BVA9504331 
DOCKET NO.  93-09 653     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Togus, Maine

THE ISSUE

Entitlement to an increased evaluation for post-traumatic stress
disorder, currently evaluated as 50 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

J. Horrigan, Counsel

INTRODUCTION

The veteran served on active duty from February 1943 to February
1946.

This matter came before the Board of Veterans' Appeals (Board)
from an August 1992 rating decision of the Department of Veterans
Affairs (VA) Regional Office (RO) in Togus, Maine, which denied
an evaluation in excess of 30 percent for post-traumatic stress
disorder (PTSD).  Pursuant to a Hearing Officer's decision of
November 1992, the rating for PTSD was increased from 30 percent
to 50 percent, effective December 12, 1990.

REMAND

In October 1993, after the case was received at the Board,
additional medical evidence was received in support of the
veteran's claim from the Connection Mental Health Associates.
The veteran last received a VA psychiatric examination in July
1992.  The clinical evidence received subsequent to that exami-
nation indicates that the veteran's psychiatric symptomatology
may have increased in severity.  The record also indicates that
additional relevant clinical evidence is available which is not
in the claims folder.

In view of the foregoing and given the duty to assist the veteran
in the development of his claim under the provisions of 38
U.S.C.A. 5107(a) (West 1991), this case is remanded to the RO for
the following action:

1.  The RO should contact the veteran and
request that he provide the names,
addresses, and approximate dates of
treatment of all VA and non-VA health care
providers who have treated him for
psychiatric symptomatology from 1991 to
the present.  When the requested
information and any necessary authoriza-
tions have been obtained, the RO should
attempt to obtain copies of all indicated
records which are not currently in the
claims folder.  The requested docu-
mentation should include clinical records
from the VA Mental Health Clinic in Togus,
Maine, the PTSD Clinical Team associated
with that facility, and the Connections
Mental Health Associates at 136 Union
Street in Bangor, Maine.  All records
obtained should be associated with the
claims folder.

2.  Then, the veteran should be afforded a
psychiatric examination to determine the
current degree of severity of his PTSD.
All necessary special studies should be
performed and all clinical findings
reported in detail.  The claims folder
must be made available to the examining
physician prior to his evaluation so that
he may study the pertinent clinical
records in detail.  Based on his
examination findings and a review of the
record, the examiner should provide a
Global Assessment of Function (GAF) Score
indicating the level of impairment
produced by the veteran's PTSD.  It is
imperative that the examiner explain the
meaning and significance of the GAF Score.
Additionally, the examiner should
specifically comment on the degree to
which the PTSD affects the veteran's
initiative, flexibility, efficiency and
reliability levels.

3.  Then, after conducting any further
development deemed appropriate, the RO
should again adjudicate the veteran's
claim.  If the benefit sought on appeal
remains denied, he and his representative
should be provided with a Supplemental
Statement of the Case and afforded a
reasonable opportunity to respond.

Thereafter, the case should be returned to the Board for further
consideration, if appropriate.  By this remand, the Board
intimates no opinion as to the outcome warranted in this case.
No action is required of the veteran until he is so informed.

          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).