BVA9504306 DOCKET NO. 93-08 059 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUES 1. Entitlement to service connection for bilateral hearing loss disability. 2. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for residuals of a right knee injury. 3. Entitlement to an increased (compensable) evaluation for myositis, mild, lower dorsal region. 4. Entitlement to an increased rating for traumatic arthritis, right hand, residuals of fractures of the radius and ulna, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD K. Ehrman, Associate Counsel INTRODUCTION The veteran had active duty from January 1942 to December 1945. The appeal comes before the Board of Veterans' Appeals (Board) from rating decisions of the Chicago, Illinois, Regional Office (RO), dated in September 1991 and September 1992. The September 1991 rating decision denied claims for entitlement to service connection for bilateral hearing loss disability, and entitlement to an increased (compensable) evaluation for service-connected myositis, mild, lower dorsal region. That determination also held that new and material evidence had not been received to reopen a claim for entitlement to service connection for residuals of a right knee injury. The RO separately denied service connection for arthritis of the right knee. Additionally, the veteran has appealed the September 1992 rating decision that denied the claim for entitlement to an increased rating for traumatic arthritis, right wrist, residuals of fractures of the radius and ulna, currently evaluated as 10 percent disabling. REMAND The Board initially notes that the September 1991 rating decision denied a claim for entitlement to service connection for degenerative joint disease, lumbar spine, with scoliosis of the thoracic and lumbar spine, and with ankylosing spondylitis and degenerative arthritis of the thoracic spine. Notice of disagreement with regard to that determination was given by the veteran's May 1992 VA Form 1-9. However, that additional issue has not been developed for appeal by the RO. The Board is of the opinion that, consistent with 38 C.F.R. § 19.29(c) (1993), a statement of the case must be issued with regard to the claim for entitlement to service connection for degenerative joint disease, lumbar spine, with scoliosis of the thoracic and lumbar spine, and with ankylosing spondylitis and degenerative arthritis of the thoracic spine. Furthermore, the Board considers that issue to be inextricably intertwined with the issue of entitlement to an increased (compensable) evaluation for myositis, mild, lower dorsal region. Upon review of the veteran's claims file, the Board finds that additional treatment records may exist that have not been obtained by the RO and associated with the veteran's claims file. The veteran indicated in his May 1992 VA Form 1-9 that since 1981 he has been receiving Social Security disability benefits due to a back disorder. The Board is of the opinion that the RO should attempt to obtain copies of any additional treatment records regarding the award of Social Security disability benefits, and these records should be used in the evaluation of the veteran's claims. The veteran has also claimed treatment from Dr. R. Hayner regarding a back disability, with "pinching [of] the nerves," and the veteran's May 1992 VA Form 1-9 indicates that he can substantiate his claims with records from local hospitals and doctors. In September 1991, the RO received some additional evidence in support of the veteran's claims, including a March 1992 medical statement of Dr. R. Hayner, and reports from the Memorial Medical Center, of Springfield, Illinois. Additionally, an August 1992 VA examination of the veteran's right hand disability revealed several surgeries for carpal tunnel syndrome, bilaterally. Records regarding those surgeries are not contained in the claims file. Accordingly, the Board is of the opinion that the RO should attempt to obtain copies of any additional treatment records from Dr. R. Hayner, the Memorial Medical Center, and any other additional treatment records, including records regarding treatment received by the veteran for carpal tunnel syndrome. The Board additionally finds that the August 1992 VA neurologic and orthopedic examinations were inadequate for determining current impairment resulting from the veteran's service-connected traumatic arthritis, right hand, residuals of fractures of the radius and ulna, currently evaluated as 10 percent disabling. The neurologic examination report primarily contains findings regarding the veteran's left hand, any impairment of which is not relevant to the issue on appeal. The orthopedic examiner properly focused on impairment of the service connected right hand disability, but a specific request was made for a neurologic examination to determine the severity and etiology of any right hand numbness. The Board is unable to determine whether this additional requested development was completed. Whether there was left-right confusion on the part of an examiner is unclear. Regardless, the etiology of that disorder has not been determined, and any relationship to service connected disability was not ascertained. Finally, the orthopedic examiner ordered X- rays of the veteran's right hand, but X-ray reports were not associated with the veteran's claims file. Although service connection had previously been denied for residuals of right knee injury, service connection for right knee arthritis was only recently denied. The later denial is not subject to finality and is a new claim. Under the circumstances, the case is REMANDED for the following: 1. The RO should obtain the names and addresses of all medical care providers who treated the veteran for any disability of the back, right knee, right wrist, and hearing loss, since his separation from service in December 1945. The RO should also obtain the names and addresses of all medical care providers who recently treated the veteran for carpal tunnel syndrome of the right wrist. After securing the necessary releases, the RO should obtain these records, including any additional records from Dr. R. Hayner, and the Memorial Medical Center, of Springfield, Illinois, 62781, regarding the treatment of the veteran. 2. The RO should obtain from the Social Security Administration records pertinent to the appellant's claim for Social Security disability benefits as well as the medical records relied upon concerning that claim. 3. The veteran should be afforded VA orthopedic and neurologic examinations of his back and right wrist disabilities. The claims folder should be made available to the examiner for review before the examination. A determination should be made with regard to whether the veteran's service connected right wrist disability includes any neurologic involvement, and a determina- tion should also be made as to the etiology of carpal tunnel syndrome, if found, with an indication of any relationship to service-connected disability. The examination of the veteran's back should specifically include a determination as to whether service-connected myositis is currently active, and whether the veteran has any other back disorder, including degenerative joint disease, lumbar spine, scoliosis of the thoracic and lumbar spine, and ankylosing spondylitis and degenerative arthritis of the thoracic spine, or any neurologic deficit of the back. A determination should also be made as to the etiology of all disorders found, and any relationship to service-connected myositis disability. The examiner should also state whether there is any impairment due to myositis. The examiner should indicate whether the scoliosis is of acquired origin or whether it is a congenital or developmental defect. 4. Thereafter, the RO should readjudicate the issues of: Entitlement to service connection for bilateral hearing loss disability; whether new and material evidence has been received to reopen a claim for entitlement to service connection for residuals of a right knee injury; entitlement to an increased (compensable) evaluation for myositis, mild, lower dorsal region; and entitlement to an increased rating for traumatic arthritis, right hand, residuals of fractures of the radius and ulna, currently evaluated as 10 percent disabling. 5. The RO is to develop for appeal the issue of entitlement to service connection for degenerative joint disease, lumbar spine, scoliosis of the thoracic and lumbar spine, and ankylosing spondylitis and degenerative arthritis of the thoracic spine, and service connection for right knee arthritis. 6. The veteran is to be informed that he is under a duty to submit evidence of a well grounded claim for service connection for arthritis of the right knee and arthritis of the spine. The best record would be evidence demonstrating the presence of the disabilities during service or attributing the disabilities to service. Such evidence should be competent evidence. 7. The veteran and his representative are to be informed that if there is an intent to appeal any new issue, including the service connection issue, a properly completed substantive appeal must be submitted. 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. The Board reserves the right to dismiss any claim that is not well grounded or has not been properly completed. H. N. SCHWARTZ 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).