BVA9502645 DOCKET NO. 94-04 247 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUES 1. Entitlement to service connection for a lumbosacral spine disorder. 2. Entitlement to service connection for a right shoulder disorder. 3. Entitlement to service connection for a right knee disorder. 4. Entitlement to service connection for post-operative residuals of bilateral carpal tunnel syndrome. 5. Entitlement to an increased disability evaluation for hypothyroidism with a history of thyrotoxicosis, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Department of Veterans Affairs, California WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD J. T. Hutcheson, Associate Counsel REMAND The veteran had active military service from August 1968 to June 1978. This matter came before the Board of Veterans' Appeals (hereinafter "the Board") on appeal from a November 1992 rating decision of the Los Angeles, California Regional Office (hereinafter "the RO") which, in pertinent part, granted service connection for hypothyroidism with a history of thyrotoxicosis evaluated as 10 percent disabling and denied service connection for a lumbosacral spine disorder, a right shoulder disorder, a right knee disorder and bilateral carpal tunnel syndrome. The veteran has been represented throughout this appeal by the California Department of Veterans Affairs. The veteran asserts on appeal that the RO erred in both denying service connection for a back disorder, a right shoulder disorder, a right knee disorder and bilateral carpal tunnel syndrome and in failing to assign a disability evaluation in excess of 10 percent for his service-connected hypothyroidism. He contends that he incurred a chronic right knee disorder during active military service or, in the alternative, secondary to his service-connected hypothyroidism; incurred a chronic back disorder, a chronic right shoulder disorder and bilateral carpal tunnel syndrome secondary to his hypothyroidism; and currently experiences significant physical and industrial impairment associated with his hypothyroidism. In reviewing the claims file, the Board observes that the veteran testified at a February 1993 hearing conducted before a Department of Veterans Affairs (hereinafter "VA") hearing officer that he had undergone post-service right knee arthroscopic surgery which failed to alleviate his chronic knee complaints. Clinical documentation of such treatment has neither been requested nor incorporated into the record. The veteran stated further that he had sustained falls and other injuries while employed as a letter carrier by the United States Postal Service (hereinafter "USPS") as a consequence of his service-connected hypothyroidism. Treatment records from the Commonwealth Medical Group dated in November 1991 indicate that the veteran was injured on November 12, 1991 while working for the USPS. Documentation related to the veteran's accident has neither been requested nor incorporated into the record. Additionally, the veteran has submitted several articles and medical text extracts which advance that hypothyroidism may result in carpal tunnel syndrome. A June 1992 physical evaluation report from Lawrence Cohn, M.D., conveys that the veteran's bilateral carpal tunnel syndrome may be etiologically related to either his employment with the USPS, hypothyroidism or another cause. Given these medical opinions, the Board finds that an additional VA examination which includes orthopedic and endocrinological evaluations would be helpful in resolving the issues raised by the instant appeal. In light of the VA's duty to assist the veteran in the proper development of his claim as mandated by the provisions of 38 U.S.C.A. § 5107(b) (West 1991) and as interpreted by the United States Court of Veterans Appeals (hereinafter "the Court") in Littke v. Derwinski, 1 Vet.App. 90, 92-93 (1990), this case is REMANDED for the following action: 1. The RO should contact the accredited representative and request that the veteran submit information as to the doctor who performed his right knee arthroscopic surgery. Upon receipt of the requested information and the appropriate medical release, the RO should contact the identified physician and request that he forward all available clinical documentation pertaining to his treatment of the veteran for incorporation into the record. 2. The RO should then contact the USPS and request that it forward all available documentation as to any injuries which the veteran sustained during his employment, including that incurred on November 12, 1991, for incorporation into the record. 3. The RO should then schedule the veteran for a VA examination which includes orthopedic and endocrinological evaluations in order to determine the present nature and severity of his back disorder, right shoulder disorder, right knee disorder, post-operative residuals of bilateral carpal tunnel syndrome and service-connected hypothyroidism. The examination should be conducted in accordance with the Physician's Guide to Disability Evaluation Examinations. All indicated tests and studies should be accomplished and the findings then reported in detail. The examiners should express their opinion as to the etiology of the veteran's carpal tunnel syndrome and any identified back, right shoulder, and right knee disability. The claims folder should be made available to the examiners prior to the examination. When the requested action has been completed, and if his claim continues to be denied, the veteran should be afforded a reasonable period of time in which to respond to a supplemental statement of the case. Thereafter, subject to current appellate procedures, the case should be returned to the Board for further appellate consideration if appropriate. The veteran need not take any action unless he is further informed. The purpose of this REMAND is to allow for further development of the record. No inference should be drawn from it regarding the final disposition of the veteran's claim. JEFF MARTIN 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 is appealable to the Court. 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).