BVA9502342 DOCKET NO. 93-09 735 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUES 1. Entitlement to an increased rating for cervical myelopathy, residual of a cervical injury, with involvement of motor and sensory cervical nerves C4-C8, manifested by pain in the neck, right shoulder and right upper extremity, currently evaluated 40 percent disabling. 2. Entitlement to an increased rating for cervical myelopathy, residual of a cervical injury, with involvement of motor and sensory cervical nerves C4-C8, manifested by pain and limitation of motion of the left shoulder, currently evaluated 20 percent disabling. 3. Entitlement to an increased (compensable) rating for residuals of a left shoulder sprain. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and her husband ATTORNEY FOR THE BOARD William Harryman, Counsel INTRODUCTION The veteran had active service from November 1943 to August 1946. This case came before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania, which denied the veteran increased ratings for each of her service-connected disabilities. During the course of this appeal, the RO granted service connection for headaches as secondary to the service-connected cervical myelopathy, and assigned a 10 percent rating. The record does not reflect that the veteran has expressed any disagreement with the rating assigned for that disability. The Board notes that the veteran, in January 1993, made statements which suggest that she may be intending to claim service connection on a secondary basis for a disorder manifested by anxiety and depression. That issue has not been adjudicated or otherwise developed for appellate review, and so is referred to the RO for appropriate consideration. REMAND On review of the claims folder, it is apparent that symptoms and clinical findings of a neurological nature regarding the veteran’s arms and hands were reported on examination many years ago. However, recent examiners have attributed the veteran’s current hand symptoms to carpal tunnel syndrome. It is unclear whether those recent examiners considered the previously recorded findings when making their diagnoses. Also, a 1992 statement by a private physician indicates that he had treated the veteran from 1956 to 1972, and had referred the veteran to Dr. Eugene Weiss, a neurosurgeon, for diagnosis and treatment. In addition, in her substantive appeal, the veteran stated that she had received treatment from Dr. McAndrew. The record does not contain any records from either physician, only a brief statement by Dr. Weiss dated in 1957. Those records should be obtained, if possible. Accordingly, this case is REMANDED for the following actions: 1. The RO should request that the veteran furnish the names and addresses of all health care providers who have treated or examined her for her service-connected disabilities since separation from service, including the approximate dates of such treatment or examination. After obtaining any necessary releases, the RO should request copies of all previously unobtained medical records for the veteran from all providers indicated by her, especially from Drs. Weiss and McAndrew. All records so obtained should be associated with the claims file. 2. After the above records have been received, the RO should schedule the veteran for special orthopedic and neurological examinations. All indicated special tests should be accomplished. The complete claims folder must be made available to and be thoroughly reviewed by the examiners prior to their examinations. The examiners should provide a complete description of the veteran’s current symptoms and pertinent clinical findings regarding her neck and upper extremity disorders, and should indicate all pertinent diagnoses, as set forth in VA’s Physician’s Guide for Disability Evaluation Examinations. The examiners should, to the extent possible, reconcile any differences in their findings and diagnoses with others noted in the claims file, with particular attention given to records concerning the in-service left shoulder sprain and also to findings and diagnosis regarding the veteran’s arms and hands noted on the report of the June 1957 VA neuropsychiatric examination. In addition, the examiners should be requested to render medical opinions as to precisely what current clinical findings and diagnoses are reasonably related to the neck injury or to the left shoulder sprain sustained by the veteran in service. Complete rationale should be provided for all opinions rendered. 3. Following completion of the requested development, the RO should again consider the veteran’s claims. If action taken remains adverse to her, she and her accredited representative should be furnished a supplemental statement of the case, and should be given a reasonable period of time for response. The case should then be returned to the Board for further appellate review, if otherwise in order. By this action, the Board intimates no opinion, either legal or factual, as to the final outcome warranted in this case. No action is required of the appellant until she is notified by the RO. N. R. ROBIN 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).