Decision Date: 09/06/95 Archive Date: 09/06/95 DOCKET NO. 93-22 655 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to service connection for a lower back disorder. 2. Entitlement to service connection for a right ankle fracture. 3. Entitlement to service connection for a right foot fracture. 4. Entitlement to service connection for residuals of a bilateral hip injury. 5. Entitlement to service connection for residuals of a bilateral knee injury. 6. Entitlement to service connection for bilateral hearing loss. REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. Reynolds, Associate Counsel INTRODUCTION The veteran served on active duty from August 1945 to January 1947. This appeal arises from a July 1992 rating decision form the Nashville, Tennessee, Regional Office (RO), in which service connection for a lower back disorder, a right ankle and knee fracture, hip and knee injuries and hearing loss were denied. A notice of disagreement was received in April 1993. A statement of the case was issued and the substantive appeal was received in April 1993. REMAND The Department of Veteran Affairs (VA) has a duty to assist a claimant in the development of facts pertinent to his or her claim under 38 C.F.R. § 3.103(a) (1994). Fulfillment of the duty to assist the appellant includes the procurement and consideration of any relevant VA or other medical records. Ferraro v. Derwinski, 1 Vet. App, 326 (1991). This duty is particularly heightened when, in cases such as this, the service medical records are reportedly unavailable. The veteran has indicated in statements contained in the record that he has received treatment subsequent to service by various health care providers for his claimed service- connected disabilities. The complete records of such treatment have not been associated with the claims folder. The record on appeal also reflects that the veteran testified in September 1993 before a travel member of the Board of Veteran's Appeals sitting in Nashville, Tennessee. At that time he testified that he received treatment at a VA facility in Knoxville, Tennessee, for hearing loss. He also reported incurring tinnitus as a result of service, although this issue has not been procedurally developed for appellate purposes. He also reported that it was likely that he was accorded ear examinations at various places of employment during the years following service and, at his personal hearing, requested the assistance of VA in obtaining such records. As the record currently before the Board does not contain any clinical evidence with regard to the veteran's hearing loss, the attainment of these records would be appropriate prior to making a determination pertaining to this issue. Finally, in view of the duty of the VA to assist the veteran in the development of facts pertinent to his claim, the Board is of the opinion that additional development of the medical evidence, in the form of VA orthopedic and audiometric examinations, would facilitate proper consideration of the veteran's claim. Accordingly, this case is REMANDED for the following: 1. The veteran should be contacted to provide the names and addresses of all medical sources where he has been treated or examined since service discharge. These records, to specifically include records of Dr. Elrod, Centerville, Tennessee; Highland Park General Hospital Outpatient Clinic, Glendale Ave, Highland Park Michigan; Melvindale Outpatient Clinic, Melvindale, Michigan; Dr. Racgucakus Chiropractic Clinic, Wayne Road, Westland, Michigan; Oakwood Hospital Outpatient Clinic, Oakwood Blvd., Dearborn, Michigan; VA Outpatient Clinic, Knoxville, Tennessee; and Dr. Ronald Pack, Park West Blvd., Knoxville, Tennessee, should be secured and associated with the claims file. The veteran should be asked to sign the appropriate authorization forms releasing his medical records to VA. This information is essentially compiled in a statement from the veteran which was received in June 1992. 2. The RO should request that the veteran furnish the names and addresses of any employers that required him to undergo employment physicals. Then, with any necessary authority from the veteran, these records should be secured and associated with the claims file. 3. Upon receipt of any and all such records, the RO should request that the veteran be afforded a VA orthopedic examination in order to ascertain the nature and severity of his alleged disabilities of the lower back, right ankle and foot, hips and knees. All tests and studies indicated should be performed at this time. The examiner should be requested to present all findings, and reasons and bases therefor, in a clear, comprehensive, and legible manner on the examination report. The examiner should also be requested to render a determination as to the etiology of any and all disabilities diagnosed of the examination report. Specifically, whether any and all disabilities currently manifested are the result of, or consistent with, the veteran's inservice injury, as he has described such injury. The claims folder should be made available to the examiner prior to his or her evaluation of the veteran. 4. The veteran should also be afforded an audiometric examination. The examiner should be requested to review all records on file and express an opinion as to the probability that any current hearing loss and/or tinnitus is the result of acoustic trauma during service. The claims folder must be made available to and reviewed by the examiner prior to the examination. The examiner should provide a complete rationale for all conclusions reached. 5. Thereafter, the case should again be reviewed by the RO and appropriate action taken. The issue of service connection for tinnitus should be adjudicated. If the decision remains adverse to the veteran, both he and his representative should be furnished a supplemental statement of the case, reflecting consideration of any new evidence, and be given the opportunity to respond thereto. After the above actions have been accomplished, the case should be returned to the Board for further appellate consideration, if appropriate. No action is required of the veteran until he receives further notice. By this REMAND, the Board intimates no opinion, either legal or factual, as to the ultimate determination warranted in this case. The purpose of this REMAND is to further develop the record and to afford the veteran due process of law. As mentioned previously, the veteran is being accorded every consideration in this case to ensure full development of the record, given the fact that VA's duty to assist is "particularly great" in light of the unavailability of the veteran's service medical records. Moore v. Derwinski, 1 Vet.App. 401, 406 (1991). While regretting the delay involved in remanding this case, it is felt that to proceed with a decision on the merits at this time would not withstand Court scrutiny. JEFF MARTIN 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). - 2 -