BVA9504157 
DOCKET NO.  92-13 319     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Montgomery,
Alabama

THE ISSUES

1.  Entitlement to service connection for a chronic right foot
disability.

2.  Entitlement to service connection for a chronic right ankle
disability.

2.  Entitlement to service connection for a chronic right elbow
disability.

3.  Entitlement to service connection for an eye disability, to
include presbyopia, myopia, and astigmatism.

REPRESENTATION

Appellant represented by: Alabama Department of Veterans
Affairs

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

M. Siegel, Counsel

INTRODUCTION

The veteran served on active duty from December 1966 to October
1968, and from February 1972 to July 1990.

This case initially arose from a rating decision of December 1990
from the Montgomery, Alabama, Regional Office (RO).  In that
rating decision, the RO, in pertinent part, denied service
connection for "residuals foot and ankle condition with
metatarsalgia right foot," an eye condition including defective
visual acuity and defective color perception, and for a chronic
elbow condition.  The Board of Veterans' Appeals (Board) remanded
this case by means of a Remand decision dated in February 1993.
In a rating decision dated in March 1994, the Montgomery RO
confirmed and continued its prior denial of service connection
for chronic right foot, right ankle and right elbow disabilities.

While the veteran has indicated disagreement with the RO's
December 1990 denial of service connection for a chronic right
ankle disability, as shown by the notice of disagreement received
in January 1991 and the substantive appeal received in September
1991, the Board notes that the statement of the case and
supplemental statements of the case furnished him and his
representative have not specifically addressed that issue.
Accordingly, that issue is referred to the RO for further action
pursuant to the actions requested below.

REMAND

The veteran contends, in part, that the RO erred when it denied
service connection for right foot and eye disabilities.  He
specifically alleges that he first injured his right foot while
serving in Vietnam, and that it continues to hurt when he stands
on concrete for long periods of time.  He also alleges that he
continues to have "eye trouble" and that as he has "grown older
[his] eyes have gotten worse."

After a review of the record, it is the opinion of the Board that
additional development of the evidence is requisite prior to
further appellate consideration of these issues.  While it is
noted that this case was the subject of a prior Remand decision,
dated in February 1993, it must be pointed out that the Board
requested at that time that the veteran be accorded a Department
of Veterans Affairs (VA) orthopedic evaluation that included an
examination of his right foot, in order to ascertain the nature
and severity of any right foot disability that may currently be
manifested.  The resultant VA examination report, dated in
February 1994, contains only minimal findings with regard to the
veteran's right foot, and does not include any impressions,
findings or diagnoses with regard to the presence of a right foot
disability.  In view of the fact that his service medical records
show persistent treatment for right foot problems, with right
foot metatarsalgia found in 1980, the Board believes that the
report of a comprehensive examination of his right foot would be
of significant probative value.

The Board is also of the opinion that the report of a VA
ophthalmologic examination would be helpful.  A review of the
veteran's service medical records show persistent treatment for
eye problems, and a post service treatment record, dated in April
1992, indicates an assessment of "myopic astigmatism."  The Board
believes that the report of a current ophthalmologic examination,
in which findings are made and opinions rendered as to the nature
of any eye disability, and the possible etiology thereof, would
be probative in determining whether service connection can be
granted for any or all of the eye disorders for which the veteran
is seeking service connection.

The United States Court of Veterans Appeals (Court) has held that
the duty of VA to assist veterans in the development of facts
pertinent to their claims, under 38 U.S.C.A. § 5107(a) (West
1991) and 38 C.F.R. § 3.103(a) (1993), as set forth by the Court
in Littke v. Derwinski, 1 Vet.App. 90 (1990), requires that VA
accomplish additional development of the evidence if the record
currently before it is inadequate.  Accordingly, this claim is
REMANDED for the following:

1.  The RO should request that the veteran
undergo a VA examination of his right foot
by a podiatrist who has not previously
treated or examined him, in order to
ascertain the nature and severity of any
right foot disability that may currently be
manifested.  All tests indicated, to
include radiological studies and range of
motion as measured in degrees, should be
conducted at this time.  The examiner is to
set forth all findings,
and the reasons and bases therefor, in a
clear, compre-hensive, and legible manner
on the examination report.  The claims
folder is to be made available to the
examiner prior to this examination.

2.  The veteran should also be requested to
undergo a comprehensive ophthalmologic
examination, in order to ascertain the
nature, severity, and etiology of any
current eye disability.  All tests
indicated are to be conducted at this time.
The examining ophthalmologist should be
specifically requested to identify all eye
disabilities shown, and to indicate, if
possible, whether such disabilities are
congenital, developmental or acquired in
etiology.  All findings, and the reasons
and bases therefor, should be set forth in
a clear, comprehensive, and legible manner
on the examination report.  The claims
folder is to be made available to the
examiner prior to his or her evaluation.

3.  Following completion of the above, the
RO should again review the veteran's
claims, and determine whether service
connection can now be granted for a chronic
right foot disability, and for an eye
disability, to include presbyopia, myopia,
and astigmatism.  If the decision remains
in whole or in part adverse to the veteran,
he and his representative should be
provided with a supplemental statement of
the case, and with a reasonable opportunity
to respond thereto.  Any supplemental
statement of the case furnished the veteran
and his representative should also include
a discussion of the issue of entitlement to
service connection for a chronic right
ankle disability pursuant to the notice of
disagreement received in January 1991.  The
case should thereafter be returned to the
Board for further review, as appropriate.

(NOTE:  Notwithstanding decisions favorable
to the veteran with regard to the issues of
entitlement to service connection for a
chronic right foot disability, and for an
eye disability, to include presbyopia,
myopia, and astigmatism, the case must be
returned to the Board for review of the
issues of entitlement to service connection
for chronic right ankle and chronic right
elbow disabilities, appellate consideration
of which has been deferred pending
completion of the actions requested in this
REMAND.  In addition, even if all decisions
rendered by the RO in conjunction with this
REMAND are favorable to the veteran, he and
his representative must be furnished with a
supplemental statement of the case with
regard to the issue of entitlement to
service connection for a chronic right
ankle disability, in accordance with the
discussion presented in the INTRODUCTION
section, above.)

The veteran need take no action until he is so informed.  The
purposes of this REMAND are to obtain additional medical evidence
and to ensure compliance with due process considerations.

Appellate review of the issues of entitlement to service
connection for a chronic right ankle disability and a chronic
right elbow disability is deferred, pending completion of the
actions requested in this REMAND.

          U. R. POWELL
          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).