BVA9502545 DOCKET NO. 93-22 519 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUES 1. Entitlement to service connection for hair loss. 2. Entitlement to service connection for a psychiatric disorder as secondary to his service-connected circumcision. 3. Entitlement to service connection for residuals of exposure to hazardous material, including Halon. 4. Entitlement to an increase evaluation for residuals of circumcision, currently rated as 10 percent disabling. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARINGS ON APPEAL Appellant ATTORNEY FOR THE BOARD J. W. Loeb, Counsel INTRODUCTION The veteran served on active duty from March 1987 to January 1992. This case came before the Board of Veterans' Appeals (Board) on appeal of July and August 1992 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in North Little Rock, Arkansas. The veteran's testimony at his personal hearing before a traveling member of the Board sitting at Little Rock, Arkansas, in September 1993, included the additional issue of entitlement to service connection for multiple joint disability, apparently as a result of either being bit by sand fleas or by exposure to hazardous material, such as Halon. REMAND A review of the record reveals that the veteran testified at his Board hearing that he had received psychiatric treatment from a Dr. Kledge at the VA Hospital in Little Rock; however, those records do not appear to be on file. Additionally, the February 1992 VA dermatological examination did not give any opinion as to the likely cause of the veteran's hair loss. Consequently, because further development is necessary prior to final disposition of this case, the case is REMANDED to the RO for the following actions: 1. The veteran should be permitted to submit any additional evidence in his possession that is pertinent to any of the issues on appeal. He should also be asked to provide the names, addresses and approximate dates of treatment of all health care providers, including Dr. Kledge and any other VA providers, who have treated him for hair loss, a psychiatric disorder, residuals of hazardous material, and residuals of a circumcision, since service discharge. He should be asked to fill out any necessary consent forms for the release of his private medical records. The RO should then obtain copies of all indicated records which are not already on file and associate them with the claims folder. 2. The veteran should also be afforded a special dermatological examination by a board certified dermatologist, if available, in accordance with the VA Physician's Guide for Disability Evaluation Examinations, to determine the current nature and severity of any excessive hair loss. All necessary tests and studies should be conducted, and all findings should be reported in detail. If excessive hair loss is diagnosed, the examiner should give an opinion whether it is at least as likely as not that the disorder is causally related to the veteran's service, such as being bitten by sand fleas. The rationale for all opinions expressed should be fully explained. The claims folder must be made available to the examiner for review before examination of the veteran. 3. The veteran should also be afforded a special psychiatric examination by a board certified psychiatrist who has not previously examined him, in accordance with the VA Physician's Guide for Disability Evaluation Examinations, to determine the current nature and severity of any acquired psychiatric disorder. All necessary tests and studies should be conducted, and all findings should be reported in detail. If an acquired psychiatric disorder is diagnosed, the examiner should give an opinion whether it is at least as likely as not that the disorder is causally related to the veteran's service, including his service-connected residuals of a circumcision. The rationale for all opinions expressed should be fully explained. The claims folder must be made available to the examiner for review before examination of the veteran. 4. The veteran should also be afforded a special urological examination by a board certified urologist, if available, in accordance with the VA Physician's Guide for Disability Evaluation Examinations, to determine the current severity of his service-connected circumcision residuals. All necessary tests and studies should be conducted. All findings should be reported in detail and should include a description of the severity of any lesions or disfigurement. Color unretouched photographs of the affected area should be taken and associated with the file. The rationale for all opinions expressed should be fully explained. The claims folder must be made available to the examiner for review before examination of the veteran. 5. The RO should also adjudicate the raised issue of entitlement to service connection for multiple joint disability, which should include performing any necessary development relevant to this issue. 6. Thereafter, the issues on appeal should be readjudicated by the RO. After the above actions have been completed, if any of the issues remains denied, a supplemental statement of the case should be issued to the veteran and his representative and an opportunity should then be afforded the veteran and his representative for a response. If service connection for multiple joint disability is denied, the veteran should be notified and told of his appellate rights. Should he exercise those, the RO should respond accordingly. The case should then be returned to the Board, if otherwise in order. The veteran need take no action until otherwise notified. F. JUDGE FLOWERS 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).