BVA9501440 DOCKET NO. 93-11 469 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUES 1. Entitlement to restoration of a 100 percent evaluation for post-splenectomy pneumococcal sepsis and septic shock complications. 2. Entitlement to an increased evaluation for post-splenectomy pneumococcal sepsis and septic shock complications with major depression, currently evaluated as 50 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Anna Bryant, Counsel INTRODUCTION The veteran had active miliary service from June 1976 to June 1980. This matter came before the Board of Veterans' Appeals (Board) on appeal from an August 1991 rating decision of the Boise, Idaho, Regional Office (RO) of the Department of Veterans Affairs (VA), which reduced the schedular evaluation for the veteran's service- connected post-splenectomy pneumococcal sepsis and septic shock complications from 100 percent to 50 percent disabling, effective November 1, 1991. During the same time frame, the RO granted service connection for major depression. REMAND The veteran and his representative contend that the 50 percent disability evaluation currently assigned for his service- connected post-splenectomy pneumococcal sepsis and septic shock complications with major depression is inadequate to compensate the veteran for the effects of that disability. Essentially, it is maintained that the 100 percent rating should be restored. In this regard, the accredited representative has advanced contentions that the veteran is totally incapacitated both socially and industrially due to the symptomatology attributable to his service-connected post-splenectomy pneumococcal sepsis and septic shock complications with major depression. Review of the evidentiary record reflects that the veteran has not been provided a VA examination referable to the service-connected disability at issue since May 1991, the examination on which the reduction was based. Under the circumstances of this case, the Board concludes that additional medical development of the record would be beneficial prior to appellate disposition. Accordingly, further appellate consideration will be deferred and the case is REMANDED to the RO for the following action: 1. The veteran should be requested to identify any sources of recent medical treatment received by him for the service- connected post-splenectomy pneumococcal sepsis and septic shock complications with major depression, and to furnish signed authorizations for release to the VA of private medical records in connection with each non-VA source he identifies. Copies of the medical records from all sources he identifies (not already in the claims folder) should then be requested. 2. The RO should schedule the veteran for an examination by a specialist in internal medicine for the purpose of determining the current severity of his service-connected post-splenectomy pneumococcal sepsis and septic shock complications with major depression. All indicated tests and studies should be performed and reported. The claims folder should be made available and reviewed by the examiner prior to the examination of the veteran. 3. The veteran should also be accorded a complete psychiatric examination by a psychiatrist. The evaluation should include a longitudinal review of the veteran's psychiatric history and a complete examination to determine the nature, extent and etiology of the veteran's psychiatric symptoms. All indicated tests and studies should be performed, including complete psychological testing. A Global Assessment of Functioning Scale should be entered. The claims folder should be made available and reviewed by the examiner prior to the examination of the veteran. 4. The regional office should reconsider the method of evaluating major depression. If it is determine that there is a single disability, rather than separate psychiatric and spleen disabilities, that decision should be supported in the record. The RO must establish that there are organic and psychiatric aspects of a single disability entity, otherwise separate evaluations should be established. After the above development has been completed, the RO should review the evidence and determine whether the veteran's claim may now be granted. If the determination remains adverse to the veteran, he and his representative should be furnished a supplemental statement of the case which summarizes the pertinent evidence, fully cites the applicable legal provisions and reflects detailed reasons and bases for the decision reached. The veteran and his representative should be given the opportunity to respond thereto. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order, following appropriate appellate procedures. The purpose of the REMAND is to further develop the record. The Board does not intimate any opinion, either factual or legal, as to the ultimate disposition warranted in this case. No action is required of the veteran until he receives further notice. H. N. SCHWARTZ 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).