BVA9507939 
DOCKET NO.  93-17 198     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUE

Restoration of a 30 percent rating for sinusitis

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

R. T. Jones, Counsel

INTRODUCTION

The veteran served on active duty from August 1942 to January
1946.

This matter comes to the Board of Veterans' Appeals (Board) on
appeal of a June 1992 rating decision of the St. Petersburg,
Florida, Regional Office (RO) of the Department of Veterans
Affairs (VA), which reduced the evaluation for sinusitis from 30
to 10 percent.

REMAND

The VA has a duty to assist the veteran in developing facts
pertinent to claims.  38 U.S.C.A. § 5107(a)(West 1991); 38 C.F.R.
§§ 3.103(a), 3.159 (1994).  This duty includes obtaining all
private and governmental records, and, when indicated by the
circumstances of the case, ordering a medical examination.  Murphy
v. Derwinski, 1 Vet.App. 78 (1990); Littke v. Derwinski, 1
Vet.App. 90 (1990).

The veteran's representative has requested a remand to obtain
pertinent treatment records from a private physician.

Furthermore, the RO, when reducing the evaluation of the
veteran's sinusitis, did not consider the provisions of 38 C.F.R.
§ 3.344, pertaining to special considerations in a case of a
reduction of a disability evaluation that has been in effect for
5 or more years.   In Brown v. Brown, 5 Vet.App. 413 (1993), the
United States Court of Veterans Appeals (Court) essentially held
the RO and the VA must do the following:  (1) review the entire
record of examinations and the medical-industrial history to
ascertain whether the recent examination is full and complete;
(2) not use examinations less full and complete than those on
which payments were authorized or continued as a basis of
reduction; (3) ratings on account of diseases subject to
temporary and episodic improvement will not be reduced on any one
examination, except in those instances where all the evidence of
record clearly warrants the conclusion that sustained improvement
has been demonstrated; and (4) although material improvement in
the physical or mental condition is clearly reflected, the rating
agency will consider whether the evidence makes it reasonably
certain that the improvement will be maintained under the
ordinary conditions of life.  38 C.F.R. § 3.344(a).

On the basis of the foregoing, the case is remanded to the RO for
the following actions:

1.  The RO should ask the veteran to
identify (names, addresses, dates) all
other sources of medical treatment for
sinusitis since 1991; after obtaining the
necessary authorization(s), the RO should
obtain the related records (specifically
including treatment records from Michael D.
Romano, M.D., in Pompano Beach, Florida),
in accordance with 38 C.F.R. § 3.159.  All
records obtained should be associated with
the appellate record.

2.  After the foregoing has been completed
to the extent possible, a special VA ears,
nose, throat (ENT) examination should be
conducted to determine the nature and
extent of the veteran's sinusitis.  The
examination should be conducted in
accordance with the VA's Physician's Guide
for Disability Evaluation Examinations and
should include all indicated studies.  The
claims file must be made available to the
examiner for study prior to the examination
to provide him/her with as accurate a
history of the veteran's sinus disorder as
possible.

3.  Thereafter, the RO should review the
veteran's claim for restoration of a 30
percent rating for sinusitis.  The review
must include consideration of the
provisions of 38 C.F.R. § 3.344.

If, after RO review, the decision remains adverse to the veteran,
a supplemental statement of the case, which includes the
provisions of 38 C.F.R. § 3.344 should be issued and the veteran
and his representative afforded an opportunity to respond.
Thereafter, the case should be returned to the Board for
appellate review.

          THOMAS J. DANNAHER
          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) (1994).