BVA9502804 DOCKET NO. 93-10 828 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to an increased rating for service-connected diabetes mellitus, currently rated as 20 percent disabling. 2. Entitlement to an increased rating for service-connected arteriosclerotic heart disease, currently rated as 30 percent disabling. 3. Whether new and material evidence has been submitted to reopen a claim for service connection for a low back disorder. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Richard E. Coppola, Associate Counsel INTRODUCTION It appears from the evidence that the veteran had several periods of active duty between August 1961 and December 1984. In November 1989, the St. Petersburg, Florida, Department of Veterans Affairs (VA) Regional Office (RO) denied service connection for arthralgia of the thoracic and lumbar spine. The RO also denied service connection for chronic lumbar muscle strain. The RO notified the veteran of the denial by letter dated December 11, 1989. The veteran did not appeal that determination. This matter came before the Board of Veterans' Appeals (Board) on appeal from a rating decision of December 1992 which denied increased ratings for the service-connected disabilities at issue and the claim to reopen service connection for a back disorder. In his notice of disagreement, the veteran appears to raise a claim for an increased rating for his service-connected right knee disorder. In his substantive appeal, he appears to raise a claim for service connection for arthritis of the hands, elbows and lower left hip. These matters are referred to the RO for clarification and any appropriate action. REMAND The veteran maintains that his diabetes has worsened such that he has had to increase his insulin intake and that he has received additional VA treatment of his service-connected disabilities. The evidence includes VA treatment records dated only as recent as January 1992. The veteran also requested that he be afforded a current VA compensation examination of these disorders. The representative argues that the veteran should be afforded a VA examination in order to determine the current nature and severity of the disabilities at issue. In support of the claim to reopen service connection for a back disorder, the representative argues that the veteran's report of medical examination at separation is not currently part of the service medical records. In March 1987, the RO requested the service medical records from the National Personnel Records Center (NPRC). In reply to a request for a copy of the physical examination at discharge, the NPRC indicated in March 1987 that records needed to answer the inquiry were not currently available and that the RO should resubmit its request in 60 days. In light of a March 1987 response from the NPRC, the RO should ascertain whether there are additional service medical records which have not yet been obtained. Under the present circumstances, the Board finds that additional development of the evidence is necessary. Accordingly, the case is REMANDED for the following actions: 1. The RO should ascertain whether there are any additional service medical records which are not currently part of the claims folder, including a copy of any medical examination conducted prior to the veteran's final separation from active duty. If so, the RO should obtain the additional service medical records or certify their unavailability. Any evidence obtained should be made part of the claims folder. 2. The RO should obtain from the veteran the names and address of all medical care providers, VA or otherwise, who treated him for his service-connected diabetes mellitus and arteriosclerotic heart disease since January 1992. After securing any necessary releases, the RO should obtain these records. Any evidence obtained should be made part of the claims folder. 3. The veteran should then be afforded examinations by specialists in orthopedics, endocrinology, and cardiology. The orthopedic examination is to determine the nature and etiology of any low back disorder. The endocrine and cardiovascular examinations are to determine the nature and extent of the veteran's service- connected diabetes mellitus and arteriosclerotic heart disease. The scope of the examinations should be broad enough to cover all diseases, injuries, and residual conditions which are suggested by the veteran's complaints, symptoms or findings at the time of examination. All complaints or symptoms having a medical cause should be covered by a definite diagnosis. The examinations should be conducted in accordance with the Physician's Guide for Disability Evaluation Examinations. The disabilities should be evaluated in relation to their history, with emphasis upon the limitation of activity, to include employability, imposed by the disabling conditions. The physicians must be provided the claims folder prior to the examinations so that they may review historical data contained therein to obtain a true picture of the progress of the disorders. The examinations should include all appropriate diagnostic testing and studies. The examination reports should describe all significant positive findings, particularly those relating to limitation of function. The orthopedic examiner should offer an opinion as to whether any current low back disorder can be dissociated from the findings noted during service in May 1984 of low back pain for approximately 10 years and the assessment of mild degenerative joint disease of the lumbosacral spine. 4. When the above development has been completed, the RO should review the claims folder and ensure that the requested development has been completed. The rating decision should reflect consideration of all potentially applicable criteria, to include consideration of the applicability of 38 C.F.R. § 3.321(b)(1). If the decision remains adverse to the veteran in any way, he and his representative should be furnished with a supplemental statement of the case which summarizes the pertinent evidence, fully cites the applicable legal provisions, and reflects detailed reasons and bases for the decision. They should then be afforded the applicable time period to respond. Thereafter, subject to current appellate procedures, the case should be returned to the Board for further appellate consideration, if appropriate. The veteran need take no action until he is further informed. The purpose of this REMAND is to obtain additional information and to ensure due process of law. No inference should be drawn regarding the final disposition of the claim as a result of this action. GARY L. GICK 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 action has been taken in accordance with the Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and 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).