BVA9501857 
DOCKET NO.  90-51 862     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Cleveland, Ohio

THE ISSUES

1.  Entitlement to an increased evaluation for post-traumatic
stress disorder, currently evaluated as 30 percent disabling.

2.  Entitlement to a total disability evaluation for compensation
pursuant to the criteria under 38 C.F.R. § 4.16(c)(1994).

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Ronald R. Bosch, Counsel

INTRODUCTION

The veteran served on active duty from April 1965 to March 1969.

This appeal arose from a July 1989 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Cleveland, Ohio.  The RO granted entitlement to service
connection for post-traumatic stress disorder which was assigned
a 30 percent evaluation.

The Board of Veterans' Appeals (Board) remanded this case to the
RO for further development in a decision issued in November 1991.

The RO affirmed a 30 percent evaluation for post-traumatic stress
disorder when it issued a rating decision in December 1992.

In a March 1994 decision, the Board remanded the case to the RO
for further adjudicative actions.

The RO affirmed its previous determination in a June 1994 rating
decision.

REMAND

A review of the record discloses that the veteran's psychiatric
symptomatology has been variously diagnosed.  The RO has not
specifically denied service connection for his various
psychiatric disorders diagnosed in his case such as polysubstance
abuse, major depression, and a personality disorder. However, in
its rating action on June 10, l994, the RO pointed out that "His
major problems were his personality disorders, poly substance
abuse, and difficulties in relating to others in a social and
industrial environment".  The RO clearly distinguished the
service connected PTSD from the aforementioned conditions in
denying a rating in excess of 30 percent.  Evidence obtained on
remand from the Social Security Administration included the
report of a November 1988 psychiatric examination.  There are
reports of VA examination in 1989 and VA hospitalization in 1990
that provide numerous findings.  On the other hand, the report of
VA hospitalization in 1992 contains limited findings.

The Board recognizes that this is the third time the veteran's
claim for increase has been remanded , but it is essential his
claim be adjudicated properly and fairly. We apologize for the
delay.  His claim is well-grounded and very plausible.
Therefore, a comprehensive contemporaneous examination is here
below requested to properly assess the severity of post-traumatic
stress disorder, including its impact on the veteran's ability to
work, and action is requested to complete all adjudicate action
of any inextricably intertwined issue as noted below.

Accordingly, the case is REMANDED to the RO for the following
development:

1.  The veteran should be examined by a
board of two psychiatrists to determine the
extent, severity and correct diagnosis(es)
of all psychiatric disorder(s) present, and
the extent and severity of his service
connected post-traumatic stress disorder.
The examiners must review the claims file
to include the previous examinations and
diagnoses. The examination is to be
conducted in accordance with the diagnostic
criteria set out in Chapter 14 of the VA
Physician's Guide for Disability Evaluation
Examinations.  All indicated studies
including psychological studies are to be
conducted.  The psychiatrists should
distinguish, if possible, the
symptomatology attributable to PTSD from
that attributable to another psychiatric
impairment.  If polysubstance abuse to
include alcohol abuse is found, the
examiners should furnish an opinion whether
it is a manifestation of PTSD or a
separate, primary disorder. The
psychiatrists should assess the impact of
post-traumatic stress disorder on the
veteran's ability to obtain and maintain
gainful employment.  The report of
examination should include a complete
rationale for all opinions expressed.  The
examiners should assign a numerical code
under the Global Assessment of Functioning
Scale, and include a definition of the
numerical code consistent with the American
Psychiatric Association's DIAGNOSTIC AND
STATISTICAL MANUAL FOR MENTAL DISORDERS
(3rd ed. rev., 1987).  The RO should review
the examination report to confirm that it
is in accordance with the above directives
and if not, the examination should be
returned to the examiners for corrective
action.

2.  The RO should readjudicate the issues
of entitlement to an increased evaluation
for post-traumatic stress disorder and a
total disability evaluation for
compensation pursuant to 38 C.F.R. §
4.16(c), and also adjudicate issues of
service connection for any other
psychiatric disorder fond to exist, as such
issues constitute inextricably intertwined
issues with that now on appeal.

If the benefits requested on appeal are not granted to the
veteran's satisfaction, the RO should issue a supplemental
statement of the case.  A reasonable period of time for a
response should be afforded.  Thereafter, the case should be
returned to the Board for further appellate review, if otherwise
in order.  By this REMAND, the Board intimates no opinion as to
any final outcome warranted.  No action is required of the
veteran until he is notified by the RO.

          BRUCE KANNEE
          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) (1993).