93 Decision Citation: BVA 93-14630

 Y93 

                 BOARD OF VETERANS' APPEALS
                   WASHINGTON, D.C. 20420

DOCKET NO.  92-19 948       )    DATE
                            )
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                          THE ISSUE

Entitlement to an increased rating for the postoperative
residuals of a meniscectomy of the left knee, currently
evaluated as 10 percent disabling.

                       REPRESENTATION

Appellant represented by:  Disabled American Veterans

                   ATTORNEY FOR THE BOARD

Keith W. Allen, Associate Counsel
                        INTRODUCTION

This matter comes before the Board of Veterans' Appeals
(Board) on appeal from November 1990 and January 1991 rating
decisions of the New Haven, Connecticut, Department of
Veterans Affairs (VA) Regional Office (RO), which denied an
increased rating for the postoperative residuals of a
meniscectomy of the left knee.  The veteran's notice of
disagreement was received in January 1991.  The statement of
the case was issued in February 1991.  The substantive
appeal was received in April 1991.  The veteran was
scheduled to appear at a personal hearing before a traveling
member of the Board in October 1992, however, he cancelled
the scheduled hearing by letter received in October 1992,
and requested that the Board proceed on his appeal without
one.  The case was received at the Board later that month
and docketed in November 1992.  The veteran's representative,
Disabled American Veterans, submitted additional written
argument in support of the claim in February 1993.

The veteran had active service from August 1948 to February
1950.

                           REMAND

The veteran's claim is well grounded within the meaning of
38 U.S.C.A. § 5107(a) (West 1991).  That is, the Board finds
that he has presented a claim which is not inherently
implausible.  However, we are not satisfied that all
relevant facts have been properly developed.  We agree with
the veteran's representative that the case must be remanded
since further assistance is required to comply with the duty
to assist mandated by 38 U.S.C.A. § 5107(a) and 38 C.F.R.
§§ 3.103, 3.159 (1992).  The United States Court of Veterans
Appeals has held that the duty to assist the veteran in
developing available facts and evidence to support a claim
includes obtaining all relevant medical evidence and
providing an adequate VA examination.  Littke v. Derwinski,
1 Vet.App. 90 (1990).

Subsequent to a July 1950 VA examination for compensation
purposes, the veteran was granted service connection for the
postoperative residuals of a left knee meniscectomy in a
November 1950 rating decision of the RO.  At that time, a
10 percent evaluation was assigned and has remained
effective ever since.

The veteran was last given a VA examination, for the
disability now on appeal, in July 1955 in conjunction with a
request for an increased evaluation.  In September 1990, the
veteran again requested that his assigned rating of 10
percent be reevaluated based upon the need for VA outpatient
and hospital treatment from January 1989 to November 1990.
A review of the clinical records of treatment from that
period show mostly treatment for disabilities, unrelated to
the subject matter of this appeal; nevertheless, they show
that the left knee was aspirated in September 1990.

In December 1991 and February 1993 statements to the Board,
the veteran's representative requested that the case be
remanded to the RO for a current VA orthopedic examination.
Recognizing that the last VA examination of record was
performed in July 1955, that the clinical record from
September 1990 mentions treatment for the left knee and
because the veteran has complained that his left knee
symptoms have progressively worsened since that time, we are
of the opinion that additional development would be helpful
prior to final appellate disposition.

Accordingly, the case is REMANDED to the RO for the
following action:

         The RO should schedule the veteran for a
         VA orthopedic examination, including
         X-ray studies, to determine the nature
         and extent of the postoperative residuals
         of the left knee meniscectomy.  Care
         should be taken to clearly delineate the
         postoperative residuals associated with
         the veteran's left knee meniscectomy
         versus left knee symptoms or pathology
         resulting from any other disorders
         unrelated to the subject of this appeal.
         The claims folder should be provided to
         the examiner, to permit a review of the
         veteran's medical history, and an opinion
         should be requested as to the current
         status of the veteran's left knee disorder
         and the extent of impairment caused
         thereby.

Following completion of this action, the RO should again
review the claim.  If the claim remains denied, the veteran
and his representative should be provided with an
appropriate supplemental statement of the case and given a
reasonable opportunity to respond thereto.  Then, the case
should be returned to the Board for further appellate
consideration.  The veteran and his representative need take
no action until they are notified.


                 BOARD OF VETERANS' APPEALS
                   WASHINGTON, D.C. 20420

        L. W. TOBIN                   STEPHEN A. JONES

                         J. F. GOUGH

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) (1992).