BVA9502603 DOCKET NO. 93-07 952 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder (PTSD). 2. Entitlement to a compensable evaluation for bilateral sensorineural hearing loss. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The appellant ATTORNEY FOR THE BOARD Raymond F. Ferner, Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from an April 1991 rating decision of the Department of Veterans Affairs (VA) Regional Office in Nashville, Tennessee, (RO) which denied the benefit sought on appeal. The veteran, who had active service from October 1966 to October 1969, appealed that decision to the BVA, and the case was received at the Board in April 1993. The veteran's representative has referred to claims for nonservice-connected pension benefits as being denied by rating decisions dated in April 1991 and February 1993, and the RO's failure to notify the veteran of those denials. While it does not appear that either rating decision specifically denied claims for nonservice-connected pension benefits, the veteran's representative has raised what can be construed as an informal claim for that benefit. However, this matter is not currently before the Board since it has not been prepared for appeal, and will be referred to the RO for appropriate action. REMAND At the outset, the Board notes that the veteran was previously denied service connection for PTSD by rating decision dated in March 1987. The veteran was notified of that determination and of his appellate rights by letter dated that same month, but an appeal was not filed. The basis of that denial of service connection was that PTSD was not shown by the evidence of record. Recently submitted evidence includes a record from a VA staff psychologist which contains an assessment of PTSD with depression and anxiety. This would appear to constitute new and material evidence which is sufficient to reopen the previously denied claim. It would appear that the veteran has not been afforded an opportunity to provide specific information concerning stressful incidents he was exposed to while in Vietnam; for example, names, dates, places and circumstances concerning individuals he witnessed being wounded or killed, or other stressful incidents. In this regard, while the veteran may have been diagnosed as having PTSD by a VA staff psychologist, it is not clear that the record reflects that the veteran experienced an event that is outside the range of usual human experience and would be markedly distressing to almost anyone. Such an event is a prerequisite to a diagnosis of PTSD. The Board is of the opinion that the veteran should be afforded an opportunity to provide information which is necessary for his claim for service connection for PTSD. Should the veteran provide information which can be verified, given the diagnosis of PTSD of record, the Board believes the veteran should be afforded a psychiatric examination to determine whether the diagnostic criteria for a diagnosis of PTSD have been met. Also, it would appear that the veteran has been provided hearing aids subsequent to the last VA audiological examination. As such, a further audiological examination would be useful. Therefore, in order to give the veteran every consideration with respect to the present appeal, it is the Board's opinion that further development of the case is desirable. Accordingly, this case is REMANDED for the following actions: 1. The RO should request from the veteran a comprehensive statement containing as much detail as possible regarding the stressful incidents the veteran reports he was exposed to while serving in Vietnam. The veteran should be asked to provide specific details of the stressful events, such as the dates, places, detailed descriptions of events, and any other identifying information concerning any other individuals involved in the events, including their names, ranks, units of assignment or any other identifying detail. The veteran is advised that this information is necessary to obtain supportive evidence of the stressful incidents and he is requested to be as specific as possible because without such details, an adequate search for verifying information cannot be conducted. Should the veteran provide information concerning stressful incidents which is subject to verification, the RO should obtain such verification from the United States Army and Joint Services Environmental Support Group. 2. If the development requested in the first paragraph is completed, the veteran should be afforded a psychiatric examination to ascertain the nature, severity and manifestations of all psychiatric disorders which may be present. The primary purpose of this examination is to determine whether the veteran satisfies the diagnostic criteria contained in the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (3rd ed. rev. 1987) for a diagnosis of PTSD. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, but should include appropriate psychological studies with applicable subscales. Since it is important "that each disability be viewed in relation to its history [,]" 38 C.F.R. § 4.1 (1994), copies of all pertinent medical records in the veteran's claims file or, in the alternative, the claims file must be made available to the examiner for review prior to, and during, the examination. 3. The veteran should be afforded an audiological examination to ascertain the severity and manifestations of his bilateral sensorineural hearing loss. Any and all indicated evaluations, studies and tests deemed necessary by the examiner should be accomplished. Since it is important "that each disability be viewed in relation to its history [,]" 38 C.F.R. § 4.1 (1994), copies of all pertinent medical records in the veteran's claims file or, in the alternative, the claims file must be made available to the examiner for review prior to, and during, the examination. When the development requested has been completed, the case should again be reviewed by the RO on the basis of the additional evidence. If the benefits sought are not granted, the veteran and his representative should be furnished a supplemental statement of the case, and be afforded a reasonable opportunity to respond before the record is returned to the Board for further review. The purpose of this REMAND is to obtain additional development, and the Board does not intimate any opinion as to the merits of the case, either favorable or unfavorable, at this time. The veteran is free, of course, to submit any additional evidence he desires to have considered in connection with his current appeal. No action is required of the veteran until he is notified. WARREN W. RICE, JR. 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) (1993).