BVA9400685
DOCKET NO.  92-13 230     )       DATE
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THE ISSUES

1.  Entitlement to service connection for hepatitis C with resultant
cirrhosis of the liver.

2.   Whether new and material evidence has been submitted to reopen a
claim of entitlement to service connection for a heart disorder.

REPRESENTATION

Appellant represented by: The American Legion

ATTORNEY FOR THE BOARD

B. Hoeft, Associate Counsel

INTRODUCTION

The veteran served on active duty from August 1958 to May 1980.

This matter came before the Board of Veterans' Appeals (the Board) on
appeal from an October 1991 rating decision from the Waco, Texas,
Regional Office (RO), which denied entitlement to service connection
for hepatitis C and cirrhosis of the liver and denied entitlement to
service connection for a heart disorder on the grounds that no new and
material evidence had been submitted to warrant reopening of a
previous claim.  A notice of disagreement was received in
December 1991.  A statement of the case was issued in March 1992.
A substantive appeal was received in the same month.  By an April 1992
rating decision, the RO confirmed its prior decision.  A supplemental
statement of the case was also issued in that month.  The case was
received and docketed at the Board in August 1992.

The veteran has been represented by the American Legion.  The case
was referred to that organization in August 1992 and they entered
additional argument in September 1992.

REMAND

The Board has carefully reviewed the veterans' claims file and notes
that the veteran had three back operations in 1980.  The veteran has
alleged that during the first one, in February 1980, he had a
transfusion requiring 8 units of blood.  It is from that blood
transfusion, that the veteran believes he contracted hepatitis C and
the resulting liver damage.

The Board notes that the complete records from the 1980 surgeries are
not contained in the record.  Specifically, there is no information to
verify that the veteran actually had a blood transfusion in 1980.  In
fact, the veteran's attending physician, J. Quintana, M.D., in June
1991, stated that the 1980 blood record was not available for him to
review.

As a result, the Board has determined that additional development is
necessary in order to comply with the Department of Veterans Affairs'
(VA's) duty to assist.  The U.S. Court of Veterans Appeals (the Court)
has held that VA has a duty to assist the veteran in the development
of facts pertinent to his claim, and that this duty includes the
acquisition of pertinent records.  38 U.S.C.A. § 5107(a) (West 1991);
38 C.F.R. § 3.103(a) (1992); Littke v. Derwinski, 1 Vet.App. 90
(1990); Hyder v. Derwinski, 1 Vet. App. 221 (1991).

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

1.  The RO should contact the William Beaumont
Army Medical Center and obtain the complete
hospitalization records for the back operations
in February, October and November 1980,
including history, physical, X-ray reports, lab
reports, consultations, orders, nurses notes,
etc., and other information pertaining to the
veteran's treatment.  Special attention should
be given to any records relating to blood
transfusions and the source of the blood used in
any transfusions.  These records should be
associated with the claims file.

2.  The RO should obtain any outpatient or
inpatient records from VA treatment facilities
reflecting treatment of the veteran's hepatitis
C and cirrhosis since February 1992.  These
records should be associated with the claims
file.

3.  After any necessary releases are obtained
from the veteran, the RO should contact any
other health care providers listed by the
veteran and request that they furnish complete
copies of records pertaining to testing and
treatment of the veteran's hepatitis C and
cirrhosis since separation from service.  These
records should also be associated with the
claims file.

4.  Thereafter, a special VA examination should
be conducted to determine presence or absence,
type, nature and extent of the veteran's
hepatitis and cirrhosis of the liver.  All
indicated tests and studies should be performed.
The claims file must be made available for
review by the examining physician prior to the
examination.  The examining physician should be
asked to offer an opinion concerning the cause
and etiology of any hepatitis or liver damage
found to be present.

5.  Finally, the RO must readjudicate the
veteran's claim for entitlement to service
connection for hepatitis C with resulting
cirrhosis of the liver.

Following completion of these actions and, if the decision remains
unfavorable, the veteran and his representative should be provided
with a supplemental statement of the case and afforded a reasonable
period of time in which to respond.

Thereafter, in accordance with the current appellate procedures, the
case should be returned to the Board for completion of appellate
review.

No action is required of the veteran until further notice is issued.

The issue of whether new and material evidence has been submitted to
warrant reopening of a prior claim of entitlement to service
connection for a heart disorder is deferred until the directives of
this remand are completed.

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

          WILLIAM J. REDDY        JAN DONSBACH

          JOAQUIN AGUAYO-PERELES

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).