BVA9503632 
DOCKET NO.  92-23 712     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Winston-Salem,
North Carolina

THE ISSUES

1.  Entitlement to an effective date prior to May 31, 1990 for
the assignment of a 30 percent rating for residuals of a right
shoulder wound involving Muscle Group I with arthritis, to
include the issue of whether rating actions of April and December
1947, which reduced the 30 percent rating to 10 percent, were
based on clear and unmistakable error.

2.  Entitlement to a compensable rating for dermatophytosis of
the hands and feet retroactive to June 1946, to include the issue
of clear and unmistakable error in a June 1946 rating action.

3.  Entitlement to service connection for diabetes mellitus.

4.  Entitlement to service connection for impotence as secondary
to diabetes mellitus.

5.  Entitlement to service connection for peripheral neuropathy
of the lower extremities as secondary to diabetes mellitus.

6.  Entitlement to service connection for a lipoma of the chest.

7.  Entitlement to a compensable rating for dermatophytosis of
the hands and feet.

REPRESENTATION

Appellant represented by: David R. Dowell, Attorney

WITNESSES AT HEARINGS ON APPEAL

Appellant and his wife

ATTORNEY FOR THE BOARD

Thomas A. Pluta, Counsel

INTRODUCTION

The veteran had active service from June 1944 to June 1946.  This
appeal originally arose from an October 1990 rating action of the
Winston-Salem, North Carolina Regional Office (RO) which denied
service connection for diabetes mellitus and an evaluation in
excess of 10 percent for a right shoulder disability.  By rating
action of June 1992, the RO granted a 30 percent rating for the
veteran's right shoulder disability; this constitutes a
substantial grant of the benefit sought on appeal with respect to
that issue.  This appeal also arises from the June 1992 rating
action which denied service connection for impotence and
peripheral neuropathy of the lower extremities as secondary to
diabetes mellitus, and for a lipoma of the chest, and a
compensable rating for dermatophytosis of the hands and feet; and
from a September 1992 hearing officer's decision which denied an
effective date prior to May 31, 1990 for the assignment of a
30 percent rating for the right shoulder disability, and a
compensable rating for dermatophytosis of the hands and feet
retroactive to June 1946.

REMAND

The U.S. Department of Veterans Affairs (VA) has a duty to assist
the veteran in the development of facts pertinent to his claim.
38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993).
The United States Court of Veterans Appeals (Court) has held that
the duty to assist the veteran in obtaining and developing
available facts and evidence to support his claim includes
obtaining adequate VA examinations; the Court also stated that
the Board must make a determination as to the adequacy of the
record.  Littke v. Derwinski, 1 Vet.App. 90 (1990).  Fulfillment
of the statutory duty to assist includes the conduct of a
thorough and contemporaneous medical examination, one which takes
into account the records of prior medical treatment, so that the
evaluation of the claimed disability will be a fully-informed
one.  Green v. Derwinski, 1 Vet.App. 121 (1991).  Appellate
review discloses that the VA dermatologist who evaluated the
veteran's service-connected dermatophytosis in March 1992 did not
have the veteran's claims folder available to him at the time of
the examination and is, therefore, not in compliance with the
dictates of the Green case which demands corrective action..

Moreover, the VA has a 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 conclusion.  Schafrath v. Derwinski,
1 Vet.App. 589 (1991).  These regulations include, but are not
limited to, 38 C.F.R. §§ 4.1 (1994) and 4.2.  Also, 38 C.F.R.
§ 4.10 (1994) 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 etiological, anatomical, pathological, laboratory and
prognostic data required for ordinary medical classification,
full description of the effects of the disability upon the
person's ordinary activity.  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 to enable the VA to
make a more precise evaluation of the level of the disability and
of any changes in the condition.  Schafrath, 1 Vet.App. at 594.
Under the circumstances, we find that additional development is
required, and the case is REMANDED to the RO for the following:

1.  The veteran should be requested to
provide the names and addresses of all
medical providers, if any, where he has
been treated for a skin condition since
1992.  After obtaining the necessary
releases from the veteran the names medical
providers should be contacted and requested
to provide copies of their records of
treatment from the veteran.

2.  The veteran should then be afforded a
special VA dermatology examination to
determine the extent and degree of severity
of his dermatophytosis of the hands and
feet.  Such tests as the examining
physician deems necessary should be
performed.  The claims folder must be made
available to the examining physician prior
to the examination so that he may review
pertinent aspects of the veteran's medical
history, and comment upon the effects of
the disability upon the veteran's ordinary
activity and how it impairs him
functionally.

Following completion of this action, the RO should review the
evidence and determine whether the veteran's claim may now be
granted.  If not, he and his representative should be furnished
an appropriate Supplemental Statement of the Case, and the case
should be returned to the Board for further appellate
consideration.  Appellate consideration of the issues of
entitlement to an effective date prior to May 31, 1990 for the
assignment of a 30 percent rating for residuals of a right
shoulder wound, a compensable rating for dermatophytosis of the
hands and feet retroactive to June 1946, and service connection
for a lipoma of the chest,
diabetes mellitus, and impotence and peripheral neuropathy of the
lower extremities as secondary to diabetes mellitus, is deferred,
pending completion of this REMAND action.

          ______________________________
          C.W. SYMANSKI
          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).