BVA9501628 
DOCKET NO.  93-09 372     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in New York, New
York

THE ISSUE

Entitlement to an increased rating for left knee disability,
currently evaluated as 20 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Constance C. Hickey, Associate Counsel

INTRODUCTION

The veteran had active service from December 1948 to December
1954.

This appeal to the Board of Veterans' Appeals (Board) arises from
the August 1992 rating decision of the Department of Veterans
Affairs (VA) Regional Office (RO) New York, New York which
granted an increased rating of 20 percent for left knee
disability.

While it is not clear, the veteran's comments in his notice of
disagreement and substantive appeal suggest that he may be
raising a claim of service connection for a right knee disability
as secondary to his service-connected left knee disability.  The
RO should thus seek clarification from the veteran regarding
whether he wishes to pursue such a claim and, if so, take
appropriate action.

REMAND

In his substantive appeal the veteran twice made statements to
the effect that he needs a left knee replacement.  His statements
suggest that consideration of or recommendation for such a
procedure is noted in VA medical records and his comments further
suggest the possibility that there may be additional records
pertaining to VA treatment more recent than that already
documented in the record.  In view of the veteran's statements,
the Board finds that additional development should be undertaken
to ensure that all relevant evidence is obtained for review.

Since the Board's appellate review must be deferred pending the
development noted above, additional examination of the veteran's
left knee should also be conducted to ensure that the record
contains the report of a contemporaneous examination of the
veteran's service-connected disability once the case is returned
to the Board for further appellate review, if in order.  See
Caffrey v. Brown, 6 Vet.App. 377 (1994).

Accordingly, to ensure that the VA has met its duty to assist the
veteran in developing the facts pertinent to his claim, the case
is REMANDED to the RO for the following actions:

1.  The veteran should be specifically
asked to state whether any physician has
advised him that he may need left knee
replacement surgery and, if so, when he was
advised regarding this and by whom.

2.  The RO should obtain any clinical
records which may be available in light of
the response received from the veteran
pursuant to the above action.

3.  The RO should also obtain all current
VA medical records pertaining to treatment
of his service-connected left knee
disability.  All additional  medical
records received should be placed in the
claims folder for review.

4.  Thereafter, the veteran should be
afforded a VA orthopedic examination to
evaluate the current status of his service-
connected left knee disability.  All
indicated special studies or tests should
be accomplished.  The claims folder should
be made available to the examiner for
review before the examination.

5.  After the development requested above
has been completed, the RO should again
consider the veteran's claim on the basis
of all pertinent evidence of record.  If
the determination remains adverse to him,
the veteran and his 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 veteran need take no action until notified.

          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) (1993).