BVA9505559 
DOCKET NO.  93-12 855     )       DATE
          )
          )

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

THE ISSUES

1.  Entitlement to an increased (compensable) disability rating
for pseudofolliculitis barbae.

2.  Entitlement to service connection for bilateral hearing loss.

3.  Entitlement to service connection for hypertrophic
degenerative joint disease of the knees and hips.

ATTORNEY FOR THE BOARD

Darryl A. Joe, Associate Counsel

INTRODUCTION

The veteran had active military service from August 1965 to May
1989.

This matter came before the Board of Veterans' Appeals (the
Board) on appeal from a rating action of March 1992 by the
Manila, Philippines Regional Office (RO) of the Department of
Veterans Affairs (VA), which, in relevant part, granted service
connection for pseudofolliculitis barbae and assigned a
noncompensable rating to that disorder, and denied the veteran's
claims seeking service connection for bilateral sensorineural
hearing loss and hypertrophic degenerative joint disease of the
knees and hips.  The veteran filed a notice of disagreement with
that rating decision in June 1992.  His substantive appeal was
filed in July 1992.  Thereafter, in September 1992, the veteran
requested that his claims folder be transferred from the Manila
RO to the Montgomery, Alabama RO.  In a subsequent rating action
in March 1993, following the transfer of the veteran's records,
the RO confirmed and continued the prior rating action.

The Board also acknowledges that in his notice of disagreement,
the veteran raised a claim for service connection for
hypertrophic degenerative disease of the ankles.  This issue was
not adjudicated by the RO and is not before the Board for
appellate review.  It is referred to the RO for appropriate
consideration.

The issue of service connection for bilateral sensorineural
hearing loss will be deferred pending completion of the
development below.

REMAND

In various statements filed with VA, the veteran has argued that
a VA examination performed in January 1992 was inadequate for
rating his pseudofolliculitis barbae, since he was wearing a
beard at the time of the examination, and the lesions beneath the
beard were not readily apparent to the examiner.  A photograph
taken on the occasion of the 1992 VA examination confirms that
the veteran was wearing a beard at that time.  In view of the
veteran's contentions regarding the adequacy of the examination,
as well as the significant period of time which has passed since
he was last examined by the VA in January 1992, the Board
concludes that he should be accorded another VA examination, in
accordance with the VA's duty to assist the veteran in the
development of facts pertinent to his claim.

Regarding the issue of service connection for hypertrophic
degenerative joint disease of the knees and hips, we observe that
review of the veteran's service medical records shows that he was
diagnosed as having rheumatoid arthritis, and he is now service
connected for rheumatoid arthritis of the left elbow and hand.
His discharge examination in May 1989 included findings of
generalized arthritic changes of the elbows, knees, and fingers
and a diagnosis of rheumatoid arthritis was made.  The VA
examination in January 1992 led to diagnoses of osteoarthritis of
both hips and degenerative joint disease of both knees.  However,
the report of the 1992 VA examination provides no conclusive
findings regarding the origin of the degenerative arthritis of
the knees and hips.  In view of the clinical data currently of
record, it is important to clarify the exact nature of the
veteran's knee and hip disabilities in order to ascertain if the
changes seen in those areas is due to any process which may be
related to service.

In light of the above, further appellate consideration will be
deferred and this case is REMANDED to the RO for the following:

1.  In the event the veteran has received
recent private and/or military or VA
treatment for any of the disorders
described above, up-to-date records of
such treatment should be secured and made
a part of the claims folder.

2.  The veteran should be scheduled for a
special dermatology examination to
establish the current severity of
pseudofolliculitis barbae.  All indicated
studies should be performed and all
clinical findings should be reported in
detail.  If the veteran presents for
examination wearing a beard, the examiner
should determine whether a thorough
examination for possible lesions, or other
skin pathology, beneath the beard can be
accomplished without requiring the veteran
to shave.  The veteran's claims folder
should be made available to the examiner
prior to the examiner.

3.  The veteran should also be scheduled
for special rheumatology and orthopedic
examinations.  All indicated studies
should be performed and clinical findings
reported in conformity with the
Physician's Guide for Disability
Evaluation Examinations.  The
rheumatologist should report clinical
findings regarding any manifestations of
rheumatoid arthritis now present in any
joint.  The orthopedic examiner should
particularly examine the joints of the
lower extremities and describe any
manifestations of disability, including
arthritic changes, involving those joints.
X-rays should be ordered as appropriate.
If arthritic changes are found, the nature
and likely etiology of such changes should
be described, including whether it is
likely that they are part of a systemic
process and whether there is any
relationship of them to the joint
manifestations noted in service.  The
veteran's claims folder should be made
available to the examiners prior to the
examination.

When the requested development has been completed, the RO should
review the veteran's claims.  If any issues on appeal remain
denied, the veteran should be issued a supplemental statement of
the case and afforded the requisite 60 days within which to
respond.  38 C.F.R. § 20.302(c) (1994).  Thereafter, subject to
current appellate procedure, the veteran's claims should be
returned to the Board for further appellate consideration, if in
order.

The purpose of this REMAND is to further develop the record.  By
this action, the Board intimates no opinion as to the ultimate
determination warranted on the issues on appeal.  No action is
required of the veteran until he is contacted.

          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).