BVA9507191 
DOCKET NO.  92-14 307     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Buffalo, New York

THE ISSUES

1.  Entitlement to service connection for ulcerative colitis.

2.  Entitlement to service connection for hypertension.

3.  Entitlement to service connection for a skin disease.

4.  Entitlement to service connection for a disability due to
alcohol use secondary to post-traumatic stress disorder (PTSD).

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

WITNESSES AT HEARING ON APPEAL

The appellant and Ms. N. S.

ATTORNEY FOR THE BOARD

W. H. Wetmore, Counsel

INTRODUCTION

The veteran served on active duty from March 1968 to March 1970
and from October 1970 to August 1976.

The Board of Veterans' Appeals (Board) initially received this
case on appeal from a January 1990 RO rating decision.  A hearing
was held at the Board in November 1992.  The Board remanded the
case in February 1993 and April 1994.

REMAND

In its recent remand, the Board explained at length the reasons
for the need to provide opinions as to the import of the medical
records in the claims files in the February 1993 remand.  In the
April 1994 remand, the Board again explained why medical opinions
as to the matters for appellate consideration were desirable
before a final appellate decision should be entered.  The record
still does not contain such opinions.

The Board previously requested only that the claims files be
reviewed by certain specified specialists and that their
responses to certain questions be entered in the record.

The Board finds it necessary that the claims file be reviewed by
medical specialists and that their opinions as to the medical
probabilities of certain relationships be placed in the record.

Under these circumstances, this case is REMANDED to the RO for
the following:

1.  A panel of two psychiatrists should be
convened to review the claims files and
provide an opinion as to the medical
probability that the veteran's abuse of
alcohol is a manifestation, consequence,
part of the constellation of symptoms or
otherwise related to his PTSD as opposed to
a separate and distinct disease entity
which is unrelated to his PTSD.  The
rationale, findings deemed pivotal and any
other factors which the reviewers consider
significant in reaching their opinion
should be set forth.

2.  After the above has been accomplished,
a cardiologist should review the claims
files to determine the medical probability
that the veteran's PTSD and related
disabling manifestations are causative
factors in the onset of his hypertension.
The rationale, findings deemed pivotal and
any other factors which the reviewer
considers significant in reaching the
opinion should be set forth.

3.  After the above has been accomplished,
a gastroenterologist should be asked to
review the claims files, including the
psychiatrists' report, and determine the
medical probability that the veteran's PTSD
and related disabling manifestations are
causative factors in the onset of his
ulcerative colitis.  The reviewer should
specifically comment on the significance of
copies of portions of medical reference
texts received from the veteran in January
1991.  The rationale, findings deemed
pivotal and any other factors which the
reviewer considers significant in reaching
the opinion should be set forth.

4.  The RO should take adjudicatory action
based on the evidence obtained pursuant to
the development sought above.  If the
benefit sought by the veteran is not
granted, a supplemental statement of the
case should be prepared.

After the veteran and his representative have been given an
opportunity to respond to the supplemental statement of the case,
the claims folder should be returned to this Board for further
appellate review, if in order.  No action is required by the
veteran until he receives further notice.  The purpose of the
remand is to procure clarifying data and to comply with governing
adjudicative procedures.  The Board intimates no opinion, either
legal or factual, as to the ultimate disposition of this appeal.

          STEPHEN L. WILKINS
          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).