BVA9505374 
DOCKET NO.  93-16 813     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Roanoke,
Virginia

THE ISSUE

Entitlement to an increased rating for psychoneurosis, currently
evaluated as 50 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESSES AT HEARING ON APPEAL

The appellant and his wife

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

INTRODUCTION

The veteran had active service from February 1943 to October
1945.  This appeal arises from an October 1990 rating decision of
the Roanoke, Virginia, Regional Office (RO), which denied a
rating in excess of 30 percent for the veteran's psychiatric
disorder.  By a rating dated in June 1992, the disability rating
for the psychiatric disorder was increased from 30 percent to 50
percent.  The veteran expressed his dissatisfaction with this
rating and submitted an application for increased compensation
based on unemployability.  This claim was denied by a rating
dated in May 1993.  The case was initially received at the Board
of Veterans' Appeals (Board) in August 1993 and administratively
remanded by letter to the RO in October 1993.  The RO provided
the veteran with copies of documents in the claims folder and
returned the case to the Board in December 1993.

REMAND

The duty to assist includes conducting a thorough and
contemporaneous examination of the veteran that takes into
account the records of prior medical treatment.  Green v.
Derwinski, 1 Vet.App. 121 (1991).  This is to ensure that the
evaluation of a disability is a fully informed one.  The severity
of psychiatric disability is based upon actual symptomatology as
it affects social and industrial adaptability.  See 38 C.F.R.
§§ 4.129, 4.130 (1993).  The veteran was afforded a Department of
Veterans Affairs (VA) psychological evaluation in April 1992.
The psychologist did not provide a Global Assessment of
Functioning Scale code or otherwise offer an opinion as to the
degree to which the veteran's initiative, flexibility, efficiency
and reliability levels were affected by the psychiatric disorder.
In addition, significant additional treatment records have been
obtained from the veteran's treating physician, William Zimmer,
M.D., to include a September 1992 statement in which Dr. Zimmer
opined that the veteran was unable to work at any meaningful
employment due to psychiatric problems.

In view of the foregoing, the Board is persuaded that the veteran
should be afforded a VA psychiatric examination and that complete
current records should be obtained from Dr. Zimmer.

Accordingly, the case is REMANDED to the RO for the following
actions:

1.  The RO should contact the veteran and
obtain the names and addresses of all
mental health care providers from whom he
has received treatment in recent years.
Thereafter, the RO should obtain legible
copies of all records which have not
already been obtained to include those from
William Zimmer, M.D., from September 1992
to the present.  Once obtained, all records
must be associated with the claims folder.

2.  Following completion of the above
development, the veteran should be afforded
a comprehensive VA examination in
psychiatry.  This study should be conducted
in accordance with the VA Physician's Guide
for Disability Evaluation Examinations.
All indicated tests, including appropriate
psychological studies, should be conducted.
The claims file must be made available to
and reviewed by the examiner prior to the
examination.  The disability should be
evaluated in relation to its history, with
emphasis upon the limitation of activity,
to include time lost from employment,
imposed by the service-connected
psychoneurosis.  The examiner should assign
a Global Assessment of Functioning Score
consistent with the American Psychiatric
Association's Diagnostic and Statistical
Manual For Mental Disorders, and explain
what the assigned score represents.  In
addition, the examiner should also discuss
the impairment of the veteran's ability to
establish and maintain relationships and
gainful employment, as well as the
reduction in initiative, flexibility,
efficiency and reliability levels which may
be attributable to the psychoneurosis.

3.  Following completion of the foregoing,
the RO must review the claims folder and
ensure that the foregoing development has
been completed in full.  If any development
is incomplete, appropriate corrective
action should be implemented.  When the
requested development is fully completed,
the RO should readjudicate the veteran's
claim.  The rating decision should reflect
consideration of the applicability of the
provisions of 38 C.F.R. §§ 3.321(b)(1) and
either 4.16(b) or 4.16(c) if the disability
rating is increased to 70 percent for the
psychiatric disorder.  The veteran and his
representative should be furnished with a
supplemental statement of the case.  They
should then be afforded the applicable time
to respond.

Thereafter, subject to current appellate procedures, the case
should be returned to the Board for further appellate
consideration, if appropriate.  The veteran need take no action
until he is further informed.  The purpose of this REMAND is to
obtain additional information and to ensure due process of law.
No inference should be drawn regarding the final disposition of
the claim as a result of this action.

          GARY L. GICK
          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 deter-
mination.  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).