BVA9504614 
DOCKET NO.  93-12 524     )       DATE
          )
          )

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

THE ISSUE

Entitlement to an increased rating for the residuals of a left
nephrectomy, currently evaluated as 30 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

A. D. Jackson, Associate Counsel

REMAND

The veteran had active duty from August 1951 until November 1957.

This matter came before the Board of Veterans' Appeals (Board) on
appeal from a rating decision from the Houston, Texas, Regional
Office (RO).  The rating decision dated in March 1992, denied an
increased rating for the residuals of a left nephrectomy.

The veteran contends that he should be granted a higher rating
for the residuals of a left nephrectomy which is manifested by
pain in the right side and frequent urination.  He claims his
right kidney is not functioning properly.  He claims that the RO
did not take into account or properly weigh the evidence of
record, including Department of Veterans Affairs (VA) clinical
evidence and statements submitted in support of the claim.

The veteran's representative has requested that this case be
remanded.  It is noted that the veteran has indicated in a letter
dated in September 1993 that he is scheduled for a renal
consultation at a VA medical center in San Antonio, Texas.  The
veteran indicated that this was requested by a VA physician.  The
veteran further noted that he is receiving treatment from his
private physician in Dallas, Texas.  Treatment records from both
VA facilities and the veteran's private physician are needed for
proper adjudication of this claim.

It is further noted that effective February 17, 1994 the rating
criteria for this disability changed slightly, and may have an
impact on this appeal.  In light of this and the treatment
records noted above, further VA examination is required.

The veteran raised the issue of service connection for
hypertension as secondary to the residuals of a left nephrectomy
at his personal hearing in November 1992.  A rating decision
dated in February 1993 denied service connection for hypertension
however, it not clear from the record that the veteran was
notified.  The veteran's representative has requested that this
issue be developed for appellate review and the Board interprets
the representative's October 1993 statement to represent a notice
of disagreement to the rating action denying service connection
for hypertension .

To ensure that the VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the RO for the following development:

1.  The RO should obtain through
appropriate procedures, the records of Dr.
George Kakaska of Dallas Texas, referred to
in the veteran's September 1993
correspondence.

2.  The RO should initiate appropriate
efforts to secure any additional VA
treatment records developed at the VA
facility in San Antonio and elsewhere, if
applicable, pertaining to his kidney
disorder.

3.  The veteran should be afforded a VA
urologic examination to determine the
extent and severity of the veteran's
service connected kidney disability.  The
examiner should also determine whether or
not the veteran manifests hypertension, and
if this can be reasonably related to his
kidney disability.  The claims folder
should be made available to the examiner
for review before the examination and any
tests deemed appropriate accomplished.

4.  After the development requested above
has been completed to the extent possible,
the RO should again review the record.  If
any benefit sought on appeal, for which a
notice of disagreement has been filed,
remains denied, the appellant and
representative should be furnished a
supplemental statement of the case and
given the opportunity to respond thereto.

Thereafter, the case should be returned to the Board, if in
order.  The Board intimates no opinion as to the ultimate outcome
of this case.  The appellant need take no action unless otherwise
notified.

          E. W. SEERY
          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).