BVA9506304 DOCKET NO. 93-13 287 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an increased rating for degenerative joint disease of the cervical spine, currently evaluated as 30 percent disabling. 2. Entitlement to financial assistance in acquiring specially adapted housing or a home adaptation grant. 3. Entitlement to financial assistance in the purchase of an automobile or other conveyance and entitlement to assistance in acquiring adaptive equipment for an automobile or other conveyance. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and his wife ATTORNEY FOR THE BOARD William Harryman, Counsel INTRODUCTION The veteran retired in 1981 after approximately 20 years’ active service. This case came before the Board of Veterans’ Appeals (Board) on appeal from a decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama, in June 1992 which denied the claimed benefits. It appears from statements in the file, that the veteran may wish to continue his appeal with respect to the evaluation assigned for degenerative arthritis of the lumbar spine, despite the April 1993 rating action which implemented assignment of a higher rating for that disability. This should be clarified by the RO, with appropriate action taken. REMAND On review of the claims file, the Board notes that a VA rheumatologist in December 1992 had ordered electromyography and nerve conduction studies to evaluate whether the veteran had any neuropathy. The record does not indicate whether those examinations were carried out. Further, that examiner stated that he questioned the diagnosis of rheumatoid arthritis, and opined that the veteran’s pain complaints exceeded those to be expected from osteoarthritis. The Board believes that additional medical information would be helpful in considering the veteran’s claims, specifically as to whether he, in fact, has rheumatoid arthritis or any neuropathy due to any of his service-connected disabilities, as to whether the degree of disability consistently reported by the veteran is commensurate with the pathology which is now present, and finally as to the degree of impairment attributable to the service- connected cervical and lumbar spine disabilities, and rheumatoid arthritis. It is also clear from the veteran's May 1993 statement and his representative's argument of February 1994 that the appeal is being continued as to the issue of the proper evaluation of the service-connected degenerative joint disease of the cervical spine. Accordingly, this issue should be further developed on appeal. Accordingly, this case is REMANDED for the following actions: 1. The RO should obtain up-to-date copies of the records of treatment for all of the veteran’s service-connected disabilities, especially the results of VA electromyographic and nerve conduction studies ordered in December 1992, if completed. 2. The RO should schedule the veteran for special orthopedic, rheumatologic and neurologic examinations to evaluate his service-connected cervical and lumbar spine disabilities and rheumatoid arthritis of multiple joints. All indicated special studies, including X-rays and electromyographic and nerve conduction studies, if not recently completed, should be accomplished. The veteran’s claims file should be made available to and be reviewed by the examiners prior to their examinations. The examinations should be as complete as possible and should, of course, be conducted in accordance with VA’s PHYSICIAN’S GUIDE FOR DISABILITY EVALUATION EXAMINATIONS, and should include a complete description of the veteran’s complaints, current clinical findings regarding all involved joints and all extremities, and all relevant diagnoses. Each of the examiners should be asked to comment specifically as to the degree of pain reported by the veteran during the various maneuvers required by the examination, as to whether the pain reported was objectively verifiable, and as to whether the degree of pain reported was supported by adequate pathology. Complete range of motion studies of the cervical and lumbar spine, and all extremities should be undertaken. Each of the examiners should also be asked to describe any impairment of function of any of the upper or lower extremities, and comment on the veteran’s ability to ambulate without the aid of braces, crutches, canes or a wheelchair. The neurologic examiner should be requested to render an opinion as to the presence or absence of any verifiable neuropathy and to the severity of any neuropathy found. With respect to any impairment found in any of the upper or lower extremities, the examiners should state whether such impairment is attributable to any service- connected disability or disabilities. 3. Following completion of the requested development, the RO should again consider the veteran’s claims. If action taken remains adverse to him, he and his accredited representative should be furnished a supplemental statement of the case addressing all issues on appeal, and should be given the opportunity to respond. The case should then be returned to the Board for further appellate consideration, if otherwise in order. By this REMAND, the Board intimates no opinion, either legal or factual, as to any final determination warranted in this case. No action is required of the appellant until he is notified by the RO. The purpose of this REMAND is to obtain clarifying information. D. C. SPICKLER 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).