BVA9405128
DOCKET NO.  92-14 259     )       DATE
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THE ISSUES

1.  Increased rating for duodenal ulcer disease, currently evaluated
as 10 percent disabling.

2.  Increased (compensable) rating for hemorrhoids.

3.  Service connection for headaches.

4.  Service connection for an acquired psychiatric disorder.

5.  Service connection for a back disorder.

6.  Service connection for hypertension.

REPRESENTATION

Appellant represented by: AMVETS

WITNESSES AT HEARING ON APPEAL

 Appellant and appellant's spouse

ATTORNEY FOR THE BOARD

William L. Pine, Counsel

INTRODUCTION

The appellant stated in March 1992 that he cannot work or perform
certain other activities because of ulcer pain.  The Louisville,
Kentucky, regional office should clarify whether the appellant is
raising a claim for a total disability rating based on individual
unemployability, and take appropriate action.

REMAND

The appellant avers that his service-connected hemorrhoids and his
service-connected duodenal ulcer have become more disabling since his
August 1990 VA examination.  He asserts, and the Board agrees, that a
more current examination is necessary to fairly adjudicate his claim.

The appellant also avers that service hospital clinical records from
March to April 1972 would reveal psychiatric treatment that is not
reported in the discharge summaries.  The appellant's representative
asserts that the appellant should be provided an opportunity to
complete VA Form 21-4176, Report of Accidental Injury in Support of
Claim for Compensation or Pension, regarding alleged head and back
injuries relevant to his claims for headache and back disorders.  The
Board feels that there is a relative paucity of service medical
records in the claims folder for a veteran of 20 years service.  We
note that certain clinical records were previously requested by the
regional office, but nothing on the form returned from National
Personnel Records Center indicates that it was a response to the
request.  Where the service department or the government may be the
custodian of records alleged to be relevant to a disability claim,
special efforts should be made to obtain those records.  See Jolley
v. Derwinski, 1 Vet.App. 37 (1991).

If any additional service records that are obtained reveal the
alleged psychiatric treatment, back or head injuries, then relevant
neurologic, orthopedic, or psychiatric examinations would be in
order.  38 C.F.R. § 3.326 (1993).

In his claim for disability benefits (VA Form 21-526), the appellant
listed three health care practitioners as having treated him over the
years.  Records from only one of them have been sought.  Records from
the other practitioners should be obtained, if possible.

Accordingly, the case is REMANDED for the following:

1.  Request the appellant to complete VA Form(s)
21-4176, Report of Accidental Injury, as to any
head or back injury alleged to have occurred in
service.

2.  Repeat the request for all available service
medical records, including clinical records from
Portsmouth Naval Hospital from March 4, 1972, to
March 31, 1972, and from Bethesda Naval Hospital
from March 31, 1972,  to April 4, 1972, see M21-
1, Part III,  4.01(h)(4)(i) (Oct. 6, 1993), and
any ships records indicated by the appellant's
response to VAF 21-4176.  See M21-1, Part III,
Addendum D (Oct. 6, 1993).  Add any records
obtained to the claims folder.

3.  Request the appellant to provide
authorization for release of information and
request private medical records from Hode
Hensley, Warfield, Kentucky, and Debrah Lovejoy,
Lovely, Kentucky 41321, as authorized by the
appellant.  Add any records obtained to the
claims folder.

4.  Schedule the appellant for VA examinations
to determine the current status of hemorrhoids,
internal and external, and of duodenal ulcer
disease, and for any other examinations, i.e.,
neurologic, orthopedic, or psychiatric,
indicated as warranted by any service or private
medical records obtained in the course of the
above ordered development.  Provide the claims
folder to all examiners.

Thereafter, personnel of the originating agency shall readjudicate the
claim and determine whether the appellant's claim may now be allowed.
If not, provide the appellant with an appropriate supplemental
statement of the case, indicating that he has a reasonable time to
respond, and return the case to the Board for further appellate
consideration, if appropriate.

This REMAND is to develop evidence and to afford the appellant due
process of law.  Appellate review of all certified issues is deferred
pending completion of the dictates of this order.  The Board intimates
no opinion as to the final outcome warranted in this case.

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

*
           (Member Temporarily Absent)       MATTHEW J. GORMLEY,III

          KENNETH R. ANDREWS, JR.

*38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of Veterans'
Appeals Section, upon direction of the Chairman of the Board, to
proceed with the transaction of business without awaiting assignment
of an additional member to the Section when the Section is composed
of fewer than three Members due to absence of a Member, vacancy on
the Board or inability of the Member assigned to the Section to serve
on the panel.  The Chairman has directed that the Section proceed
with the transaction of business, including the issuance of
decisions, without awaiting the assignment of a third Member.

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).