BVA9501940 DOCKET NO. 93-08 904 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to an increased evaluation for status post partial medial meniscectomy, chondromalacia, and degenerative changes of the left knee, currently evaluated as 10 percent disabling. 2. Entitlement to an increased evaluation for chondromalacia of the right knee with degenerative changes, currently evaluated as 10 percent disabling. 3. Entitlement to service connection for bilateral hearing loss. 4. Entitlement to service connection for tinnitus. 5. Entitlement to service connection for hypertension. 6. Entitlement to service connection for a chronic headache disorder REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and his wife ATTORNEY FOR THE BOARD T. S. Kelly, Associate Counsel INTRODUCTION The veteran had active military service from August 1977 to August 1990. In April 1992, the veteran requested service connection for foot problems, to include plantar warts. As this matter is not properly before the Board of Veterans' Appeals (Board), it is referred to the regional office (RO) for further development. REMAND A review of the veteran's claims file demonstrates that he has had normal and elevated blood pressure readings during and after service. No diagnosis, however, of essential hypertension has been made. The Board further notes that the veteran continued to complain of headaches at the time of his July 1992 personal hearing, indicating that he would get headaches up to five times per week, which would last anywhere from a couple of minutes to ten minutes in duration. Transcript page 6 (T. 6). The veteran further indicated that he believed his headaches were related to his high blood pressure. (T. 6). The veteran's representative indicated that the veteran was not given an examination which was requested at the time of the October 1990 VA examination. A review of the file demonstrates that while a request was made by the October 1990 VA neurological examiner that the veteran undergo a cerebral magnetic resonance imaging test, it does not appear that this test was performed. We are also of the opinion that performing an additional neurological evaluation, to include all appropriate studies, as well as an opinion as to whether the veteran presently has a chronic headache disorder, and, if so, whether it is related to any headaches incurred in service, would be beneficial in reaching a determination in this matter. To ensure that the VA has met its duty to assist the claimant in developing the facts pertinent to the claim, the case is REMANDED to the regional office (RO) for the following development: 1. The RO should request that the National Personnel Records Center conduct a thorough search of its files for any additional service medical records of the veteran. Specific emphasis should be placed upon obtaining the veteran's service separation medical examination. 2. The RO should obtain the names and addresses of all medical care providers who have treated the veteran since his separation from service for any of the disabilities presently on appeal. After securing the necessary release, the RO should obtain copies of those records. 3. The RO should also obtain copies of all treatment records of the Jacksonville, Florida, VA Outpatient Clinic from April 1992 to the present. 4. The RO should then schedule the veteran for a VA examination by an appropriate medical specialist in order to determine whether he has essential hypertension. The examination should be in conformance with the Physician's Guide for Disability Evaluation Examinations. The examiner should be requested to express an opinion whether the veteran has essential hypertension. The claims folder must be made available to the examiner for review prior to the examination. 5. The RO should schedule the veteran for a VA neurological examination to determine the nature of any headache disorder. All appropriate tests and studies should be performed. The examiner should state whether a "cerebral MRI" should be performed. The claims folder must be made available to the examiner for review prior to the examination. The examiner should be requested to render an opinion whether the veteran has a chronic headache disorder, and, if so, the etiology of the disorder, and whether or not it is related to any headaches reported by the veteran in service. 6. The RO should schedule the veteran for a special VA orthopedic examination to determine the severity of his service-connected right and left knee disorders. All appropriate tests and studies, including range of motion testing and x-ray studies, should be performed. Range of motion testing is to be reported in degrees, and all findings are to be reported in detail. The examiner should report any evidence of painful motion on examination. 7. The RO should also arrange for an evaluation, including appropriate audiological studies, of the veteran's hearing by a otolaryngologist. The examiner should be requested to review the claims folder, especially the audiometric reports during service, and express an opinion whether the veteran's hearing in his left ear became worse during service. If a hearing disability did increase during service, the examiner should express an opinion whether such increase in disability was due to the natural progress of the disease. The examiner should also express an opinion whether the veteran has tinnitus and, if so, the cause thereof. It is essential that the claims folder be given to the examiner before the examination. After the completion of the above requested development, the RO should review the appellant's claim. If the benefits sought on appeal remain denied, a supplemental statement of the case should be given to the veteran and his representative. They should be afforded a reasonable period of time to respond. Thereafter, the case should be returned to the Board for further appellate consideration. By this remand, the Board intimates no opinion as to the ultimate outcome of this case. JOHN E. ORMOND 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).