BVA9507482 
DOCKET NO.  93-18 437     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Phoenix,
Arizona

THE ISSUE

Entitlement to an increased evaluation for post-traumatic stress
disorder (PTSD), currently rated as 50 percent disabling.

REPRESENTATION

Appellant represented by: Arizona Veterans Service
Commission

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

J. W. Loeb, Counsel
INTRODUCTION

The veteran served on active duty from October 1967 to July 1969.
This case came before the Board of Veterans' Appeals (Board) on
appeal from an August 1991 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Phoenix, Arizona.

Although the veteran indicated in his October 1991 notice of
disagreement that he was unemployable due to his PTSD, subsequent
correspondence by and on behalf of the veteran does not refer to
his unemployability.

REMAND

A review of the claims file reveals that the most recent VA
psychiatric examination was in February 1984 and that subsequent
medical reports from G. Robert Baker, Ph.D., and James G. Hill,
M.D., which are dated from March 1990 to June 1992, indicate that
the veteran is severely impaired as a result of his PTSD.  The
Board also notes that the veteran was hospitalized at a VA
facility for treatment of PTSD and depression caused by a divorce
and the loss of his job; it was noted during hospitalization that
the veteran's condition improved and that he was to receive
follow-up treatment at the Tucson, Arizona VA Medical Center.
The record does not contain any subsequent examination report of
the veteran's post-hospital psychiatric condition or any
outpatient treatment records.  A June 1992 letter from Dr. Baker
reveals that he last treated the veteran in November 1991 but
does not include any associated clinical information.

Based on the above, the Board finds that additional development
is required prior to final disposition of this case.  Therefore,
this case is being REMANDED to the RO for the following actions:

1.  The veteran should be permitted to
submit any additional evidence in his
possession that is pertinent to the issue
on appeal.  He should also be requested to
provide the complete names, addresses, and
dates of treatment of any physicians or
facilities, including the VA, that have
treated him for his service-connected PTSD
since 1991.  Any medical provider
identified should be asked for copies of
the veteran's clinical records not
currently on file.  Any records obtained
should be associated with the claims
folder.  The veteran should be asked to
sign any necessary consent forms for
release of his private medical records.

2.  The RO should obtain from Dr. Baker,
1333 East Madison Ave., Suite 201, El
Cajon, California  92021, and associate
with the claims file, copies of the
veteran's treatment records since April
1991, which is the date of the last
comprehensive report.

3.  The veteran should be given a special
psychiatric examination, in accordance with
the VA Physician's Guide for Disability
Evaluation Examinations, to determine the
current severity of his service-connected
PTSD.  The claims folder must be made
available to the examiner for review.  The
examiner should obtain a recent employment
history from the veteran, to include the
amount of time lost from work due to PTSD,
if employed, and any attempts to obtain
employment, if unemployed.  All necessary
tests and studies, including appropriate
psychological studies, should be conducted,
and all findings should be reported in
detail.  The examiner should be asked to
include a Global Assessment of Functioning
Score with the diagnostic formulation and
explain what the assigned score represents.
The examiner should also provide an opinion
as to the extent to which the veteran's
PTSD interferes with his ability to
establish and maintain relationships as
well as the reduction in initiative,
efficiency, flexibility and reliability
levels due to PTSD.

4.  The RO should then readjudicate the
issue on appeal,  to include consideration
of the provisions of 38 U.S.C.A. § 5107(b)
(West 1991), 38 C.F.R. §§ 3.321(b)(1) and
4.7 (1994), and the decision of the United
States Court of Veterans Appeals in Massey
v. Brown, 7 Vet.App. 204 (1994).  The RO
should also ask the veteran whether he is
contending that his PTSD renders him
unemployable and, if the veteran answers in
the affirmative, adjudicate the issue of
entitlement to a total rating based on
unemployability and furnish him his
appellate rights  .

When the above actions have been completed, unless all benefits
sought are granted to the satisfaction of the veteran, the
veteran and his representative should be provided with a
supplemental statement of the case on all issues in appellate
status and given the applicable time period to respond.  The case
should then be returned to the Board, if otherwise in order.  The
veteran need take no action until notified.

          EUGENE A. O'NEILL
          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) (1994).