BVA9507776 
DOCKET NO.  93-13 936     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Houston, Texas

THE ISSUE

Entitlement to service connection for impotence secondary to
service-connected absence of the left testicle.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Ronald R. Bosch, Counsel

INTRODUCTION

The veteran served on active duty from April 1948 to February
1954.

This appeal arose from a July 1990 rating decision denying
entitlement to service connection for impotence secondary to
service-connected absence of the left testicle.

REMAND

On file is a December 1990 letter from Larry N. Eckman, M.D., who
reports that testosterone level studies, along with central
nervous system hormones, luteinizing hormone and follicle
stimulating studies revealed that the veteran's testosterone
levels were considered on the low side at 291, and that both
luteinizing hormone and follicle stimulating hormone studies were
markedly elevated indicating testicular failure.  Dr. Eckman
noted that historically the veteran's impotence was associated
with the orchiectomy on the left and studies also indicated
gonadal failure.  Dr. Eckman opined that it appeared that this
was related to the veteran’s traumatic injury in service.

In considering this opinion, and contrary opinions of record, the
Board notes that it has not been determined whether the veteran's
hormonal level, if low, is reflective of primary testicular
failure on a strictly genitourinary basis, or secondary
testicular failure, on an endocrinological basis.  More detailed
expository studies are indicated and would materially assist in
the disposition of the veteran's appeal.

Further development is also warranted in view of the veteran’s
standing request for a hearing.  While the claims folder does
reflect that the veteran in January 1992, requested that a
hearing be deferred, following the deferral period the record
does not reflect that the veteran was ever given an opportunity
to present testimony before a hearing officer.  Accordingly, the
veteran’s desires as to a hearing should be clarified.

Therefore, pursuant to VA's duty to assist the veteran in the
development of facts pertinent to his claim under 38 U.S.C.A. §
5107(a) (West 1991); 38 C.F.R. 3.103(a) (1994), the Board will
not decide the issue certified for appellate review pending a
REMAND of the case to the RO for the following development:

1.  The RO should schedule the veteran for
an examination by an appropriate specialist
(urologist or endocrinologist) to conduct a
prolactin study for the purpose of
determining whether the veteran's right
testicular failure, if present, is primary
(genitourinary) or secondary
(endocrinological) in nature.  All further
indicated necessary studies should be
conducted.  The claims file must be made
available to and reviewed by the examiner
prior to the examination.

2.  The RO should contact the veteran, and
request that he advise VA whether or not he
desires to present hearing testimony.  If
so, a hearing should be scheduled.

3.  After undertaking any development
deemed appropriate in addition to that
specified above, the RO should readjudicate
the issue of entitlement to service
connection for impotence as secondary to
service-connected absence of the left
testicle.  The application of the doctrine
announced in Allen v. Brown, No. 93-245
(U.S. Vet. App. Mar. 17, 1995) must be
considered.

If the benefits requested are not granted to the veteran's
satisfaction, the RO should issue a supplemental statement of the
case including consideration of the criteria under diagnostic
code 7524.  A reasonable period of time for a response should be
afforded.  Thereafter the case should be returned to the Board
for further review, if otherwise in order.  By this REMAND, the
Board intimates no opinion as to any final outcome warranted.  No
action is required of the veteran until he is notified.

          DEREK R. BROWN
          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).