BVA9507271 
DOCKET NO.  93-10 048     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Fort Harrison,
Montana

THE ISSUE

Entitlement to service connection for a psychiatric disorder.

REPRESENTATION

Appellant represented by: The American Legion

WITNESSES AT HEARING ON APPEAL

Appellant and his Sister.

ATTORNEY FOR THE BOARD

Brynn K. Bloomgren, Associate Counsel

INTRODUCTION

The appellant had active service from August 1978 to August 1982.
This matter came before the Board of Veterans' Appeals
(hereinafter the Board) on appeal from a May 1992 rating decision
of the Fort Harrison, Montana, Regional Office (hereinafter RO)
of the Department of Veterans Affairs (hereinafter VA), which
denied entitlement to service connection for a psychiatric
disorder.  The RO also denied entitlement to service connection
for a left ankle sprain, upper respiratory infection, muscle
strain of both calves, ulcers, tinea pedis, and low back strain.
During his personal hearing, the veteran withdrew his appeal of
the denial of service connection for all of the claimed disorders
except for a psychiatric disorder.

REMAND

The veteran contends that service connection is warranted for a
psychiatric disorder.  He claims that he received treatment
during service for situational adjustment disorder and
schizotypal personality.  He states that he currently suffers a
psychiatric disorder, traceable to service.  He refers to
supporting medical opinions from his private treating
specialists.  He argues that he has not been afforded a VA
psychiatric examination.

The record shows that the veteran was treated at the Golden
Triangle Community Health Clinic from August 1988 to the present.
According to statements from the veteran's private treatment
specialists, the veteran's primary diagnosis is currently bipolar
disorder, manic, psychotic, with symptoms currently in remission
through the use of medication.  Reportedly, the initial diagnosis
was schizophrenia, paranoid type.  Robert M. Fry, ACSW, and James
L. Day, M.D., stated that the veteran does have some overlapping
symptoms, and that it is not unusual for a person with the
veteran's illness to have a variety of diagnostic labels as the
illness progresses.  They wrote that there can be a significant
overlap of symptoms with schizotypal personality, schizophrenia,
and bipolar disorder.  They opined that, based on the service
history provided by the veteran, including episodes of bizarre
and grandiose thinking, it sounded as if his symptoms developed
initially in the service.

The record contains a collection of private treatment reports
from the Golden Triangle Community Health Clinic and the Montana
Deaconess Medical Center in Great Falls, Montana, dated from
August 1988 through September 1991.  These reports refer to the
veteran's hospitalization at the Montana Deaconess Medical Center
for two weeks in August 1988, following an acute psychotic
episode with paranoid features.  In addition, a history of
psychiatric problems is noted, stemming from a period of time
when the veteran was involved in an auto accident in August 1987,
and he required treatment in a chemical dependency program in
Colorado for alcohol abuse.  The record does not contain the
reports of the August 1988 hospitalization at Montana Deaconess
Medical Center nor the 1987 records from the chemical dependency
program.  The VA has a duty to obtain all relevant medical
records under 38 U.S.C.A. § 5107 (West 1991);  Murphy v.
Derwinski, 1 Vet.App. 78, 82 (1990);  See also Littke v.
Derwinski, 1 Vet.App. 90 (1991).  In addition, we believe that
the entire record, including service medical records and private
clinical records, should undergo a full review by a VA
psychiatrist, with an examination of the veteran, to determine
whether the veteran's current psychiatric disorder is causally
related to the symptoms shown during service.

Based on the aforesaid, the case is REMANDED for the following
development:

1.  The RO should obtain and associate with
the claims file the August 1988
hospitalization records from the Montana
Deaconess Medical Center in Great Falls,
Montana, and the 1987 records pertaining to
veteran's course of treatment in the
chemical dependency program in Colorado.

2.  After any records received as a result
of the above development have been
associated with the claims file, an
evaluation of the record and an examination
of the veteran should be conducted by a
board of two psychiatrists to determine
whether the veteran has a current
psychiatric disorder causally related to the
psychiatric symptoms noted during service.
The examination should be performed after a
complete review of the veteran's service and
post-service psychiatric history, and the
examination should be conducted in
accordance with the VA Physician's Guide to
Disability Evaluation Examinations (March 1,
1985) and DSM IV (1994).  Psychological
testing and any other indicated studies may
be performed record.  If more than one
psychiatric disorder is shown, the examiners
should differentiate among the symptoms
attributable to each disorder and explain
their relationship, if any, to the symptoms
shown during service.

The claims folder and a copy of this
REMAND shall be made available to the
examiner prior to the examination.

After the requested development has been completed to the extent
possible, the RO should again review the record.  If the benefits
sought on appeal are not granted, the RO should furnish the
veteran and his representative a supplemental statement of the
case, including a summary of the relevant evidence, citation to
the applicable laws and regulations, and reasons and bases for
the decision, and be afforded the opportunity to respond before
the record is returned to the Board for further appellate review.

The purpose of this remand is to obtain additional development
and the Board does not intimate any opinion as to the merits of
the case.  No further action is required of the veteran until he
is notified.

          BETTINA S. CALLAWAY
          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).