BVA9500016 
DOCKET NO.  93-08 826     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Jackson,
Mississippi

THE ISSUE

Entitlement to an increased rating for service-connected
hemorrhoidectomy with anal fissure, currently rated as 20 percent
disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

A. S. Nemeth, Associate Counsel

INTRODUCTION

The veteran's active service extended from July 1944 to June
1946.

This matter comes before the Board of Veterans' Appeals (Board)
on appeal from the November 1992 rating decision by the
Department of Veterans Affairs (VA) Regional Office (RO) in
Jackson, Mississippi, which denied an increased rating for the
service-connected residuals of a hemorrhoidectomy with anal
fissure, currently rated as 20 percent disabling.  The current
rating has been in effect since November 1985.

REMAND

The veteran claims that he should be granted an increased rating
due to fecal incontinence related to his service-connected
disability.  The claims file presents a long history of the
veteran's complaints of leakage and fecal incontinence.  In a
January 1993 VA examination, the examining physician diagnosed an
external hemorrhoid and decreased rectal sphincter tone secondary
to hemorrhoidectomy with resultant fecal incontinence.  Although
this diagnosis provided an objective finding regarding fecal
incontinence, it did not provide adequate information for ratings
purposes.  Therefore, the RO should afford the veteran an
examination by a VA physician specializing in disorders of the
anus and rectum.

In view of the foregoing, it is the opinion of the Board that
this case should be remanded to the RO for the following
development:

1.  The veteran should be given an
examination by a VA physician specializing
in ano-rectal disorders.  A copy of this
remand and the claims folder must be made
available to and be reviewed by the examiner
prior to the examination.  The report of the
examination should include a detailed
account of all manifestations of the
residuals of a hemorrhoidectomy with anal
fissure found to be present.  The specialist
should specifically examine the veteran for
decreased rectal sphincter tone.  The
physician should discuss the disorder with
the veteran and determine the frequency and
extent of the involuntary bowel movements.
All necessary tests should be conducted.
The examiner should review the results of
any testing prior to the completion of the
report and should provide complete rationale
for all conclusions reached.  The physician
should review all medical records on file
and specifically render an opinion on the
following:

A.  Is the veteran's sphincter
tone consistent with occasional
involuntary bowel movements?

B.  Is the veteran's sphincter
tone consistent with fairly
frequent involuntary bowel
movements?

C.  Is the veteran's sphincter
tone consistent with constant
slight, or occasional moderate
leakage?

D.  Is the veteran's sphincter
tone consistent with extensive
leakage?

E.  Would it be advisable for the
veteran to wear a pad due to
leakage and/or involuntary bowel
movements?

3.  The RO should review the examination
report and
determine if it is adequate for rating
purposes and in compliance with this Remand.
If not, the report should be returned for
corrective action.

Following completion of these actions, the RO should review the
veteran's claim.  If the decision remains unfavorable, the
veteran and his representative should be provided with a
supplemental statement of the case and afforded a reasonable
period of time in which to respond.  Thereafter, the case, in
accordance with the current appellate procedures, should be
returned to the Board for completion of appellate review.

No further action on the part of the veteran is required until
further notice.

          JAN DONSBACH
          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).