BVA9505782 DOCKET NO. 93-12 269 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs (VA) Regional Office (RO) in New Orleans, Louisiana THE ISSUES 1. Entitlement to service connection for arthritis of the right shoulder. 2. Entitlement to service connection for a disability manifested by leg and ankle pain. 3. Entitlement to service connection for arthritis of the right knee. 4. Entitlement to service connection for arthritis of the left knee. 5. Entitlement to service connection for asthma. 6. Entitlement to service connection for headaches. 7. Entitlement to an increased rating for diabetes, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. F. Halsey, Counsel INTRODUCTION The veteran served on active duty from March 1970 to July 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 1992 rating decision. Although the veteran's representative submitted a statement dated September 28, 1992, in which numerous issues were identified for appeal, the veteran submitted a substantive appeal and a February 1993 statement that limited the issues to those listed on the title page of this case. At an August 1993 hearing, the limited scope of the appeal was confirmed by the veteran and his representative. Although the question of entitlement to service connection for headaches has previously been characterized as including a claim of service connection for tinnitus, the Board notes that service connection was granted for tinnitus in the March 1992 determination by the RO. Consequently, it is unnecessary to consider the issue of entitlement to service connection for tinnitus. This case was before the Board in June 1993, when it was remanded by letter to the RO so that a hearing could be conducted. A hearing before a member of the Board sitting in New Orleans, Louisiana, was held in August 1993. REMAND The veteran contends that he has asthma that began during his period of military service. His service medical records are replete with entries relating to treatment for allergies and associated rhinitis. Additionally, asthma has been mentioned. A January 1981 entry shows that he was given Ventolin and Theo-Dur for asthma. Pulmonary function was tested in March 1981, and the results were considered normal, except that flow volume loops had the appearance of mild restrictive lung disease. Nevertheless, it was reported that such a finding was not supported by other pulmonary functions. In September and October 1981, asthma was again mentioned. Records dated from January 1982 to October 1982 show that the veteran continued to use Theo-Dur. A specific finding of bilateral expiratory wheezing was noted on October 5, 1982. Spirometric tests done in October 1982, November 1985, and October 1989 were considered normal, yet asthma was still reported as a diagnosis in a March 1989 record. However, in October 1989, a pulmonary consultation report was reviewed and considered within normal limits. It was specifically reported that asthma was controlled. A December 18, 1989, record entry shows that the veteran was using a Proventil inhaler and had a diagnosis of restrictive airways disease. Thereafter, the veteran's service records show that he used a Proventil inhaler. A history of asthma was reported by the veteran when he was examined for retirement in February 1991, but the examination report shows that his lungs were considered normal. The veteran was examined twice by VA after retiring from military service, once in October 1991, when it was noted that he brought up the question of asthma, but had never been treated for it. The second time was in January 1992, when it was reported that he used a Proventil inhaler, but had no evidence of asthma. These examination findings stand in marked contrast to the records prepared during service showing repeated treatment for asthma. They also tend to demonstrate that the examiner(s) either did not have or did not review the veteran's service medical records. Despite the repeated references to asthma during service, it appears odd that pulmonary function testing performed in service was time and again interpreted as being within normal limits. Since service connection may not be granted without some demonstration of current disability due to specific disease or injury, 38 U.S.C.A. §§ 1110, 1131 (West 1991), an attempt must be made to reconcile the absence of findings made on post-service examinations with the clinical impressions reported during service. This requires medical expertise which is beyond the purview of the Board. See Colvin v. Derwinski, 1 Vet.App. 171 (1991). In order to obtain such evidence, the case is REMANDED for the following actions: 1. An examiner with expertise in pulmonary function should be asked to review the claims file, including the veteran's service records, and examine the veteran. Pulmonary function studies and any other tests deemed necessary to arriving at a diagnosis should be conducted. The examiner should provide an opinion as to whether it is at least as likely as not that the veteran has asthma which had its onset during military service. All findings, opinions, and bases therefor should be set forth in detail. 2. The RO should take adjudicatory action based on the entire record. If the claim of service connection for asthma is denied, a supplemental statement of the case should be issued. After the veteran and his representative have been given an opportunity to respond to any supplemental statement of the case, the claims folder should be returned to this Board for further appellate review. No action is required of the veteran until he receives further notice. The purposes of this remand are to procure clarifying data and to comply with governing adjudicative procedures. The Board intimates no opinion, either legal or factual, as to the ultimate disposition of this appeal. (Consideration of the other issues on appeal is deferred pending completion of the development sought in this remand.) M. CHEEK 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).