BVA9504150 
DOCKET NO.  93-09 131     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Columbia, South
Carolina

THE ISSUE

Entitlement to an increased (compensable) rating for residuals of
a shell fragment wound of the left knee.

REPRESENTATION

Appellant represented by: The American Legion

INTRODUCTION

The veteran had active military service from February 1965 to
October 1966.  This matter comes before the Board of Veterans
Appeals (Board) on appeal from an August 1992 rating action of
the Columbia, South Carolina, Regional Office (RO) of the
Department of Veterans Affairs (VA).

According to the appellate record at this time, there has been no
notice of disagreement submitted with a December 1992 rating
action denying a rating in excess of 10 percent for a post-
traumatic stress disorder or with a October 1994 rating action
denying service connection for various claimed residuals of agent
orange exposure.  As such, the appeal is limited to the issue
stated on the title page of this decision.

CONTENTIONS OF APPELLANT ON APPEAL

The veteran and his representative contend that traumatic
arthritis of the left knee is part and parcel of his service-
connected left knee disorder, that there is functional loss of
the left knee due to pain, that there is lateral instability of
the knee, that he currently wears a left knee brace and that a
compensable rating is warranted for the left knee disorder.

DECISION OF THE BOARD

The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991), has reviewed and considered all of the
evidence and material of record in the veteran's claims file.
Based on its review of the relevant evidence in this matter, and
for the following reasons and bases, it is the decision of the
Board that the evidence is in favor of an increased (compensable)
rating for residuals of a shell fragment wound of the left knee.

FINDING OF FACT

The service-connected residuals of shell fragment wound of the
left knee are manifested by a 1.5 inch scar on the medial aspect
of the knee, tenderness in the area of the scar, X-ray evidence
of minimal traumatic arthritis and a 15 degree limitation of
flexion of the knee.

CONCLUSION OF LAW

A 10 percent rating is warranted for residuals of a shell
fragment wound of the left knee.  38 U.S.C.A. §§ 5107(a), 1155
(West 1991); 38 C.F.R. §§ 3.321(b), Part 4, 4.40, Codes 5010,
5260 (1994).

REASONS AND BASES FOR FINDING AND CONCLUSION

Initially, I find the claim to be well-grounded within the
meaning of 38 U.S.C.A. § 5107(a).  The service medical records in
the claims folder consist only of the enlistment and separation
examinations.  Under ordinary circumstances, this Member of the
Board would be reluctant to evaluate residuals of a shell
fragment wound without complete service medical records.
However, in this particular case the nature of the shell fragment
wound in terms of the area of involvement, and the descriptions
in post service medical records, are such that more complete
service medical records are not indispensable to a proper
evaluation of the disorder.  I have further concluded that it is
in the veteran's best interest to proceed with a decision on the
merits.  At this time, and in this context, I find that the duty
to assist the veteran has been adequately complied with.

The DD 214 reveals that the veteran received a purple heart medal
and that he twisted his left knee as a result of a wound received
in enemy action in Vietnam in March 1966.  The service discharge
examination makes no reference to left knee pathology.

On VA orthopedic examination in February 1990, it was indicated
that the shrapnel fragment in the left knee, in service, was
embedded in the left patella and was removed through the wound,
without additional incision.  The examination was essentially
negative, but the veteran complained of left knee pain and an X-
ray of the left knee revealed minimal narrowing of the joint and
an abnormal bony prominence, possibly due to old trauma.

VA outpatient treatment records reveal that in October 1990 there
was marked quadriceps atrophy, tenderness of the left knee joint,
slight anterior cruciate laxity and a range of motion of the left
knee from 0 degrees to 130 degrees.  There was mild sclerosis of
the left medial tibial plateau.  In October 1991, the left knee
was mildly tender, medially.

On a VA dermatological examination in February 1992, there was a
1.5 inch scar secondary to shell fragment wound over the left
knee.

On VA orthopedic examination in February 1992, there was no
instability of the knee.  Range of motion was from 0 degrees to
125 degrees.  There was a complaint of pain on flexion, with
medial and lateral testing and with palpation of the patella.  X-
rays were noted to reveal possible early degenerative changes of
the knee joint.  The veteran was advised to continue to wear a
knee brace and to take Indocin as prescribed.

It is not completely clear in this case whether the shell
fragment wound scar is tender and painful, so as to warrant a 10
percent rating under Code 7804.  This may be the case, but the
complaints of pain and tenderness appear to exist in the knee
joint separate and apart from the scar.  What is clear is that
there is beginning traumatic arthritis in the left knee and a 15
degree limitation of flexion of the knee.  (See 38 C.F.R. § 4.71
Plate II (1994)).  There is also painful motion of the knee.  All
of this warrants a 10 percent rating under Code 5010.  There is
traumatic arthritis in the left knee with a minimal limitation of
flexion.  The limitation of flexion, in and of itself, would not
be compensable under code 5260.  However, traumatic arthritis of
a major joint with less than a compensable limitation of motion
warrants a 10 percent rating.  38 C.F.R. Part 4, Codes 5010,
5003.

A rating in excess of 10 percent is not warranted on an
extraschedular basis because the residuals of shell fragment
wound of the left knee do not result in frequent hospitalization
or in marked interference with employment.  38 C.F.R. § 3.321(b)
(1994).

ORDER

A increased (compensable) rating for residuals of a shell
fragment wound of the left knee is granted to the extent
indicated, subject to laws and regulations governing the payment
of monetary awards.

          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.

NOTICE OF APPELLATE RIGHTS:  Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals within
120 days from the date of mailing of notice of the decision,
provided that a Notice of Disagreement concerning an issue which
was before the Board was filed with the agency of original
jurisdiction on or after November 18, 1988.  Veterans' Judicial
Review Act, Pub. L. No. 100-687, § 402 (1988).  The date which
appears on the face of this decision constitutes the date of
mailing and the copy of this decision which you have received is
your notice of the action taken on your appeal by the Board of
Veterans' Appeals.