BVA9506094 
DOCKET NO.  88-14 606     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Providence, Rhode Island

THE ISSUE

Entitlement to restoration of a 50 percent rating for post-
traumatic stress disorder (PTSD).

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Sabrina M. Tilley, Counsel

REMAND

The veteran served on active duty from February 1967 to February
1970.

This matter originally came to the Board of Veterans' Appeals
(Board) on appeal from the October 1986 rating decision, in which
the Regional Office (RO) confirmed and continued the 30 percent
rating for the service-connected PTSD.  This disability rating
had been reduced from a 50 percent rating by a previous rating
decision in September 1986.  This case was previously before the
Board, but was remanded in May 1990 and again May 1992 for
additional development.

Following the May 1992 remand, the RO afforded the veteran an
additional Department of Veterans Affairs (VA) psychiatric
examination in December 1993.  The VA psychiatrist reached the
conclusion that the veteran had depressive disorder, recurrent,
severe, without psychotic features.  Social phobia, simple
phobia, alcohol dependence, cannabis dependence, cocaine
dependence, and a personality disorder were noted as well.  There
was no diagnosis of PTSD, the condition for which the veteran is
currently in receipt of compensation benefits.

The Board finds it critically important to the issue at hand to
determine if the veteran currently has symptoms of PTSD and if
depressive disorder, the phobias, substance abuse, and the
personality disorder are either related to or distinguishable
from the veteran's PTSD.  Incidentally, an opinion as to this
latter concern was addressed in the previous Board remand.  In
view of the foregoing, the case is remanded again to the RO for
the following actions:

1.  The veteran's clinical records should
be reviewed by a psychiatrist, who is
requested to determine the current nature
and severity of the veteran's service-
connected psychiatric disability.  In
particular, the psychiatrist is requested
to determine if the veteran currently has
PTSD.  If PTSD is present, the psychiatrist
should determine the current severity of
that disorder.  Also, the psychiatrist is
requested to comment on the medical
probability that any of the veteran's other
psychiatric conditions, including
depressive disorder, phobias, substance
abuse, or personality disorder, are related
to his service-connected PTSD.  The
clinical basis of the decision reached
should be set forth in detail.  The
examination report should include a
complete diagnostic assessment consistent
with the Diagnostic and Statistical Manual
of Mental Disorder, Third Edition, Revised,
of the American Psychiatric Association
(DSM-III-R), including the Global
Assessment of Functioning (GAF) scale on
Axis V.  The psychiatrist is requested to
comment on how the clinical findings impact
on the veteran's social and industrial
adaptability.

2.  The RO then should review the veteran's
claim for a restoration of a 50 percent
rating for PTSD in light of the additional
development.  If the benefit sought on
appeal is not granted, then the veteran and
his representative should be provided with
a supplemental statement of the case.

After he and his representative have been given an opportunity to
respond, the case file should be returned to the Board for
further appellate review, if necessary.  The purposes of this
REMAND are to procure clarifying data and to comply with
governing adjudicative procedures.  The Board intimates no
opinion, either legal or factual, as to the ultimate disposition
of this appeal.

          LAWRENCE M. SULLIVAN
          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).