BVA9503629 
DOCKET NO.  93-08 071     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Columbia, South
Carolina

THE ISSUES

1.  Entitlement to service connection for hypertension, deep vein
thrombosis, and repair of ruptured aneurysm of the thoracic
aorta, as secondary to service-connected disabilities.

2.  Entitlement to a rating in excess of 30 percent for anxiety
reaction with depression.

REPRESENTATION

Appellant represented by: The American Legion

WITNESSES AT HEARING ON APPEAL

Appellant and his wife

ATTORNEY FOR THE BOARD

D. B. Weiss, Associate Counsel

REMAND

The veteran had active military service from February 1943 to
February 1946.

It is noted that the initial issue for appellate review included
only an increased rating for anxiety reaction with depression.  A
June 1992 rating decision denied the additional claims, which
were developed for appellate review.

The Board of Veterans' Appeals (Board) notes that the veteran has
filed a claim under 38 U.S.C.A. § 1151.  At his personal hearing,
he also expressed doubt as to his ability to work due to his
service-connected disabilities.  (transcript of hearing at page 7
or t. 7.)  It is unclear whether he claims a total rating based
on individual unemployability.  These claims are not inextricably
intertwined with the instant claims and are not developed for
appellate review.  Therefore, they are not before the Board at
this time.  They are referred to the regional office (RO) for
action to include inquiring of the veteran whether he desires to
claim a total rating based on individual unemployability.

The appellant contends that he has hypertension with secondary
deep vein thrombosis and aneurysm of the thoracic aorta which are
proximately due to or the result of his service-connected anxiety
reaction and left varicocele.  He claims that his own medical
research supports this position, in particular, with reference to
the causal role of anxiety reaction.  (t. 8-9.)  In a statement
dated in July 1992, the representative requested that the
regional office investigate whether hypertension with deep vein
thrombosis and ruptured aneurysm are medically related to
service-connected anxiety reaction with depression.  The
representative asked that an independent medical expert or
Department of Veterans Affairs (VA) examiner be requested to
report on this issue.  To ensure that the duty to assist has been
fully satisfied, this case is REMANDED to the RO for the
following actions:

1.  The RO should obtain the names and
addresses of all medical care providers who
treated the veteran for the claimed
disorders, including the psychiatric
disorder, since September 1992.  After
securing the necessary release, the RO
should attempt to obtain these records.

2.  The veteran should be afforded a VA
cardiology examination to determine what
are the veteran's current cardiological
diagnoses, and what are their etiological
interrelationships, if any.  The examiner
should be asked to determine what
etiological relationship, if any, exists
between left varicocele or anxiety reaction
with depression and each cardiological
diagnosis.  If the examiner is unable to
answer any question stated herein, then
this should be expressly stated.  The
claims folder must be made available to the
examiner for review before the examination.
Any indicated additional consultations or
diagnostic tests should be provided.

3.  The veteran should be scheduled for a
VA psychiatric examination to determine the
current extent of his service-connected
psychiatric disorder.  The examiner should
assign the veteran a score on the Global
Assessment of Functioning scale found in
the American Psychiatric Association:
Diagnostic and Statistical Manual of Mental
Disorders, and must explain the meaning of
the numerical code assigned.  The examiner
should also express an opinion concerning
the effect of the veteran's specific
psychiatric symptomatology on his social
and industrial adaptability.  The claims
file must be made available to the examiner
for study prior to the examination.

4.  After the development requested above
has been completed to the extent possible,
the RO should again review the record.  The
RO should consider the request that an
opinion be obtained from an independent
medical expert.  If any benefit sought on
appeal, for which a notice of disagreement
has been filed, remains denied, the
appellant and representative should be
furnished a supplemental statement of the
case and given the opportunity to respond
thereto.

Thereafter, the case should be returned to the Board, if in
order.  The Board intimates no opinion as to the ultimate outcome
of this case.  The appellant need take no action until otherwise
notified.

          WILLIAM J. REDDY
          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).