BVA9501179 DOCKET NO. 93-12 245 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to an increased disability evaluation for a thyroid disorder, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The veteran and his spouse ATTORNEY FOR THE BOARD Anna Bryant, Counsel REMAND The veteran had active military service from July 1957 to October 1965. This matter came before the Board of Veterans' Appeals (Board) on appeal from an October 1991 rating decision of the St. Petersburg, Florida, Regional Office (RO) of the Department of Veterans Affairs (VA). Service connection was established for hyperthyroidism (formerly diagnosed as hyperthyroidism with findings characteristic of Grave's disease) by a December 1966 rating decision. This disorder was rated as 30 percent disabling under Diagnostic Code 7900 from October 1965 until March 1, 1967, when the rating was reduced to the current 10 percent. Private medical records dated in 1991 and an October 1991 VA examination reflect that the veteran's condition is now diagnosed as hypothyroidism rather than hyperthyroidism. The Diagnostic Code for hypothyroidism is 7903. A supplemental statement of the case issued in December 1992 cited the criteria for rating hyper- thyroidism under Diagnostic Code 7900. On the occasion of the veteran's hearing on appeal before a hearing officer in October 1992, it was pointed out that he suffered from fatigability, weight changes, mood swings and insomnia. It was also noted that he was receiving outpatient treatment, including medications, on an ongoing basis. Review of the evidentiary record reflects that the veteran has not been provided a VA examination since October 1991. In this regard, the accredited representative has advanced contentions that the veteran should be afforded a new VA examination in order to assess the current severity of his thyroid condition. In view of the above, further appellate consideration will be deferred and the case is REMANDED to the RO for the following action: 1. The veteran should be requested to identify all recent sources of medical treatment received by him for his thyroid disorder. Copies of the medical records from all sources he identifies (not already in the claims folder) should then be obtained and added to the claims folder. 2. The RO should schedule the veteran for an examination by an appropriate specialist for the purpose of determining the current severity of the residuals of hyperthyroidism. The examination should be performed in accordance with the guidelines set forth in Chapter 12 of the VA Physician's Guide for Disability Evaluation Examinations. The scope of the examination should be broad enough to cover all conditions attributable to thyroid dysfunction which are suggested by the veteran's complaints, symptoms or findings at the time of examination. Examinations by other specialists should be made where indicated. Tests commonly performed in the assessment of the thyroid patient should be done, including measurement of the hormones T3 and/or T4, ECG's and X-rays of the chest and cervical area for substernal thyroid and tracheal deviation. Any significant impairment affecting the eyes, sympathetic nervous system, and/or cardiovascular system should be identified and described. The claims folder should be made available to the examiner prior to the examination. 3. After the above development has been completed, the RO should review the evidence and determine whether the veteran's claim may now be granted. If the determination remains adverse to the veteran, he and his representative should be furnished a supplemental statement of the case which summarizes the pertinent evidence, fully cites the applicable legal provisions and reflects detailed reasons and bases for the decision reached. If hypothyroidism is diagnosed on the VA examination, the criteria for rating this disorder under Diagnostic Code 7903 should be cited and its applicability discussed. The veteran and his representative should be given the opportunity to respond thereto. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order, following appropriate appellate procedures. The purpose of the REMAND is to further develop the record. The Board does not intimate any opinion, either factual or legal, as to the ultimate disposition warranted in this case. No action is required of the veteran until he receives further notice. GARY L. GICK 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 deter- mination. 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) (1993).