BVA9507885 
DOCKET NO.  93-12 221     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Pittsburgh,
Pennsylvania

THE ISSUES

Entitlement to service connection for dementia.

Entitlement to service connection for major depression.

REPRESENTATION

Appellant represented by: The American Legion

ATTORNEY FOR THE BOARD

Robert A. Leaf, Counsel

REMAND

The veteran had active duty from September 1942 to November 1945.
A September 1992 rating decision of the Pittsburgh, Pennsylvania,
Regional Office (RO) of the Department of Veterans Affairs (VA)
denied service connection for dementia and major depression.
This appeal to the Board of Veterans' Appeals (Board) stems from
that rating decision.

Service connection is in effect for postoperative residuals,
thyroidectomy for hyperthyroidism with anxiety, psychoneurosis.
The record discloses that the veteran was evaluated periodically
following service separation for anxiety reaction.  In addition,
a diagnosis of depressive reaction was rendered by a VA examiner
in December 1953.  Subsequently, VA and private examiners during
the 1960's and 1970's observed that the veteran's neurosis was
characterized by feelings of both anxiety and depression.  In
July 1981, the veteran was hospitalized at a private medical
facility for involutional depression.

A VA psychiatrist, who examined the veteran in June 1992,
remarked that there appeared to be both organic and psychiatric
factors which might contribute to the veteran's current clinical
status.  It was believed that organic factors appeared prominent
although the veteran had a rather extensive history of medical
and physical problems which might also play a role in
precipitating depressive and anxiety complaints.  The diagnoses
included dementia, rule out organic affective disorder, and rule
out major depression.

The veteran was admitted to VA hospitalization in October 1991.
It was related that he had sustained a gunshot wound to the head
in 1987 and had undergone a craniotomy; he thereafter developed a
seizure disorder.  A July 1991 MRI showed brain atrophy,
especially in the right temporal lobe.  He indicated that he had
once drunk heavily over the past 55 years.  He stated that he had
been depressed for his entire life and referred to a "sad home
life."  At discharge from hospitalization in July 1992, the
diagnoses included dementia secondary to head trauma, organic
affective disorder and major depression.

To ensure that the Department of Veterans Affairs (VA) has met
its duty to assist the claimant in developing the facts pertinent
to the claim and to ensure full compliance with due process
requirements, the case is REMANDED to the regional office (RO)
for the following development:

1.  The RO should obtain the names and
addresses of all medical care providers, if
any, who treated the veteran for depression
since service.  After securing the
necessary release, the RO should obtain
named records not already associated with
the claims folder.  In addition, any VA
outpatient or hospital records since July
1992 should be obtained.

2.  The veteran should then be afforded a
VA psychiatric examination to determine the
nature and extent of any psychiatric
disorder now present.  Any indicated
special studies should be performed and
clinical findings reported in detail.  The
psychiatrist should be specifically
requested to express an opinion as to the
probable etiology of any depressive
disorder found and as to whether it is
causally related to anxiety disorder, which
is rated as part of his service-connected
residuals of thyroidectomy for
hyperthyroidism.  A complete rationale
should be provided for any conclusions
reached.  The claims folder should be made
available to the examiner for review before
the examination.

3.  After completion of the development
described above, the RO should again review
the record to determine if the claim for
service connection for major depression may
now be granted.  If the decision remains
adverse to the veteran, a supplemental
statement of the case should be furnished
and he and his representative provided an
opportunity for response.

Thereafter, the case should be returned to the Board, if in
order.  The Board intimates no opinion as to the ultimate outcome
of this case.  The appellant need take no action unless otherwise
notified.

Appellate consideration of the issue of entitlement to service
connection for dementia is deferred pending the development
described above.

          D. C. SPICKLER
          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).