BVA9503643 
DOCKET NO.  93-09 135     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Montgomery,
Alabama

THE ISSUE

Entitlement to special monthly pension by reason of being in need
of regular aid and attendance or on account of being housebound.

REPRESENTATION

Appellant represented by: Alabama Department of Veterans
Affairs

ATTORNEY FOR THE BOARD

Ronald R. Bosch, Counsel

INTRODUCTION

The veteran served on active duty from July 1943 to April 1946.

This appeal arose from a March 1993 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Montgomery, Alabama.  The RO denied entitlement to special
monthly pension by reason of being in need of regular aid and
attendance or on account of being housebound.

The case has been forwarded to the Board of Veterans' Appeals
(Board) for appellate review.

REMAND

A review of the claims file discloses that the RO utilized
recently dated VA outpatient treatment reports to determine that
the appellant did not require the regular aid and attendance of
another individual to assist him in daily care, and that he was
not housebound by reason of his disabilities.  The veteran was
last formally examined by VA as to the nature, extent, and
severity of his disabilities in August 1991.

The veteran's disabilities have been reported to consist of an
adjustment disorder with mixed emotional features, evaluated as
50 percent disabling; degenerative joint disease of both knees,
evaluated as 20 percent disabling; hypertension, evaluated as 10
percent disabling; cholelithiasis, evaluated as 10 percent
disabling; and post-traumatic stress disorder, evaluated as
noncompensable.  The combined schedular evaluation is 70 percent
for pension purposes.

As the VA outpatient treatment reports reviewed by the RO are not
sufficiently expository as to the current nature, extent, and
severity of the veteran's multiple disorders, the Board is of the
opinion that contemporaneous VA examinations including an aid and
attendance/housebound examination would materially assist in the
adjudication of the claimant's appeal.

Pursuant to VA's duty to assist in the development of facts
pertinent to the appellant's claim under 38 U.S.C.A. § 5107(a)
(West 1991);  38 C.F.R. § 3.104(a) (1994), a final decision is
being deferred pending a REMAND of the case to the RO for further
development as follows:

1.  The RO should schedule the veteran for
an examination by a VA psychiatrist as well
as an examination for aid and
attendance/housebound benefits.  The
psychiatric examination should be conducted
in accordance with the diagnostic
procedures outlined in Chapter 14 of the VA
Physician's Guide for Disability Evaluation
Examinations.  All indicated studies are to
be undertaken.  The psychiatric examiner
should assign a numerical score based on
the Global Assessment of Functioning Scale
(GAF) provided in the American Psychiatric
Association's Diagnostic and Statistical
Manual of Mental Disorders, (3rd. ed. 1987)
(DSM-III-R).  It is imperative that the
physicians include a definition of the
numerical code assigned under DSM-III-R in
order to comply with the requirements of
Thurber v. Brown, 5 Vet.App. 119 (1993).
The entire claims folder and a copy of this
Remand must be made available to and
reviewed by the examiners prior to the
examinations.

2.  The RO should review the examination
reports to ensure that they are in complete
compliance with the instructions contained
in this Remand.  If the examination reports
are not in complete compliance, the RO
should undertake appropriate corrective
action.

3.  After undertaking any development
deemed appropriate in addition to that
specified above, the RO must list all of
the veteran's disabilities on a formal
rating document, and readjudicate the issue
of entitlement to special monthly pension
by reason of being in need of aid and
attendance or on account of being
housebound.

If the benefit requested on appeal is not granted to the
veteran's satisfaction, the RO should issue a supplemental
statement of the case and afford a reasonable period of time for
a response.  Thereafter, the case should be returned to the Board
for further appellate review, if otherwise in order.  By this
REMAND, the Board intimates no opinion as to any final outcome
warranted.  No action is required of the veteran until he is
notified by the RO.

          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) (1993).