BVA9504944 DOCKET NO. 90-48 188 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Huntington, West Virginia THE ISSUE Entitlement to an increased rating for post-traumatic stress disorder, currently evaluated as 50 percent disabling. REPRESENTATION Appellant represented by: Roger W. Rutherford, Attorney ATTORNEY FOR THE BOARD Milo H. Hawley, Counsel REMAND The veteran had active service from March 1967 to April 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 1989 rating decision by the Department of Veterans Affairs (VA) Regional Office in Huntington, West Virginia (RO), which granted service connection for post- traumatic stress disorder and assigned a 30 percent evaluation. In January 1991, the Board issued a decision denying an increase in the 30 percent evaluation assigned for the veteran's post- traumatic stress disorder. The appellant appealed the Board's decision to the United States Court of Veterans Appeals (Court). In a decision dated in March 1993, the Court vacated the Board's decision and remanded the matter to the Board. A rating decision in November 1993, assigned a 50 percent evaluation for the veteran's service-connected post-traumatic stress disorder with depression from July 1, 1992. In January 1994, the Board remanded the appeal for additional development, which included affording the veteran a VA psychiatric examination with a request that the examiner assign a Global Assessment of Functioning score for the veteran, as well as obtaining records relating to treatment of the veteran's post-traumatic stress disorder. The report of a May 1994 VA psychiatric examination does not assign a Global Assessment of Functioning score for the veteran. Nor does the examiner describe the impairing effects of the veteran's psychopathology upon his ordinary activities. Treatment records obtained reflect that records relating to the veteran's hospitalizations in June and July 1992, September and October 1993, and January, March, and April 1994, include diagnoses reflective of alcohol and Benzodiazepine dependence. On several occasions either alcohol or Benzodiazepine dependence is diagnosed with post-traumatic stress disorder rather than separately. The relationship, if any, between post-traumatic stress disorder and alcoholism and Benzodiazepine dependence must be clarified before a determination can be reached regarding the appropriate evaluation for the disability at issue. Service connection for alcoholism and Benzodiazepine dependence secondary to post-traumatic stress disorder is an inferred issue which is inextricably intertwined. Akles v. Derwinski, 1 Vet.App. 118 (1991); Harris v. Derwinski, 1 Vet.App. 180 (1991). The case must once again be REMANDED to the RO for the following: 1. The RO should contact the veteran and ask him to identify and provide releases as necessary for the health care providers who have treated him for his post-traumatic stress disorder, alcohol dependence, or Benzodiazepine dependence, from April 1994 until the present. The health care provider(s) identified should be contacted and requested to provide copies of all records relating to treatment of the veteran's post-traumatic stress disorder, alcohol dependence, or Benzodiazepine dependence, from April 1994 until the present. 2. Thereafter, the veteran should be afforded a comprehensive VA psychiatric examination. This study must be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. All indicated tests, including appropriate psychological studies with applicable subscales, must be conducted. The claims file must be made available to and reviewed by the examiner prior to the requested study. The examiner should comment as to the relationship, if any, between the service-connected post-traumatic stress disorder and alcohol and/or Benzodiazepine dependence. 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 opinion expressed must be provided. 3. Following completion of the foregoing, the RO must review the claims folder and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, including if the requested examination does not include all test reports, special studies, or opinions requested, appropriate corrective action is to be implemented. 4. The issue of entitlement to service connection for alcoholism and/or Benzodiazepine dependence secondary to post-traumatic stress disorder should be considered by formal rating action. If any issue remains denied, the veteran and his representative should be furnished with a supplemental statement of the case with respect to all issues properly in appellate status and be given the appropriate opportunity to respond thereto. Thereafter, the claims file, including the above requested evidence, 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 purposes of this REMAND are to procure clarifying data and accord the veteran all due process. The Board intimates no opinion, either legal or factual, as to the ultimate disposition of this appeal. E. W. SEERY 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).