BVA9502843 
DOCKET NO.  92-13 617     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri

THE ISSUE

Entitlement to an increased rating for an anxiety reaction
currently rated as 30 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

C. R. Olson, Counsel

INTRODUCTION

The veteran's active military service extended from August 1943
to December 1945.

This matter comes before the Board of Veterans' Appeals (Board)
on appeal from a March 1992 rating decision by the Department of
Veterans Affairs (VA) Regional Office (RO) in St. Louis,
Missouri.  That rating decision, in part, continued a 30 percent
rating for an anxiety reaction, manifested by cardiovascular
symptoms, which had been in effect since January 1948.  A rating
action in May 1993 granted a separate 10 percent rating for
hypertension and continued the 30 percent rating for anxiety
reaction.

REMAND

The case was previously before the Board in January 1993.  The
Board granted a separate rating for the cardiovascular disease
that was incurred during the veteran's active wartime service.
The Board remanded the case for adjudication of various aspects
of the claim and examination of the veteran.  The requested
development included a psychiatric examination.

The United States Court of Veterans Appeals (Court) has held that
VA examinations must be in accordance with the VA Physician's
Guide for Disability Evaluation Examinations (Physician's Guide).
See Littke v. Derwinski, 1 Vet.App. 90 (1990).  The Court has
also held that the examination reports must contain sufficient
information to rate the disability in accordance with the
applicable rating criteria.  See Massey v. Brown, No. 93-135
(U.S. Vet. App. Dec. 6, 1994).

Review of the report of the July 1993 VA psychiatric examination
shows that most of the report was dedicated to repeating the
veteran's complaints about his daughter's marital and financial
problems.  There were very limited objective findings, most of
which would not help distinguish manifestations of the current or
next higher rating.  That is, whether the veteran is logical,
coherent, without psychotic thought content, having no major
cognitive deficits and competent does not help to determine if he
has the definite impairment associated with the current rating or
the considerable impairment required for the next higher rating.

Consequently, in accordance with the most recent guidance from
the Court, the case must be remanded so the veteran can be
scheduled for an examination in accordance with the Physician's
Guide and which provides sufficient information to rate his
psychiatric disability.

To ensure that VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the RO for the following development:

1.  The RO should schedule the veteran for
a comprehensive VA psychiatric examination
to be conducted by an examiner who has
never previously examined or treated the
veteran, if such an arrangement can be
made.  The study is to be conducted in
accordance with the Physician's Guide.  All
indicated tests, including appropriate
psychological studies with applicable
subscales, are to be conducted.  The report
of examination should include a detailed
description of all manifestations of
anxiety reaction found to be present.  The
examiner should assess the impact of the
disability on the veteran's ability to
function in a work and social environment.
The claims file must be made available to
and be reviewed by the examiner prior to
the requested study.  The examiner must
assign a Global Assessment of Functioning
Score consistent with the American
Psychiatric Association's DIAGNOSTIC AND
STATISTICAL MANUAL FOR MENTAL DISORDERS (3d ed.
rev., 1987), and explain what the assigned
score represents.  A complete rationale for
any and all opinions offered must be
provided.

2.  The RO should review the examination
report and determine if it is adequate for
rating purposes and in compliance with this
Remand.  If not, the report should be
returned for corrective action.

Following completion of these actions the RO should review the
veteran's claim.  If the decision remains unfavorable, the
veteran and representative should be provided with a supplemental
statement of the case and afforded a reasonable period of time in
which to respond.  Thereafter, in accordance with the current
appellate procedures, the case should be returned to the Board
for completion of appellate review.  The Board intimates no
opinion as to the ultimate outcome of this case.

The appellant need take no action unless otherwise notified.

          JAN DONSBACH
          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).