BVA9500028 
DOCKET NO.  93-08 041     )       DATE
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Des Moines,
Iowa

THE ISSUES

1.  Entitlement to service connection for right knee disability.

2.  Entitlement to service connection for low back disability.

REPRESENTATION

Appellant represented by: The American Legion

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Alan S. Peevy, Associate Counsel

INTRODUCTION

The veteran had active military service from February 1962 to
February 1964.

This case is before the Board of Veterans' Appeals (Board) on
appeal from a March 1992 rating decision by the Des Moines, Iowa,
Regional Office (RO).  A notice of disagreement was received in
May 1992, and a statement of the case was issued in June 1992.
The veteran's substantive appeal was received in August 1992.
The veteran testified at a personal hearing at the RO in October
1992, and a supplemental statement of the case was issued in
December 1992.

The veteran is represented by The American Legion.

REMAND

The essence of the contentions advanced in the present case is
that the veteran suffers from right knee disability and low back
disability which are proximately due to or the result of his
service-connected left knee disability.  Preliminary review of
the June 1992 statement of the case discloses that the RO denied
the veteran's claims based on its finding that there was "no
conclusive evidence" of any relationship between the veteran's
service-connected left knee disability and any right knee and low
back disorders.  However, the evidence required to warrant a
grant of disability benefits does not have to be conclusive.  The
question is whether the evidence supports the claim or is in
relative equipoise, with the veteran prevailing in either event,
or whether a fair preponderance of the evidence is against the
claim, in which case the claim is denied.  38 U.S.C.A. § 5107(b)
(West 1991); Gilbert v. Derwinski, 1 Vet.App. 49, 55 (1990).
Since it appears that the wrong standard of proof may have been
applied in this case, additional action is required before the
Board can undertake its appellate review.

Further, recognizing that it has been approximately three years
since the last Department of Veterans Affairs (VA) examination
dealing with the issues on appeal, the Board is of the opinion
that it would be appropriate to schedule the veteran for another
examination, especially in view of the need to defer appellate
consideration of this case pending additional RO action as
outlined above.

Accordingly, the case is hereby REMANDED to the RO for the
following actions:

1.  All VA medical reports documenting
treatment of the veteran's right knee
and back since 1992 should be obtained
and made of record.

2.  The veteran should be scheduled for
a VA examination by a board-certified
orthopedic specialist (who has not
previously examined the veteran) for
the purpose of ascertaining the nature
and etiology of the veteran's right
knee and back disabilities.  It is
imperative that the claims file be made
available to and be reviewed by the
examiner prior to the examination, and
the examination report should clearly
document this review.  All indicated
tests, including radiological studies,
are to be accomplished.  The examiner
should be asked to state an opinion as
to whether or not any found disorders
of the right knee and back are
etiologically related to the veteran's
service-connected left knee disability.
A clear rationale should be provided
for the examiner's opinion.

3.  After completion of the above, the
RO should review the expanded record
and determine whether the veteran's
claims can be granted.  In making this
determination, the RO should decide
whether the preponderance of the
evidence is against the veteran's
claims (in which case a denial would be
in order), or whether the preponderance
of the evidence is for the veteran's
claims, or whether there exists a
balance of the positive evidence with
the negative evidence (which, in either
case, would support a grant of the
benefit(s) sought).  If the RO's
determination as to either or both
issues is adverse to the veteran, then
the veteran and his representative
should be furnished a supplemental
statement of the case setting forth a
summary of the evidence, a citation to
and discussion of applicable laws and
regulations, and a detailed analysis of
the reasons for the RO's decision(s).
After affording the veteran and his
representative a reasonable opportunity
to respond, the case should be returned
to the Board for further appellate
review.

The purpose of this decision is to ensure consideration of the
veteran's claim under applicable laws and regulations.  The Board
intimates no opinions as to the ultimate determinations to be
made in this case.

          ALBERT D. TUTERA
          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) (1993).