BVA9506525 
DOCKET NO.  93-09 797     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Waco, Texas

THE ISSUE

Entitlement to an increased rating for chronic tinnitus with
dizziness and disturbance of balance, currently evaluated as 30
percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Michael E. Kilcoyne, Counsel

INTRODUCTION

The veteran had active military service from August 1983 to
February 1985.

The matter on appeal arises from a June 1992 rating action by the
aforementioned regional office (RO).  The veteran expressed his
disagreement with that decision in a letter received at the RO in
October 1992.  A statement of the case was issued in January
1993, and a substantive appeal was received in February 1993.  In
April 1993, the veteran appeared at a hearing conducted at the RO
before a member of a traveling section of the Board, after which,
the case was forwarded to the Board in Washington, D.C.

REMAND

The record reveals that in June 1991, the veteran submitted a
claim for service connection for a disability he described as
"Balance problem with ears...Dizzy spells...ringing in ears.
Irritable attitude, confusion."  In connection with that claim,
the veteran was afforded a VA examination in August 1991.  The
report of that examination, showed that although a psychiatric
evaluation was recommended to evaluate the veteran's complaints
that included fatigue, dizziness, tinnitus and irritability, none
was apparently conducted.  That notwithstanding, because the
veteran complained of intermittent tinnitus and vertigo in
service, and these complaints persisted after service, the RO
awarded service connection for a disability it characterized as
chronic tinnitus with dizziness and disturbance of balance.

In May 1992, the veteran underwent another VA examination which
included an evaluation to determine the extent of any disease or
injury to the brain, an ear, nose and throat consultation, as
well as a psychiatric evaluation.  Significantly, these
examinations revealed no evidence of any systemic disease or
neurologic disorder.  However, the psychiatric examiner concluded
that the overall disability picture was suggestive of an atypical
somatoform disorder.

The veteran indicated in a letter to the RO dated in December
1991, that he had a mental disability, and at the hearing
conducted in April 1993, the veteran specifically raised the
claim of service connection for a psychiatric disorder.  In view
of the medical evidence which suggests that the veteran's
underlying disability may be psychiatric in nature, the
resolution of the issue currently on appeal is inextricably
intertwined with the question of service connection for a
psychiatric disorder.  A claim which is inextricably intertwined
with a pending claim must be adjudicated prior to a final order
with respect to the pending claim.  Harris v. Derwinski, 1
Vet.App. 180 (1991).  Accordingly, in order to ensure that an
equitable result is obtained in this appeal, the case is Remanded
to the RO for the following:

1.  The veteran should be asked to identify
the places at which he has received
treatment for any disability at issue since
1991, after which, the RO should attempt to
obtain and associate with the claims file,
copies of any  records of such treatment
identified.

2.  Next, the veteran should be scheduled
for special psychiatric and ear evaluations,
the purpose of which is to determine the
correct diagnosis and etiology of any
disability present.  Any indicated test,
study or further consultations should be
accomplished, and the examinations should be
conducted in accordance with the pertinent
provisions of the VA Physician's Guide for
Disability Evaluation Examinations.  Each
examiner is requested to indicate in his or
her report the etiology of any disorder
diagnosed, and the bases upon which each
examiner's conclusions rest must be set
forth.  The claims folder must be made
available to the examiners prior to
examination in order to assist them in
arriving at a proper conclusion and
diagnosis(es).

3.  Upon completion of the above, the RO
should enter a decision regarding the claim
for service connection for a psychiatric
disorder, and in the event of an unfavorable
decision, the veteran must be informed of
the need to file a notice of disagreement if
he takes issue with the decision.  If a
notice of disagreement is submitted, the
issue should then be discussed in a
supplemental statement of the case, and an
opportunity should be given to file a
substantive appeal.  The RO should also
enter a decision with respect to the
increased rating issue already certified on
appeal.  If this decision remains adverse to
the veteran, he and his representative
should be provided with a supplemental
statement of the case and given an
opportunity to respond to it before the case
is returned to the Board for further review.

No action is required of the veteran until he is further
informed.

          EUGENE A. O'NEILL
          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.

(CONTINUED ON NEXT PAGE)
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).