BVA9504555 DOCKET NO. 91-45 529 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Louisville, Kentucky THE ISSUES 1. Entitlement to service connection for an acquired psychiatric disorder. 2. Entitlement to an increased evaluation for angina pectoris, currently rated 30 percent disabling. 3. Entitlement to an effective date earlier than February 20, 1991, for the grant of service connection for angina pectoris. REPRESENTATION Appellant represented by: American Red Cross ATTORNEY FOR THE BOARD C. S. Freret, Counsel INTRODUCTION The appellant had active military service from November 1954 to November 1956 and from November 1960 to November 1961. This appeal comes before the Board of Veterans' Appeals (Board) from a June 1991 rating decision by the Department of Veterans Affairs (VA) Louisville, Kentucky, Regional Office (RO), which denied entitlement to service connection for an acquired psychiatric disorder (on the basis that new and material evidence had not been submitted to reopen a previously denied and final claim for that benefit), denied entitlement to service connection for angina pectoris, and denied entitlement to increased evaluation for the appellant's service-connected hypertension and tachycardia. In an August 1992 appellate decision, the Board determined that new and material evidence had been submitted since an unappealed May 1978 rating decision had denied entitlement to service connection for an acquired psychiatric disorder, and that, therefore, the claim was reopened. The Board's decision in August 1992 also granted service connection for angina pectoris. The Board then remanded the issue of entitlement to service connection for an acquired psychiatric disorder to the RO for the purpose of having the appellant examined by a psychiatrist to determine the etiology of his psychiatric disorder (specifically whether it had been caused by his service-connected cardiovascular disability). Pursuant to the Board's August 1992 appellate decision, the RO, in a September 28, 1992, rating decision, categorized the appellant's cardiovascular disability as angina pectoris with hypertension and tachycardia, and assigned a 30 percent disability evaluation, effective February 20, 1991. The appellant subsequently underwent VA psychiatric and cardiovascular examinations in February 1994, and a June 1994 rating decision denied service connection for an acquired psychiatric disorder and also denied an increased disability evaluation for angina pectoris. In a February 1994 statement (VA Form 1-646), the appellant's representative appears to raise the issue of entitlement to service connection for diabetes mellitus. This claim is not inextricably intertwined with the current claim and has not been developed for appellate consideration by the RO. Therefore, this matter is referred to the RO for appropriate action. REMAND The appellant asserts that he has an acquired psychiatric disorder that is etiologically related to his service-connected cardiovascular disorder, now manifested by angina pectoris with hypertension and tachycardia. He claims that his angina pectoris with hypertension and tachycardia is more severely disabling than currently evaluated, therefore warranting a higher disability rating. He also argues that an effective date earlier than February 20, 1991, should be assigned for the grant of service connection for angina pectoris. In its August 1992 REMAND, the Board had requested that the examining psychiatrist proffer an opinion as to whether the appellant had an acquired psychiatric disorder that had been caused by his service-connected cardiovascular disease. In reviewing the psychiatric evaluation conducted in February 1994, the Board finds that the psychiatrist's dialogue is unclear as to whether the appellant's service-connected cardiovascular disease caused his psychiatric disorder. The psychiatrist did state that the appellant's generalized anxiety disorder, when accompanied by panic attacks, may imitate his angina pectoris or aggravate, but not cause, his hypertension or sinus tachycardia. While this statement indicates that the appellant's psychiatric disorder did not cause his cardiovascular problems, it does not address the reverse question of whether the appellant's service-connected cardiovascular disease led to the development of his psychiatric disorder. VA has a duty to assist the appellant in the development of facts pertinent to his claims. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1994). The United States Court of Veterans Appeals (Court) has held that the VA's duty to assist the appellant in obtaining and developing available facts and evidence to support his claim includes obtaining adequate VA medical examinations. Littke v. Derwinski, 1 Vet.App. 90 (1990). 1. The RO should have a psychiatrist review the entire claims file and then express an opinion as to whether the appellant's psychiatric disorder was caused by his service-connected cardiovascular problems. If the psychiatrist feels that additional examination/testing is necessary before he can adequately address this question, then the appellant should be scheduled for such evaluation or testing. The examiner should also be requested to present all opinions and findings, and the reasons and bases therefor, in a clear, comprehensive, and legible manner on the examination report. 2. Following completion of the foregoing, the RO must review the claims file and ensure that all of the requested development has been conducted and completed in full. If any development is incomplete, including the absence of any test reports, special studies, or opinions requested as part of the examination, appropriate corrective action is to be implemented. After the above requested actions have been completed, the RO should review the appellant's claims with regard to the additional evidence obtained. If any of the benefits sought on appeal remains denied, a supplemental statement of the case should be furnished to the appellant and his representative. They should be afforded a reasonable period of time to respond. Thereafter, the case should be returned to the Board for further appellate consideration. The issues of entitlement to an increased evaluation for angina pectoris and to an earlier effective date for the award of service connection for angina pectoris are deferred, pending completion of the development requested above. The purpose of this REMAND is to obtain addition medical evidence and to ensure that the appellant is afforded due process of law. No opinion, either legal or factual, is intimated as to the merits of the appellant's claims by this REMAND. He is not required to undertake any additional action until he receives further notification from the VA. BETTINA S. CALLAWAY 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).