BVA9502618 
DOCKET NO.  93-09 676     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Jackson,
Mississippi

THE ISSUE

Entitlement to an increased evaluation for residuals of a
fracture to the left radial head, to include arthritis, currently
evaluated as 20 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Susan S. Toth, Associate Counsel

REMAND

The veteran had active service from June 1973 to December 1977.

The VA neurological examination report of June 1992 contains a
notation by the examiner that the claims folder was unavailable
and that EMG nerve conduction studies should be conducted.  In
this regard, the VA has a duty to assist the veteran in the
development of facts pertaining to his claim.  38 U.S.C.A.
§ 5107(a) (West 1991); 38 C.F.R. § 3.303(a) (1994).  The duty to
assist includes, when appropriate, the duty to conduct a thorough
and contemporaneous examination of the veteran which takes into
account the records of prior medical treatment.  Green v.
Derwinski, 1 Vet.App. 121, 124 (1991).  This is to ensure that
the evaluation of the disability is a fully informed one.

Since additional VA examination is indicated, the RO should
attempt to procure recent medical treatment records.  The veteran
mentioned at the hearing conducted at the RO in November 1992
that he was receiving treatment from a Dr. Keith.  The veteran
should be requested to provide his name and address so medical
treatment records can be obtained.  The United States Court of
Veterans Appeals (Court) has held that the duty to assist the
claimant includes obtaining available medical records that are
relevant to the claimant's appeal.  Littke v. Derwinski, 1
Vet.App. 90 (1990).

VA regulations require that disability determinations be based
upon the most complete evaluation of the claimant's condition
that can feasibly be constructed.  For instance, 38 C.F.R. §§ 4.1
and 4.2 require that each disability be viewed in relation to its
history, that there be emphasis upon the limitation of activity
imposed by the disabling condition and that the disability be
considered from the point of view of the veteran working or
seeking work.  38 C.F.R. § 4.10 provides that in cases of
functional impairment, evaluations must be based upon lack of
usefulness of the affected part or systems and 38 C.F.R. § 4.40
requires consideration of functional disability due to pain.
These requirements for evaluation of the complete medical history
of the claimant's condition operate to protect claimants against
adverse decisions based upon a single, incomplete or inaccurate
report and they enable the VA to make a more precise evaluation
of the level of disability and of any changes in the condition.
Schafrath v. Derwinski, 1 Vet.App. 589, 594 (1991).

Under the circumstances of this case, we find that additional
assistance is required.  Accordingly, the case is REMANDED to the
RO for the following:

1.  The RO should contact the veteran and
obtain the names and addresses of all
health care providers where he has received
treatment for the left arm disability from
1992 to the present.  Thereafter, the RO
should acquire copies of all available
medical records, to include those from Dr.
Keith and the VA Medical Center in Jackson,
Mississippi, from November 1992 to the
present.  Once obtained, all records must
be associated with the claims folder.

2.  Following the receipt of medical
records, the veteran should be afforded VA
special examinations in orthopedics and
neurology to determine the extent of the
veteran's left arm disability, to include
arthritis.  The examiners should review the
entire claims file prior to the
examinations.  All indicated tests, to
include EMG nerve conduction studies,
should be conducted.  The veteran's
service-connected disability should be
evaluated in relation to its history with
emphasis upon the limitation of activity
imposed by the disabling condition in light
of the whole recorded history.  Each
examiner should render an opinion as to
what effect the disability, to include
pain, has on the veteran's ability to work.

3.  When the requested developments have
been completed and reviewed by the RO, and
in the event that the decision remains
adverse to the veteran, a supplemental
statement of the case should be prepared
and furnished to him and to his
representative.  They should then be given
an opportunity to respond.

Thereafter, the case should be returned to the Board in
accordance with current appellate procedures.  The appellant need
take no action until he is further informed.  The purpose of this
REMAND is to obtain additional information, and no inference
should be drawn regarding the final outcome of this claim as a
result of this action.

          C. W. SYMANSKI
          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).