Citation Nr: 0003841 Decision Date: 02/14/00 Archive Date: 02/15/00 DOCKET NO. 95-18 180 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Indianapolis, Indiana THE ISSUE Entitlement to service connection for liver disability. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD William D. Teveri, Associate Counsel INTRODUCTION The veteran served on active duty from September 1969 to August 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1993 rating decision by the Department of Veterans Affairs (VA) Regional Office in Indianapolis, Indiana, (RO). In a December 1998 remand, the Board detailed the procedural history of this case. The issue above remains the only issue currently before the Board. REMAND Initially, the Board notes the veteran, in a September 1999 statement, indicated that his claim is for service connection for a liver condition "defined as 'elevated liver enzymes.'" The veteran essentially contends that, if current findings indicate elevated liver enzymes, or if other current studies of liver function are found to be abnormal, those findings constitute a current disability for service connection purposes. In December 1998, after finding the veteran's claim for service connection for a liver disability well-grounded, and after determining that the duty to assist under 38 U.S.C.A. § 5107(a) (West 1991) required further medical development, the Board remanded the claim to the RO to obtain and associate with the claims file all pertinent VA and private medical records, including those which might document treatment since 1996, which were not already of record. That development has been successfully completed. The Board also instructed the RO to schedule the veteran for a comprehensive VA medical examination by an appropriate specialist for the purpose of determining the nature and severity of any liver disorder or disease, including any past hepatitis infection(s). The Board also instructed that all indicated special studies and tests should be accomplished, and that the examiner should fully report all findings and fully explain any opinion(s). A review of the July 1999 VA examination report reveals that, under the heading of "DIAGNOSTIC AND CLINICAL TESTS," is a notation that "[a]dditional blood work has been requested including complete blood count with differential and liver panel." Under the heading of "DIAGNOSIS" at the end of that report it is also stated that "[t]he complete blood count with differential is being repeated at this time." The results of that testing, however, do not appear of record, and there is no statement from the examiner of record which indicates he received the results, interpreted them, and provided the opinions requested in the December 1998 Board remand. Accordingly, as the examination report is not complete and sufficient to properly adjudicate the veteran's claim, it must be returned as inadequate for adjudication purposes. See 38 C.F.R. § 4.2 (1999); Stegall v. West, 11 Vet. App. 268, 270-71 (1998). Accordingly, the case is hereby REMANDED to the RO for the following actions: 1. The RO should obtain and associate with the claims file the reports of testing and studies noted in the July 1999 VA examination report of the veteran. If the requested tests and studies reports cannot be located, that fact, and the reasons therefor, should be documented in the claims file, and the veteran should be afforded the opportunity to complete any necessary testing, or to be scheduled for another VA examination, to include that testing, if it is found necessary. 2. After completion of the above, and if another examination or further testing is not required, the RO should request that the examiner who conducted the July 1999 VA examination of the veteran review those reports, confirm that all ordered tests and studies have been accomplished, interpret the results of those tests and studies, and describe to the fullest extent possible the nature of any liver disorder or disease found, and the relationship of that disease or disorder to the elevated liver enzyme readings noted during the veteran's military service. If a current liver disability cannot be medically diagnoses, the examiner should so state. If the examiner who conducted the July 1999 VA examination is not available, the RO should request another qualified specialist to review both the examination report and the reports of the special tests and studies, and provide the opinions requested in this remand and in the December 1998 remand. 3. After completion of the above the RO should review the examination, tests and studies reports, and the resultant opinions, to determine if they are sufficient to properly adjudicate the veteran's service connection claim. If not, the report(s) should be returned as inadequate for rating purposes. 4. After completion of the above, and completion of any additional development deemed necessary by the RO or the examiner, the RO should review the record and adjudicate the veteran's service connection claim in accordance with all current statutes, regulations, and caselaw. If the determination remains unfavorable to the veteran, the RO should furnish the veteran and his representative with an appropriate supplemental statement of the case and afford them an appropriate time to respond. The case should then be returned to the Board for appellate review. The purpose of this remand is to assist the veteran and to obtain current medical evidence as to his service connection claim. The Board also informs the veteran and his representative of the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). ALAN S. PEEVY Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 1999), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. 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) (1999).