Citation NR: 9731313	
Decision Date: 09/12/97		Archive Date: 09/17/97

DOCKET NO.  96-31 582	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs Medical and Regional Office 
Center in Wichita, Kansas


THE ISSUES

1.  Entitlement to service connection for back disability.

2.  Entitlement to service connection for neck disability.


REPRESENTATION

Appellant represented by:	Paralyzed Veterans of America, 
Inc.


WITNESS AT HEARING ON APPEAL

Appellant


ATTORNEY FOR THE BOARD

J.W. Loeb


REMAND

The veteran served on active duty from April 1985 to July 
1991.  This case came before the Board of Veterans’ Appeals 
(Board) on appeal of a May 1996 rating decision of the 
Department of Veterans Affairs (VA) Medical and Regional 
Office Center (M&ROC) in Wichita, Kansas.

The Board notes that, based on the evidence currently on 
file, further development of the medical evidence, to include 
a VA examination to determine if any current back and neck 
disabilities are etiologically related to service, is needed.  
Moreover, additional relevant evidence, from Craig N. Bash, 
M.D., was added to the file in August 1997 without being 
considered by the M&ROC and without a written waiver from the 
veteran of M&ROC consideration.  Therefore, initial 
consideration of this evidence by the M&ROC is required.  
38 C.F.R. § 20.1304(a), (c) (1996).

Accordingly, this case is REMANDED to the M&ROC for the 
following actions:

1.  The veteran should be requested to 
provide the names, addresses, and 
approximate dates of treatment for any 
health care providers who may possess 
additional records pertinent to her 
claims.  When the requested information 
and any necessary authorization have been 
received from the veteran, the M&ROC 
should attempt to obtain a copy of all 
indicated records which have not already 
been obtained.

2.  The veteran should then be provided a 
VA orthopedic examination by a board 
certified orthopedist, if available, for 
the purpose of determining the nature, 
extent and etiology of all back and neck 
disabilities present, to include 
congenital defects.  The claims file, 
including a copy of this REMAND, should 
be made available to the examiner before 
the examination for proper review of the 
medical history.  All indicated studies, 
including X-rays and MRI, if deemed 
warranted, should be performed.  
Following a review of the claims folder, 
to include the associated April 1996 X-
rays and the various medical opinions 
previously obtained, and completion of 
the above requested examination, the 
examiner should provide an opinion as to 
whether it is at least as likely as not 
that any currently present back or neck 
disability is etiologically related to 
service injury.  The rationale for all 
opinions expressed should also be 
provided.

3.  After the above, the M&ROC should 
review the claims file and ensure that 
all developmental actions, including the 
medical examination and requested 
opinions, have been conducted and 
completed in full.  The M&ROC should then 
undertake any other indicated development 
and should readjudicate the issues on 
appeal.  

4.  If the benefits sought on appeal are 
not granted to the veteran’s 
satisfaction, the M&ROC should issue a 
supplemental statement of the case for 
all issues in appellate status.  The 
veteran and her representative should 
then be given an opportunity to respond.

Thereafter, the case should be returned to the Board, if in 
order.  By this remand, the Board intimates no opinion as to 
any ultimate outcome warranted.  The appellant need take no 
action until otherwise notified.
These claims must be afforded expeditious treatment by the 
M&ROC.  The law requires that all claims that are remanded by 
the Board or by the United States Court of Veterans Appeals 
for additional development or other appropriate action must 
be handled in an expeditious manner.  See The Veterans’ 
Benefits Improvements Act of 1994, Pub. L. No. 103-446, 
§ 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West 
Supp. 1997) (Historical and Statutory Notes).  In addition, 
VBA’s ADJUDICATION PROCEDURE MANUAL, M21-1, Part IV, directs 
the ROs to provide expeditious handling of all cases that 
have been remanded by the Board and the Court.  See M21-1, 
Part IV, paras. 8.44-8.45 and 38.02-38.03.



		
	SHANE A. DURKIN 
	Member, Board of Veterans' Appeals

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) 
(1996).
- 2 -