BVA9506014 DOCKET NO. 93-07 948 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for a breathing disorder (polyps in nose) and sinusitis/rhinitis. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Daniel J. McTavish, Associate Counsel INTRODUCTION The veteran served on active duty from April 1953 to April 1955. This matter came before the Board of Veterans' Appeals (Board) on appeal of a December 1992 rating decision by the St. Petersburg, Florida Regional Office (RO) of the Department of Veterans Affairs (VA), denying entitlement to service connection for a breathing disorder (polyps in nose) and for sinusitis/rhinitis. REMAND In July 1992, the veteran submitted a claim of service connection for a breathing disorder which he described as polyps in the nose. He contends that sinusitis/rhinitis was diagnosed while on active duty. He maintains that the polyps in his nostrils are secondary to the disorders shown in service. He asserted that nasal polyps take years to develop and there was a definite connection between his breathing problems during service and his present diagnosis. The veteran and his representative requested that the veteran be examined by a board of ear, nose and throat (ENT) specialists to determine the veteran's exact diagnosis and its etiology. Service medical records indicate that the veteran was seen in May 1953 with complaints that he was unable to breathe properly. Diagnosis was sinusitis. Examination in June 1953 showed nasal congestion with edema of the mucosa and enlargement of the inferior turbinates. There was slight deviation of the septum. Allergy tests conducted in July and August 1953 showed some reaction to mixed grasses, wool, and dog epidermis. He was also seen in October and November 1953 for nasal obstruction. The diagnosis was mild chronic rhinitis. Throughout the remainder of his active duty service, he was seen several times for cold- related symptoms. Notwithstanding the findings by the RO as stated in the December 1992 rating decision, that the first possible evidence of diagnosis for a breathing disorder in the form of polyps of the nose was 1990, we note that VA outpatient treatment records as early as March 1977 revealed there were polyps in each nostril. His maxillary sinuses were tender. In June 1977, it was noted that he had nasal mucosa which was markedly hypertrophied, almost completely occluding the air passage. The examiner noted that the ENT felt that this was due to overuse of nose drops; however, the examiner noted that this condition existed before nose drops were used. Thereafter, he was seen several times on an outpatient basis for sinus pain and headaches. Diagnosis was sinusitis. A VA examination was conducted in May 1990. Examination of his nose and sinuses revealed that the turbinates were swollen and it was believed that there was a small polyp seen far up on the right nostril. The RO noted in the December 1992 rating decision that service connection for sinusitis was denied as this disorder was apparently acute and transitory with no chronic disability shown at the time of separation from service with the separation examination negative. The evidence of possible sinusitis was noted on the VA examination in 1990 with redness of the turbinates. Subsequently, sinusitis was noted on VA outpatient treatment records in July 1992. The Board agrees with the service representative that current examination should be performed by VA to determine the exact diagnosis and its etiology concerning his claimed breathing disorder and sinusitis/rhinitis, and for the purpose of establishing whether there is a relationship between his inservice treatment for nasal disorders. A current examination will also be useful in determining whether the symptoms noted from March 1977 through November 1981 likely represented a continuation of his inservice symptoms. As well, it would be beneficial to secure records, if such are available, which would establish continuity of the upper respiratory tract disorders following discharge from service. VA has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). Accordingly, this case is REMANDED to the RO for the following: 1. The RO should contact the veteran, through his representative, and ask him to identify any sources of treatment, private or VA, received for a breathing disorder and sinusitis/rhinitis subsequent to his discharge from service, particularly from May 1955 to April 1976. Attempts should then be made to obtain records of any treatment reported by the veteran. All records should be obtained in compliance with appropriate procedure. 2. The veteran should be scheduled for a VA ENT examination to determine the nature and etiology of any breathing disorder (polyps in the nose) found to be present, as well as sinusitis/rhinitis. All indicated studies should be performed and all clinical findings reported in detail. The examiner should be asked to review the veteran's service medical records and his post service medical records in conjunction with the current findings and offer an opinion, if possible, as to whether the symptoms noted subsequent to service likely represented a continuation of his symptoms reported during service and whether the inservice symptoms are causally related to his current nasal problems. In accordance with recent Court of Veterans Appeals decisions, the claims folder should be made available to the examining physician for review prior to the examination. 3. After further consideration of the claim, if the decision remains adverse to the veteran, the RO should issue a supplemental statement of the case summarizing the evidence, and law and regulations to the evidence. The RO should afford the veteran 60 days to respond to the supplemental statement of the case before the matter is returned to the Board for final adjudication, if otherwise in order. 38 C.F.R. § 20.302(c) (1993). The purpose of this REMAND is to procure clarifying data. No action is required of the veteran until further notice. N. R. ROBIN 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) (1994).