BVA9502798 
DOCKET NO.  93-13 056     )       DATE
          )
          )

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

THE ISSUE

Entitlement to an increased rating for post traumatic stress
disorder (PTSD), 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

REMAND

The veteran had active service from January 1968 to January 1970.
This appeal arises from a December 1991 rating decision of the
Huntington, West Virginia, Regional Office (RO), which denied a
rating in excess of 30 percent for PTSD.  By decision in December
1992, the rating for PTSD was increased to 50 percent.  The
veteran expressed continued disagreement with that evaluation.

The Department of Veterans Affairs (VA) has a duty to assist the
veteran in the development of facts pertaining to his claim.  38
U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993).  The
United States Court of Veterans Appeals (Court) has held that the
duty to assist includes obtaining available records which are
relevant to the claimant's appeal.  The duty to assist is neither
optional nor discretionary.  Littke v. Derwinski, 1 Vet.App. 90
(1990).  The veteran has been receiving continuing treatment for
his psychoneurosis at the Beckley VA medical center; complete
records should be obtained from that facility.

The duty to assist also includes, when appropriate, the duty to
conduct 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).  Since the last VA
psychiatric rating examination in June 1991, the veteran was
hospitalized from late June to August 1991, and has received
ongoing outpatient treatment.  The veteran's treating VA
physician reported in September 1992 that the veteran was rather
depressed, suicidal, and easily upset.  He opined that the
veteran could not look after a three year old child.  A recent
Social Security Administration (SSA) decision awarded disability
benefits to the veteran; however, the medical records upon which
that decision was based have not been obtained.  In view of the
foregoing, the Board is persuaded that the veteran should be
afforded a further VA psychiatric examination in connection with
this appeal.

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 the Beckley VA medical center from
February 1992 to the present.  Once
obtained, all records must be associated
with the claims folder.

2.  The RO should contact the SSA and
obtain legible copies of the medical
records upon which the recent decision
which awarded disability benefits to the
veteran was based.  All records should be
associated with the claims folder.

3.  Following completion of the above
developments, 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 with applicable
subscales, 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 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 as
well as the reduction in initiative,
efficiency and reliability levels which may
be attributable to the psychoneurosis (as
distinct from impairment attributable to
other conditions).

4.  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),
4.7, 4. 16(c), 4.129, and 4.130.  If the
claim is not granted to the veteran's
satisfaction, he 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).