BVA9503100 DOCKET NO. 92-23 647 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUE Entitlement to an increased evaluation for residuals of a fractured left clavicle, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD C.A. Skow, Associate Counsel REMAND The appellant served on active duty from August 1954 to August 1956. This matter came before the Board of Veterans' Appeals (the Board) on appeal from a December 1990 rating decision of the San Juan, Puerto Rico, Department of Veterans Affairs Regional Office (VARO). The appellant contends that his service-connected residuals of a fractured left clavicle are of sufficient severity to warrant an increased disability evaluation. He further contends that he retired early due to years of left shoulder pain attributable to his service-connected residuals of a fractured left clavicle. After carefully reviewing the pertinent medical evidence, including the appellant's entire medical history, in accordance with 38 C.F.R. § 4.1 (1993) and Peyton v. Derwinski, 1 Vet.App. 282 (1991), the Board finds that the medical evidence is inadequate for the purpose of determinating entitlement to increased disability evaluation. In addition, the Board notes that the appellant has raised the issue of secondary service connection for other medical conditions. The record reflects that, on the most recent VA examination in November 1990, clinical findings were negative for limitation of motion although pain was reported on flexion and elevation of the left upper extremity. At that time, mild deformity with a healed fracture of the left clavicle was found on an x-ray study along with degenerative changes of the acromioclavicular joint, absent other bone or joint pathology. In a private medical statement dated June 1991, Magin Marquez, M.D., indicated that the appellant was being treated for post-traumatic arthritis of the shoulder resulting from multiple fractures of the clavicle, and that the appellant was unable to work due to the restricted movements of his left shoulder. The Board notes that the report of VA examination dated November 1990 and the private medical statement dated June 1991 are in conflict with respect to whether or not the appellant has limitation of motion, and do not reflect the degrees of excursion of the shoulder in reaching their respective conclusions. Furthermore, in December 1991, a personal hearing was conducted at VARO. The appellant testified that he worked for the police department 21 years and retired early due to severe left shoulder pain caused by his service-connected residuals of a fractured left clavicle; he also argued that he has low back pain, degenerative joint disease, and other disabilities, as secondary to his service-connected residuals of a fractured left clavicle. While no objective evidence has been provided with respect to the reasons for his retirement or his claimed secondary disabilities, we note that these issues have not been developed. In view of the above, the Board finds that the VA has not fully complied with its duty to assist. The duty to assist includes the duty to develop the pertinent facts by conducting a thorough medical examination. Furthermore, where the record before the Board is clearly inadequate, remand is required. See Littke v. Derwinski, 1 Vet.App. 90 (1990). Accordingly, the case is REMANDED to VARO for the following development: 1. The veteran should be afforded a VA orthopedic examination to determine the nature and extent of the appellant's service-connected residuals of a fractured left clavicle. In particular, a range of motion study should be conducted to ascertain the degrees of excursion of shoulder motions, and the results should be recorded with the examiners findings. The degree of deformity of the old fracture and any impairment of function of the shoulder joint should be described. The claims folder should be made available to the examiner for review before the examination. 2. VARO should request from the appellant documentary evidence that sets forth the reasons for his early retirement. 3. VARO should develop and adjudicate all issues raised by the appellant with respect service-connection for low back pain, degenerative joint disease, and other unspecified conditions set out in sworn testimony as secondary to his service- connected residuals of a fractured left clavicle. 4. After the development requested above has been completed to the extent possible, VARO should again review the record. If any benefit sought on appeal, for which a notice of disagreement has been filed, remains denied, the appellant and 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 appellant need take no action unless otherwise notified. KENNETH R. ANDREWS, JR. 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).