BVA9504400 DOCKET NO. 92- 02 052 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Francisco, California THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for residuals of a right arm injury. 2. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for heart disease. 3. Entitlement to service connection for knee and shoulder disorders. 4. Entitlement to an increased evaluation for irritable bowel syndrome, currently evaluated as 10 percent disabling. 5. Entitlement to a total disability evaluation based on individual unemployability due to service connected disabilities. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD L. M. Barnard, Associate Counsel REMAND The veteran served on active duty from August 1935 to December 1937, and from June 1940 to October 1958. He was a prisoner of war from May 1942 to September 1945. The veteran has disagreed with the March 1990 rating decision of the San Francisco, California, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to the benefits sought on appeal. These denials were confirmed and continued by rating actions issued in December 1990 and December 1991. The veteran states that he suffered injuries to his back and knee when the vehicle he was riding in was turned over into a ravine after an explosion that occurred during the fighting on Corregidor. After he was taken prisoner, he stated that he was the victim of various beatings. It was during one of these beatings that his right arm was injured. He further states that the heart condition from which he currently suffers is the direct result of the treatment he received at the hands of his captors. He finally contends that his service connected disabilities have resulted in an inability to maintain employment. Therefore, he asserts that entitlement to the benefits should be granted. In reviewing the record, we were cognizant of the duty of VA to assist the veteran in the development of all facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993). This case was remanded by the Board in August 1992 so that the veteran could provide information as to his outpatient treatment records, and for the veteran to undergo a VA examination. In March 1993, the RO contacted the veteran at 9369 Hoyleton Way, Elk Grove, California, and requested that he provide the name of the physician and the clinic from whom he was receiving treatment. That same month, the RO sent a notice concerning the performance of the VA examination to the same address. The veteran failed to report to the examination. In April 1993, the veteran informed the RO that his new address was 3939 W. Walnut, Apt. 187, Visalia, California. In June 1993, the RO sent another notice scheduling an examination. This notice was sent to 4009 W. Ashland Avenue, Visalia, California. Again, the veteran failed to report to the scheduled examination. While the veteran failed to report to two scheduled VA examinations, the above noted evidence suggests that the veteran may not have received the notices. He provided his correct address, but the second notice was sent elsewhere. Therefore, it is our opinion that he should be given another opportunity to report for an examination. The duty to assist the veteran includes the requirement to conduct VA examinations which are an adequate basis upon which to determine entitlement to the benefits sought. Littke v. Derwinski, 1 Vet.App. 90 (1991). Examinations by specialists should be conducted in those case which present a complicated disability picture. Hyder v. Derwinski, 1 Vet.App. 221 (1991). Moreover, VA has the duty to acknowledge and consider all regulations which are potentially applicable through the assertions and issues raised in the record and to explain the reasons and bases for its conclusions. Schafrath v. Derwinski, 1 Vet.App. 589 (1991). These regulations include, but are not limited to, 38 C.F.R. § 4.1 which requires that each disability be viewed in relation to its history and that there be an emphasis placed upon the limitation of activity imposed by the disabling condition and 38 C.F.R. § 4.2 which requires that medical reports be interpreted in light of the whole recorded history, and that each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.10 provides that in cases of functional impairment, evaluations must be based upon lack of usefulness of the affected part or systems, and medical examiners must furnish, in addition to the etiological, anatomical, pathological, laboratory, and prognostic data required for ordinary medical classification, a description of the effects of the disability upon the person's ordinary activity. 38 C.F.R. § 4.40 requires consideration of functional disability due to pain. These requirements for evaluation of the complete medical history of the claimant's condition operate to protect claimants against adverse decisions based upon a single, incomplete, or inaccurate report and enable VA to make a more precise evaluation of the claimants disability and of any changes in the condition. This full description of the veteran's condition and the effect it has upon his ordinary daily activities has not been made in this case. Under the circumstances of this case, we are of the opinion that additional assistance is necessary, and this case is REMANDED to the RO for the following: 1. The RO should contact the veteran at 3939 W. Walnut, Apt. 187, Visalia, California 93277, and request that he provide the names of the physician and clinic from whom he is receiving outpatient treatment. 2. Copies of the complete VA outpatient records since April 1991 should be obtained from the VA Outpatient Treatment Clinic in Sacromento, California, and associated with the claims file. 3. Copies of any outpatient treatment at the Long Beach VA Medical enter should also be obtained and associated with the claims file. 4. After securing from the veteran a signed authorization for the release of his medical records, copies of any available treatment records should be requested from Lawrence S. Barnett, M.D., 1201 West La Veta Avenue, Suite 503, Orange, California 92668; and Jeffrey E. Barnum, M.D., 8100 Timberlake Way, Sacromento, California 95823, and these should be associated with the claims file. 5. Then, the RO should afford the veteran a general medical examination, to include an orthopedic examination in order to fully evaluate his right arm, shoulder and knee conditions. We specifically note that the notice to report to the examination should be sent to the above-noted address. The orthopedic examiner should provide an opinion as to whether the veteran suffers from shoulder and knee disorders related to trauma sustained as a prisoner of war during World War II. The examiners should render opinions at the effect that the veteran's disabilities have upon his ability to obtain and retain substantially gainful employment. All indicated special studies should be accomplished. The claims folder must be made available to the examiners prior to the examinations so that the veteran's entire history can be taken into consideration. In the event that the veteran's claims remain denied, he and his representative should be provided with an appropriate supplemental statement of the case, and the case should be returned to the Board for further appellate consideration if otherwise in order. SAMUEL W. WARNER 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).