BVA9502404 
DOCKET NO.  93-19 968     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Lincoln,
Nebraska

THE ISSUE

Entitlement to the restoration of a 40 percent rating for
limitation of extension, left elbow (major).

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

N. W. Fabian, Associate Counsel

INTRODUCTION

The veteran had active service from September 1941 to August
1945.
REMAND

The veteran was afforded a Department of Veterans Affairs (VA)
examination in September 1992, at which time extension of the
left forearm was noted by the examiner to be 95 degrees.
Photographs that were associated with an examination in August
1992 showed an apparent conflict with the examiner's noted range
of motion.  The VA examiner then provided a revised report that
stated the veteran could extend the left elbow to 175 degrees.
Based on this examination, a July 1993 rating decision reduced
the veteran's evaluation for limitation of extension under
Diagnostic Code 5207 from 40 percent to 10 percent, effective
October 1993.

The ranges of motion of the left forearm should be noted in
conformance with
38 C.F.R. § 4.71, Plate I (1993).  Consequently, the medical
evidence in file does not provide sufficient information to
evaluate the extent of the veteran's disability.  Accordingly,
the case is remanded to the regional office (RO) for the
following actions:

1.  After the necessary information and authorization
are obtained from the veteran, copies of all treatment
records for the veteran's disability of the left
elbow, VA or private, inpatient or outpatient, since
August 1992, should be obtained by the RO and added to
the claims file.

2.  After the foregoing has been completed to the extent
possible, the veteran should be afforded VA neurological
and orthopedic examinations in order to determine the
extent of the disability of his left elbow.  The physician
conducting the neurological examination should be asked to
specify the extent and nature of any neurological damage to
the veteran's left elbow or forearm, including impairment
of motor function, trophic changes, or sensory disturbances
and by identifying the specific nerve(s) affected.  The
neurological examination should be conducted in accordance
with Chapter 13 of Physician's Guide for Disability
Evaluation Examinations.  The physician conducting the
orthopedic examination should be asked to conduct the
examination in accordance with Chapter 2, Section V of the
Physician's Guide and to specify any limitation of motion
of the elbow in terms of the degree of arc as demonstrated
in Figure 2.1 of the Physician's Guide.  Any functional
impairment due to pain should also be noted by the
examiner.  Each examiner should furnish a comprehensive
report with a detailed account of any pathology found to be
present along with the information requested above.

If, after RO review of all of the evidence and pertinent law,
including 38 C.F.R. § 4.40 (1993), the decision remains adverse
to the veteran, a supplemental statement of the case, which
includes all issues for which a notice of disagreement has been
filed and which includes all pertinent law and regulations not
previously provided to the veteran, should be issued and the
veteran and his representative who should be afforded an
opportunity to respond.  Thereafter, following the usual
appellate processing, the case should be returned to the Board of
Veterans' Appeals (Board), if in order.  The appellant need take
no action until notified.

          M. SABULSKY
          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).