BVA9507473 DOCKET NO. 92-12 716 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUE Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a psychiatric disorder. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD T. S. Kelly, Associate Counsel INTRODUCTION The veteran had active military service from July 1950 to April 1954. A review of the record demonstrates that the veteran's representative, in his December 1994 informal hearing presentation, raised the issue of entitlement to service connection for alcoholism as secondary to a psychiatric disorder. While this issue has been raised, any action upon this matter by the regional office (RO) should be deferred until resolution of whether service connection for a psychiatric disorder is warranted. REMAND At the outset, it should be noted that the record includes a September 1993 opinion of a Medical Advisor to the Board of Veterans' Appeals (Board) regarding the veteran's claim. In Austin v. Brown, 6 Vet.App. 547 (1994), the United States Court of Veterans Appeals (Court) vacated and remanded a Board decision that relied on a Board Medical Advisor opinion based on due process considerations. In response to Austin, the Board determines that the veteran would be prejudiced by a decision rendered in reliance on the Board Medical Advisor opinion of September 1993. As such, while that opinion will remain associated with the claims folder, it will not be used by the Board in deciding the issue on appeal, and should not be utilized by the RO or the Department of Veterans Affairs (VA) Medical Center personnel, including the examining psychiatrist. A review of the veteran's service medical records demonstrates that the veteran was hospitalized in February 1951 for combat exhaustion. The final diagnosis was no psychiatric disease found. The veteran was rehospitalized on July 7, 1951, with an initial diagnosis of chronic, acute, aggressive reaction, which was later reclassified as an aggressive reaction. The veteran was released to duty on July 16, 1951. The veteran was rehospitalized on July 30, 1951, with an initial diagnosis of a conversion reaction. While hospitalized, the veteran's diagnosis was reclassified as a chronic, mild, anxiety reaction, manifested by headaches, nervousness, and irritability, with moderate stress and moderate incapacity. The veteran was then transferred to the 8079th Station Hospital, where a diagnosis of chronic, mild, anxiety reaction manifested by headaches, nervousness, and irritability was rendered. Moderate stress and moderate incapacity were also noted. In November 1952, the veteran was involved in an automobile accident in which he sustained a cerebral concussion. The veteran was again hospitalized in April 1953, at which time a diagnosis of a primary childhood behavior reaction manifested by temper tantrums, impulsive aggressive reactions, and anxiety attacks was rendered. The veteran was also hospitalized in August 1953, at which time a diagnosis of a persecution complex manifested by amnesia and the inability to get along with other soldiers, was rendered. On the veteran's September 1953 hospital discharge summary sheet, a diagnosis of a chronic, severe, aggressive reaction manifested by assaultiveness on fellow officers, alcoholism, and hostility towards the Army, which preexisted service, was set forth. Diagnoses subsequent to service include a personality trait disturbance, explosive type; chronic alcoholism; malabsorption syndrome; mild anxiety neurosis; depression with chronic alcohol abuse; alcohol addiction and passive aggressive personality; malingering; a passive aggressive type personality disorder; and anxiety neurosis in a passive, aggressive personality. As the veteran has had varying psychiatric diagnoses, both in service and subsequent to service, the Board is of the opinion that obtaining an additional VA examination, to include an opinion as to the etiology of any current psychiatric disorder, would be beneficial in reaching a determination in this matter. The Court has held that the duty to assist a veteran in obtaining and developing available facts and evidence to support his claims includes obtaining medical records from any source and adequate VA examinations. Littke v. Derwinski, 1 Vet.App. 90 (1991). The Court has also held that the duty to assist includes completing all development indicated by the evidence prior to determining whether new and material evidence has been submitted to reopen a previously denied claim. White v. Derwinski, 1 Vet.App. 519 (1991); Ivey v. Derwinski, 2 Vet.App. 320 (1992). To ensure that the VA has met its duty to assist the claimant in developing the facts pertinent to the claim, the case is REMANDED to the RO for the following development: 1. The RO should request that the veteran supply the names, dates, and places, of any individuals or treatment facilities that have treated him for any psychiatric disorder since September 1991. After having received proper authorization from the veteran, the RO should obtain copies of any records not already included in the claims file and associate them with the claims file. 2. The RO should also obtain copies of all treatment records of the veteran from the Poplar Bluff, Missouri, VA Medical Center, from September 1991 to the present. 3. Thereafter, the RO should schedule the veteran for a VA psychiatric examination. The claims folder must be made available to the examiner and reviewed prior to conducting the examination. After the above review, the psychiatrist should conduct the examination. If more than one psychiatric disorder is found to be present, the examiner is to associate, insofar as possible, the specific symptoms with each disorder. If a diagnosis of post traumatic stress disorder (PTSD) is deemed appropriate, the examiner must specify the "stressors" that caused the disorder and the factual basis for the stressors. All necessary special studies or tests are to be accomplished, to include psychological testing and evaluation. The examination is to be conducted in accordance with the VA's Physician's Guide for Disability Evaluation Examinations. The clinical findings are to be reported in detail. The examiner is specifically requested to render an opinion as to whether the veteran's current psychiatric disorders, if any, are etiologically related to any incidents or diagnoses rendered in service. The examiner should explain in detail the rationale behind his opinion. 4. Thereafter, the RO should determine if new and material evidence has been submitted to reopen the claim of entitlement to service connection for a psychiatric disorder, in accordance with the two-step analysis as set forth by the Court in Manio v. Derwinski, 1 Vet.App. 140 (1991). If the benefit sought on appeal remains denied, a supplemental statement of the case should be given to the veteran and his representative with regard to all issues. They should be afforded a reasonable period of time to respond. Thereafter, the case should be returned to the Board for further appellate consideration. By this remand, the Board intimates no opinion as to the ultimate outcome of this case. V. L. JORDAN 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).