BVA9504464 DOCKET NO. 93-07 240 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Albuquerque, New Mexico THE ISSUE Entitlement to specially adaptive housing or a special home adaptation grant. REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. ATTORNEY FOR THE BOARD Thomas C. Taylor, Associate Counsel INTRODUCTION The veteran served on active duty from December 1969 to September 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a December 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) which denied the veteran entitlement to specially adaptive housing or a special home adaptation grant. REMAND By a decision dated in January 1972, the RO granted service connection for Guillain-Barré polyneuritis, and assigned the veteran a 10 percent disability rating. The RO, by decision in October 1991, increased the schedular disability rating to 100 percent, and assigned him an additional allowance on account of being so helpless as to be in need of regular aid and attendance. The RO denied the veteran's request for a entitlement to specially adaptive housing or a special home adaptation grant by rating decision in December 1991 on the basis that his disability had not been established as static or permanent in nature. The Board finds that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107. He reports that he does not have enough strength in his lower extremities to stand, much less walk, and that he is only able to get around with the assistance of a wheelchair. A certificate of eligibility for assistance in acquiring specially adapted housing may be extended to a veteran if the following requirements are met: (a) The veteran has active military, naval or air service after April 20, 1898; (b) The disability must have been incurred or aggravated as the result of service as indicated in paragraph (a) and the veteran must be entitled to compensation for permanent and total disability due to: (1) The loss, or loss of use, of both lower extremities, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair, or (2) Blindness in both eyes, having only light perception, plus the anatomical loss or loss of use of one lower extremity, or (3) The loss or loss of use of one lower extremity together with residuals of organic disease or injury which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. (4) The loss or loss of use of one lower extremity together with the loss of loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. (c) This assistance will not be available to any veteran more than once. (d) The term "preclude locomotion" means the necessity for regular and constant use of a wheelchair, braces, crutches or canes as a normal mode of locomotion although occasional locomotion by other methods may be possible. 38 U.S.C.A.§ 2101(a) (West 1991); 38 C.F.R.§ 3.809 (1993). A certificate of eligibility for assistance in acquiring necessary special home adaptations, or, on or after October 28, 1986, for assistance in acquiring a residence already adapted with necessary special features, under 38 U.S.C. 2101(b) may be issued to a veteran who served after April 20, 1898, if the following requirements are met: (a) The veteran is not entitled to a certificate of eligibility for assistance in acquiring specially adapted housing under § 3.809 nor had the veteran previously received assistance in acquiring specially adapted housing under 38 U.S.C. 2101(a). A veteran who first establishes entitlement under this section and who later becomes eligible for a certificate of eligibility under § 3.809 may be issued a certificate of eligibility under § 3.809. However, no particular type of adaptation, improvement, or structural alteration may be provided to a veteran more than once. (b) The veteran is entitled to compensation for permanent and total disability which (1) is due to blindness in both eyes with 5/200 visual acuity or less, or (2) includes the anatomical loss or loss of use of both hands. (c) The assistance referred to in this section will not be available to any veteran more than once. 38 U.S.C.A.§ 2101(b); 38 C.F.R. § 3.809a. The record establishes that the veteran has the requisite service, is currently 100 percent disabled for a service connected disability, and such disability requires the use of a wheelchair. In this particular case, the question of entitlement to specially adaptive housing or a special home adaptation grant turns solely on whether or not veteran's disability is permanent. This requires contemplation of medical evidence. Where the issue is factual in nature, e.g., whether an incident occurred during service or whether a clinical symptom is present, competent lay testimony may constitute evidence. See Cartright v. Derwinski, 2 Vet.App 24 (1991). However, where the determinative issue involves medical causation or a medical diagnosis, competent medical evidence is required. Grottveit v. Brown, 5 Vet.App. 91 (1993). A VA medical evaluation report, dated in September 1991, includes the clinical impression that veteran is "recovering from acute Guillain-Barre." He argues that, although he is improving, his disability nevertheless remains essentially permanent. In order to adjudicated this claim, clarification of the medical assessment of the permanency of appellant's symptoms is required. In this regard, the record reflects that, at the time of the October 1991 rating decision, a future VA medical examination was scheduled by the RO for September 1993. The report of that VA medical examination, if held, is not of record. When, during the course of review the Board determines that further evidence or clarification of the evidence or correction of a procedural defect is essential for a proper appellate decision, the Board shall remand the case to the agency of original jurisdiction, specifying the action to be undertaken. 38 C.F.R. § 19.9. Where the record before the Board is inadequate to render a fully informed decision, a remand to the RO is required in order to fulfill the statutory duty to assist. Ascherl v. Brown, 4 Vet.App. 371, 377 (1993). In order to fulfill its statutory duty to assist the veteran and adequately develop his claim, the case is REMANDED to the RO for the following actions: 1. The RO should obtain for inclusion in the claims folder the report of the September 1993 VA medical examination, if it was in fact held. 2. In any event, the RO should schedule the veteran for a VA neurological examination in order to evaluate the nature and extent of all symptoms associated with his Guillain-Barré syndrome. The complete claims folder should be made available to the examining physician for review in conjunction with the evaluation. The examiner should be requested to review the entire record and provide an opinion as to the status of the veteran's service- connected Guillain-Barré syndrome and the permanence of the symptoms relative thereto, i.e., whether they permanently preclude locomotion without the aid of braces, canes, crutches, or a wheelchair. The examiner should identify the information on which the opinion is based. If a medical opinion in this regard is impossible to formulate, the examiner should so indicate. 3. Then, the RO should readjudicate the claim in light of all the evidence, including that obtained pursuant to the requested development. If the benefit sought on appeal remains denied and the veteran continues to disagree with the decision of the RO, he and his representative should be furnished a Supplemental Statement of the Case, and provided an opportunity to respond thereto. The RO should then return the case to the Board for further consideration. In taking this action, the Board implies no conclusion, either legal or factual, as to any ultimate outcome warranted. No action is required of the veteran until he is notified by the RO. J. F. GOUGH 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).