BVA9503226 
DOCKET NO.  93-13 023     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Nashville,
Tennessee

THE ISSUE

Entitlement to an increased evaluation for post-traumatic stress
disorder, currently rated 50 percent disabling.

REPRESENTATION

Appellant represented by: The American Legion

ATTORNEY FOR THE BOARD

S. L. Kennedy, Counsel

REMAND

The veteran served on active duty from December 1965 to December
1967.  This appeal arises from a December 1992 rating decision of
the Department of Veterans Affairs (VA), Nashville, Tennessee,
Regional Office (RO) which denied the veteran's claim of
entitlement to an increased evaluation for his service-connected
post-traumatic stress disorder (PTSD).

The VA has a duty to assist a claimant in the development of
facts pertinent to his or her claim under 38 C.F.R. § 3.103(a)
(1994).  The Court of Veterans Appeals has held that fulfillment
of the VA's duty to assist the veteran includes providing him
with a thorough and contemporaneous medical examination.
Littke v. Derwinski, 1 Vet.App. 90, 92 (1990).  The veteran was
afforded a VA psychiatric examination in September 1992.  In a
subsequently submitted substantive appeal, the veteran indicated
that the symptomatology associated with his PTSD along with the
medication that he takes for this disorder prevented him from
obtaining or retaining gainful employment.  However, a review of
the September 1992 VA examination report fails to relate the
examiner's assessment of the degree of social and industrial
impairment that may be attributed to the veteran's PTSD.  Thus, a
more current examination is needed in order to properly rate the
veteran's service-connected disorder, particularly with regard to
the degree of social and industrial adaptability currently
present.

Fulfillment of the duty to assist the appellant includes the
procurement and consideration of any relevant VA or other medical
records.  Ferraro v. Derwinski, 1 Vet.App. 326 (1991).  At the
time of the September 1992 VA examination, the veteran related to
the examiner that he was receiving ongoing treatment, including
medication for his PTSD at the VA Chattanooga outpatient clinic.
The RO should ensure that all current medical records are of
record.

In view of the foregoing, and in order to fully and fairly
adjudicate the veteran's claim, the case is REMANDED to the RO
for the following action:

1.  The RO should procure copies of all
treatment records relating to treatment of
the veteran's service-connected psychiatric
disorder from the VA outpatient clinic in
Chattanooga, Tennessee, from May 1990
through the present.

2.  The veteran should be afforded a VA
psychiatric examination to determine the
nature and extent of the service-connected
PTSD.  This examination should be conducted
in accordance with the VA Physician's Guide
for Disability Evaluation Examinations.
All indicated diagnostic tests and
procedures, including appropriate
psychological studies with applicable
subscales, should be accomplished.  The
claims folder should be made available to
the examiner prior to the examination and
the examiner should review that file prior
to the examination.  The examination report
should contain all five multiaxial
assessment levels as provided in the
Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders,
including a numerical and narrative
assessment of the veteran's level of
functioning as measured by the Global
Assessment of Functioning (GAF) scale code.
Additionally, the examiner should
specifically state whether or not the PTSD
results in reduction in initiative,
flexibility, efficiency, and reliability
levels, and if so, how this relates to the
veteran's industrial impairment.  The
examiner should provide an opinion as to
the degree of impairment of the veteran to
perform substantially gainful employment
due to PTSD.

3.  After the above actions have been
completed, the case should again be
reviewed by the RO, to include the
adjudication of the issue of entitlement to
a total rating under the pertinent
provisions of 38 C.F.R. § 4.16 (1994), if
in order, as well as all applicable legal
criteria.  The rating should reflect
consideration of the provisions of 38
C.F.R. § 3.321(b)(1).  If the determination
remains adverse to the veteran, he should
be provided a supplemental statement of the
case which includes a summary of additional
evidence submitted, any additional
applicable laws and regulations, and the
reasons for the decision.  The veteran and
his representative should be afforded the
applicable time to respond.

The case should be returned to the Board for further appellate
review on the issue currently in appellate status as well as any
issue placed in appellate status during the course of this
REMAND.  The purpose of this REMAND is to afford the appellant
due process of law.  The Board intimates no opinion, either
factual or legal, as to the ultimate conclusion warranted in this
case.

          CHARLES E. HOGEBOOM
          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 action has been taken in
accordance with the Veterans' Benefits Improvements Act of 1994,
Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and 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).