Citation Nr: 0006945 Decision Date: 03/15/00 Archive Date: 03/23/00 DOCKET NO. 97-11 444 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Portland, Oregon THE ISSUE Entitlement to a rating in excess of 30 percent for post traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD T. Robinson, Associate Counsel INTRODUCTION The veteran had active service from January 1942 to October 1943. This matter comes before the Board of Veterans' Appeals (Board) from a February 1997 rating determination of a Department of Veterans Affairs (VA) Regional Office (RO). REMAND The veteran has presented a well grounded claim within the meaning of 38 U.S.C.A. § 5107 (West 1991). In this regard, he has submitted evidence in support of this claim which renders it plausible. The Board also finds that VA has complied with its obligation to assist him with the development of that claim under the same code provision. The veteran was afforded a VA PTSD examination in April 1998, wherein a diagnosis of PTSD, chronic, was rendered with a Global Assessment Functioning (GAF) score of 61, which is descriptive of mild social and industrial impairment. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FOURTH ED, American Psychiatric Association (1994) (DSM-IV); 38 C.F.R. §§ 4.125(a), 4.130 (1999). In a June 1998 social and industrial survey, the veteran's PTSD symptoms were described as severe and chronic. VA outpatient treatment records show ongoing treatment for PTSD. The veteran is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination. Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPGCPREC 11-95 (1995). In this case, as the veteran's representative has pointed out, the medical evidence subsequent to the last VA examination shows that the veteran's disability has been described as more severe than it was on the examination. Thus, there is evidence that the veteran's disability has worsened since the last VA examination in April 1998. To ensure that VA has met its duty to assist the claimant in developing the facts pertinent to the claim and to ensure full compliance with due process requirements, the case is REMANDED to the RO for the following development: 1. The RO should request that the veteran provide the names and addresses of all health care providers who have treated him for PTSD, or psychiatric disorder, since November 1998. The RO should then take all necessary steps to obtain those treatment records, which have not already been secured. 2. The veteran should be afforded a psychiatric examination to determine the severity of his PTSD. All appropriate tests and studies, including psychological testing, should be performed and all findings should be reported in detail. If there are other psychiatric disorders found, in addition to PTSD, the examiner should specify which symptoms are associated with non- service connected psychiatric disabilities as opposed to PTSD. If the examiner is unable to answer this question, the examiner should so indicate. If there are no symptoms of PTSD, that conclusion should be noted. The claims file and a copy of this remand must be made available to the examiner prior to conduction and completion of the examination. The examiner is requested to assign a numerical code under the Global Assessment of Functioning Scale (GAF) provided in the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). The examiner should also express an opinion as to the impact of the veteran's PTSD on his ability establish and maintain effective work and social relationships. 3. Thereafter, the RO should review the claims file to ensure that all of the foregoing requested development has been completed. In particular, the RO should review the requested examination report and required opinions to ensure that they are responsive to and in complete compliance with the directives of this remand and if they are not, the RO should implement corrective procedures. 4. After undertaking any development deemed appropriate in addition to that specified above, and reviewing all evidence received, the RO should re- adjudicate the issue of entitlement to an increased rating for PTSD. If any of the benefits sought on appeal is 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 final 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. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West Supp. 1999) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44-8.45 and 38.02-38.03. Mark D. Hindin Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 1999), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. 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) (1999).