BVA9502074 
DOCKET NO.  93-08 020     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in New Orleans,
Louisiana

THE ISSUE

Entitlement to special monthly pension based on the need for
regular aid and attendance.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

James A. Pritchett,  Associate Counsel

INTRODUCTION

The evidence of record indicates that the veteran served on
active duty from June to October 1973 and from April 1975 to
December 1976.

By rating decision dated in October 1992, the New Orleans,
Louisiana, Department of Veterans Affairs (VA) Regional Office
(RO) awarded the veteran special monthly pension by reason of
being housebound.

This appeal arises from an October 1991 decision by the same RO
that denied a special monthly pension based on the need for
regular aid and attendance and from an October 1992 rating action
that continued the denial of that benefit.

REMAND

The evidence of record reveals that the veteran has a progressive
degenerative neurological disease which has been diagnosed by the
VA as a form of cerebellar degeneration.  When he was last
examined by the VA in September 1992 it was reported that the
veteran ambulated with a scissoring gait and that there was so
much spasticity that it took him a long period of time to walk
from one place to another.  Difficulty in swallowing was noted
along with choking on food and water.  On examination there was
general muscle atrophy with the physician describing the veteran
as "skin and bones".  His speech was spastic and dysarthric and
it was very difficult to communicate with him by speech.  There
was weakness in the muscles of the upper and lower extremities.
On an earlier VA examination in June 1992, there was noted to be
a marked coordination problem in the upper extremities.

Based on this evidentiary record the RO granted the veteran
special monthly pension at the housebound rate in October 1992.
The award was made effective in July 1991, and was based on a
determination that the cerebellar degeneration was 100 percent
disabling and resulted in the veteran being housebound.

The most recent pertinent evidence in the claims folder is
information received from the veteran in January 1993 that he was
working 28 hours week at a shipyard.  We do not know if the
veteran is still employed and, considering the progressive and
debilitating nature of the neurological disease we cannot rule
out the need for regular aid and attendance without further
development.

The case is Remanded for the following action:

1.  The veteran should submit a current
employment statement reflecting all hours
worked and all wages earned since January
1993 along with a description of the nature
of the work he performs.

2.  The veteran should be accorded a
comprehensive VA neurological examination
as well as an examination to evaluate the
need for regular aid and attendance, the
latter examination to be reported on VA
Form 21-2680.  All clinical findings should
be reported in detail with the neurologist
commenting on the veterans ability to bear
weight on each foot, balance of each foot,
propulsion of each foot, and grasping and
manipulation in each hand.  The veterans
ability to communicate by speech, his
ability to chew and ingest food and drink
and his mental status should likewise be
described in detail.  The presence or
absence of bladder and bowel impairment,
and, if present the degree thereof, should
also be described.

3.  When the above development is completed
the rating board should individually
evaluate and assign individual ratings for
all manifestations of the neurological
disease including, impairment in each upper
extremity andeach lower extremity, aphonia,
impairment of cranial nerve function
affecting chewing and swallowing, and, if
present, mental impairment, bladder
impairment and bowel impairment.

If the Remanded issue is not allowed, the veteran and his
representative should be furnished with a supplemental statement
of the case and afforded a reasonable time to reply thereto.
Thereafter, the case should be returned to the Board for further
appellate consideration as required.  No action is required of
the veteran until notified.  The purpose of this Remand is to
procure clarifying data.

          BRUCE E. HYMAN
          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).