO in April 1993, the veteran raised the issue of service connection for a disability of the left upper extremity. However, this issue is not currently in appellate status, and is referred to the RO for appropriate action. REMAND The VA has a duty to assist a claimant in the development of facts pertinent to his or her claim under 38 C.F.R. § 3.103(a) (1994). The United States Court of Veterans Appeals has held that fulfillment of the VA's duty to assist the veteran includes providing him with a thorough and contemporaneous medical examination. Littke v. Derwinski, 1 Vet.App. 90, 92 (1990). In this regard, the Board observes that the veteran was last afforded a VA general medical examination in March 1991; a VA neurological examination was completed in October 1991. VA treatment records added to the record since that time reflect that in June 1992 the veteran was hospitalized and underwent repair of her service-connected left inguinal hernia. Although a subsequent VA treatment record of November 1992 appears to indicate that no hernia was found on physical examination following the surgery, a more recent January 1993 entry appears to indicate that the left inguinal hernia has recurred. The veteran has recently reported that she must wear a supportive device due to the nature of this disability. The veteran has also indicated that since the June 1992 operative procedure, the pain and numbness associated with her service-connected neuropathy of the left ilio-inguinal nerve has increased in severity. The record reflects ongoing treatment at the Neurology and Anesthesia Pain Clinics at VA facilities to address these complaints. Based on the veteran's recent statements that both of her disabilities have worsened since the last VA examination, and in light of the numerous VA treatment records added to the record since that time, the Board has determined that the veteran should be afforded a current VA examination to determine the current nature and severity of the service-connected disabilities at issue. The RO should ensure that the veteran is provided such an examination for rating purposes. Fulfillment of the duty to assist the appellant includes the procurement and consideration of any relevant VA or other medical records. Ferraro v. Derwinski, 1 Vet.App. 326 (1991). The record on appeal indicates that the veteran continues to receive ongoing medical treatment for the disabilities at issue from both private and VA health care providers. The RO should ensure that any available current treatment records are associated with the assembled records. In view of the foregoing, and in order to fully and fairly adjudicate the veteran's claim, the case is REMANDED to the RO for the following action: 1. The RO should request that the veteran identify all sources of medical treatment received for the disabilities at issue since February 1993, and furnish signed authorizations for release to the VA of private medical records in connection with each non-VA medical source she identifies. Copies of the medical records from all sources she identifies (not already in the claims folder) should then be requested, to include treatment records from the Atlanta/Decatur, Georgia, VA Medical Center dated from February 1993 through the present. All records obtained should be added to the claims folder. 2. The veteran should be afforded a VA examination to determine the nature and extent of her service-connected status postoperative left inguinal hernia repair, and neuropathy of the left ilio-inguinal nerve. The scope of the examination should be broad enough to cover all residual conditions which are suggested by the veteran's complaints, symptoms or findings at the time of examination. All pertinent complaints or symptoms having a medical cause should be covered by a definite diagnosis. The examinations should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. All indicated diagnostic tests and procedures should be accomplished. The report should summarize all significant positive findings. All disability should be evaluated in relation to its history, with emphasis upon the limitation of activity, to include employability, imposed by the disorder in light of the whole recorded history. The effect of pain of on the veteran's functional impairment should be discussed. The claims folder should be made available to the examiner prior to the examination. 3. The RO should readjudicate the veteran's claim. The rating should reflect consideration of the provisions of 38 C.F.R. § 3.321(b)(1) (1994). If the determination remains adverse to the veteran, she should be provided a supplemental statement of the case which includes a summary of additional evidence submitted, any additional applicable laws and regulations, and the reasons for the decision. The veteran and her representative should be afforded the applicable time to respond. The case should then be returned to the Board for further appellate review. The purpose of this REMAND is to obtain additional evidence and ensure that the veteran is afforded all due process of law. The Board intimates no opinion, either factual or legal, as to the ultimate conclusion warranted in this case. THOMAS J. DANNAHER 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 Improvements 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) (1994).