BVA9507279 DOCKET NO. 93-05 305 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to an increased rating for an anxiety disorder, currently rated 50 percent disabling. REPRESENTATION Appellant represented by: Military Order of the Purple Heart ATTORNEY FOR THE BOARD James. J. Dunphy, Counsel INTRODUCTION The veteran served on active duty from October 1942 to March 1945. The case was previously before the Board of Veterans' Appeals (Board) in May 1994. At that time, it was remanded to the Department of Veterans Affairs (VA) Regional Office (RO) to clarify the representation, obtain all outpatient treatment records, and schedule the veteran for a social and industrial survey and a compensation examination. This development was completed, and the case is once more properly before the Board. In correspondence from the veteran, received in February 1995, the veteran indicated that he felt he had a heart problem as a result of aggravation and anxiety associated with the mis- diagnosis of his prostate cancer. This matter has not been developed for appellate consideration and is referred to the RO for appropriate action. REMAND As part of the above-noted remand, the veteran was to be examined by the VA to determine the current degree of severity of his psychiatric disorder. It was specifically requested that the claims folder be made available to the examiner, and that the examiner evaluate the veteran on the Global Assessment of Functioning (GAF) Scale. A review of the examination conducted in July 1994 indicates that the claims folder was not made available to the examiner, who commented that review of the claims folder "would have assisted considerably since all the background information is documented." The examiner stated that the veteran had moderate symptoms; however, on the GAF scale, the examiner indicated that the veteran fell between 1 and 60. A GAF code of 60 represents moderate symptoms, and is consistent with the narrative description. However, a GAF code of between 1 to 10 represents persistent danger of severely hurting self or others, or persistent inability to maintain minimal personal hygiene, or suicidal act with clear expectation of death. This conflict between descriptions of the veteran's psychiatric disorder must be resolved. Moreover, given the vast amount of information in the claims folder with regard to the veteran's treatment history, the claims folder should specifically be made available to the examiner prior to the studies for review. In correspondence from the veteran, received in February 1995, he indicated that he wished to discuss his case with the Board "in either letter, person, or telephone." It is not clear whether the veteran is seeking another hearing. He also indicated that he felt that pertinent evidence was not included in his claims folder. Accordingly, the case is remanded to the RO for the following actions: 1. The veteran should be contacted to determine whether he is requesting a hearing. In addition, he should be advised to specifically identify the evidence he feels has not been considered, as indicated in his February 1995 letter. Any appropriate development resulting from this contact should be undertaken. 2. The veteran should also be requested to indicate all health care providers who have treated him since July 1994 for his psychiatric disorder. All indicated records should be obtained and associated with the claims folder. 3. The RO should schedule the veteran for 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 must assign a GAF Score consistent with the American Psychiatric Association's Diagnostic And Statistical Manual For Mental Disorders (3rd ed. rev., 1987), and explain what the assigned score represents. A complete rationale for any opinion expressed must be provided. 4. 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. In particular, it should be noted if the GAF scale and the narrative description of the veteran's condition are consistent. If any development is incomplete, (i.e. if the requested examination does not include all test reports, special studies or opinions requested), appropriate corrective action is to be implemented. When the requested development is completed, the RO should review the case. If the benefit sought is not granted, the veteran and his representative should be provided with an appropriate supplemental statement of the case. They should also be given a reasonable period to respond. The case should then be returned to the Board for further appellate consideration. The purposes of this remand are to obtain additional information and to assist the veteran in the development of his claim. No inference should be drawn regarding the merits of the claim, and no action is required of the veteran until he is notified. 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).