BVA9505039 
DOCKET NO.  92-12 718     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Waco, Texas

THE ISSUES

1.  Entitlement to service connection for weakness of the right
arm.

2. Entitlement to service connection for swelling and weakness of
the right leg.

3.  Entitlement to an increased rating for postoperative coronary
artery disease, currently evaluated as 30 percent disabling.

4.  Entitlement to an increased rating for postoperative
arthritis of the left knee, currently rated as 20 percent
disabling.

5.  Entitlement to an increased rating for lumbosacral spine
arthritis, currently rated as 20 percent disabling.

REPRESENTATION

Appellant represented by: Texas Veterans Commission

ATTORNEY FOR THE BOARD

Heather J. Harner, Associate Counsel

INTRODUCTION

The veteran had active duty from September 1950 to September 1952
and from August 1958 to February 1977.

A review of the claims folder reveals that in a February 1992
rating action, it was noted that the issue of entitlement to
service connection for disability claimed as a result of exposure
to Agent Orange was being deferred pending promulgation of final
regulations by the Department of Veterans Affairs (VA).  In a
statement received after this rating action, the veteran
requested that his "claim be re-opened" and that he be examined
and rated for a skin condition on both legs, secondary to
exposure to Agent Orange.  Subsequently, the VA promulgated
regulations regarding disability related to exposure to Agent
Orange; however, the veteran's claim has not been considered
under these regulations.  Since this issue has not been developed
for appellate consideration and is not inextricably intertwined
with the issues on appeal, it is referred to the regional office
(RO) for appropriate action.

REMAND

In consideration of the veteran's claim for service connection
for right arm and right leg disorders, the Board requested an
opinion through the office of the Acting Director, Medical
Services, VA Central Office.  After review of the veteran's
claims folder, the physician who reviewed the claim indicated
that further testing was needed prior to a determination of
whether the veteran's right arm and right leg disorders are due
to bypass surgery for his service-connected heart disease.

To ensure that the VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the regional office for the following development:

1.        The RO should obtain all records of VA
medical treatment for the claimed
disabilities not contained in the
veteran's claims file for inclusion in
the file.

2.        The RO should obtain the names and
addresses of any private medical care
providers who have treated the veteran
since 1991 for any of the disabilities in
issue.  After securing the necessary
releases, the RO should obtain records of
such treatment for inclusion in the
veteran's claims file.

3.        As a VA Chief Medical Director's opinion
recommended a special neurology
consultation to evaluate the veteran's
disabilities, the veteran should be
afforded a VA neurological examination to
identify and evaluate any weakness and
swelling in the veteran's right arm and
leg.  The claims folder should be made
available to the examiner for review
before the examination.  All appropriate
tests, including the
electromyography/nerve conduction
velocity (EMG/NCV) study recommended in
the medical opinion, should be performed
and all impairment should be reported in
detail.  The examiner should specifically
comment upon whether there is any
discernible relationship between any
weakness of the right arm and leg and the
veteran's previous bypass surgery.  The
rationale for the examiner's opinion
should be expressed as well.

4.        As the United States Court of Veterans
Appeals has recently held that rating
examinations must be sufficiently
contemporaneous to allow the rating
authority to make an informed decision
regarding the veteran's current level of
impairment, the veteran should be
afforded VA cardiovascular and orthopedic
examinations to evaluate his current
level of disability resulting from his
service-connected postoperative coronary
artery disease and arthritis of the left
knee and lumbosacral spine.  Caffrey v.
Brown, 6 Vet.App. 377 (1994).  The claims
folder, including any medical records
obtained pursuant to the above requests,
should be made available to the examiners
for review before the examinations.  All
appropriate tests, including range of
motion studies, and X-ray studies should
be performed and all impairment should be
reported in detail.  The examiners should
describe in detail the level of
impairment caused by the coronary artery
disease and arthritis.

5.        After the development requested above has
been completed to the extent possible,
the RO 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
his representative should be furnished a
supplemental statement of the case and
given the opportunity to respond.

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.

          V. L. JORDAN
          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).