BVA9500414 DOCKET NO. 93-04 785 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Indianapolis, Indiana THE ISSUES 1. Entitlement to an increased rating for post-traumatic stress disorder (PTSD), currently evaluated as 10 percent disabling. 2. Entitlement to an increased (compensable) rating for hearing loss of the left ear. 3. Entitlement to a total compensation rating based on individual unemployability. 4. Entitlement to reimbursement for travel expenses to a Department of Veterans Affairs Medical Center (VAMC) for treatment of service-connected PTSD. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Richard F. Williams, Counsel INTRODUCTION The veteran served on active duty from July 1967 to March 1969, and from December 1974 to April 1975. This matter comes to the Board of Veterans' Appeals (Board) on appeal, in part, from a May 1992 decision of the Department of Veterans Affairs (VA), Indianapolis, Indiana, Regional Office (RO), which granted service connection and assigned a 10 percent rating for PTSD. The veteran disagreed with the 10 percent rating. The veteran subsequently appealed a Marion, Indiana, VAMC decision in August 1992 denying entitlement to reimbursement for travel expenses to the VAMC for treatment of his PTSD. He also appealed a December 1992 RO decision denying a compensable rating for his hearing loss of the left ear, a rating in excess of 60 percent for residuals of a gunshot wound to the right forearm, and a total compensation rating based on individual unemployability. He testified at a hearing conducted before a member of the Board in February 1993. REMAND The veteran appealed a December 1992 RO decision (during this appeal) denying a rating in excess of 60 percent for his service- connected residuals of a gunshot wound of the right forearm; he has indicated that he is seeking special monthly compensation for loss of use of the right upper extremity, including the hand. However, this matter has not been developed for appellate consideration. It has also been claimed on behalf of and by the veteran during this appeal that service connection for residuals of a fracture of the left forearm is warranted either on a secondary basis (38 C.F.R. § 3.310(a) (1993)) or under the provisions of 38 C.F.R. § 3.383 (1993). (See written argument and transcript of personal hearing testimony, both dated in February 1993). However, since the RO has not adjudicated this issue, the Board does not have jurisdiction. I find that both issues are "inextricably intertwined" with the issue of entitlement to a total compensation rating based on individual unemployability, within the meaning of Harris v. Derwinski, 1 Vet.App. 180 (1991); Holland v. Brown, 6 Vet.App. 443 (1994). Accordingly, the special monthly compensation and service connection issues must be adjudicated and, if denied, both claims must be developed for appellate consideration by the RO prior to Board review of the claim for a total compensation rating based on individual unemployability. The veteran's claims for an increased rating for his PTSD and a total compensation rating based on individual unemployability are well grounded, meaning not inherently implausible, and the file indicates there is a further duty to assist him in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103, 3.159 (1993). He testified at a February 1993 hearing conducted before a member of the Board that he is currently being treated for PTSD at a VAMC. (See hearing transcript, page 2). The duty to assist him includes the obligation to obtain ongoing treatment records while a claim is pending. Murincsak v. Derwinski, 2 Vet.App. 363 (1992). Thus, the additional relevant medical records should be secured. The veteran also testified at the February 1993 Board hearing that he was receiving Social Security Administration (SSA) disability benefits based upon his PTSD and his "physical condition," which presumably includes his residuals of a gunshot wound of the right forearm. The statutory duty to assist requires that the VA obtain the SSA decision and all medical records used in making the determination, and consider the documents as evidence in the VA claim. See Murincsak. While it is not clear whether there are any medical records utilized in adjudicating the SSA decision which are not currently on file, the SSA decision itself is not of record. The veteran has undergone several psychiatric examinations in recent years, including evaluations performed by a VA psychiatrist in May and November 1992. He and his representative, however, have expressed dissatisfaction with these examinations. At the February 1993 Board hearing, his representative specifically requested a VA psychiatric examination performed by a different psychiatrist. While the VA examinations noted above appear to be adequate, in the spirit of providing the veteran every opportunity to present his argument, the Board will comply with this request. It is also my judgment that a social and industrial survey would be helpful in resolving the total compensation rating based on individual unemployability claim. Regarding the reimbursement for travel expenses issue, there is also need for additional development. Specifically, I note that the VAMC administrative folder is not associated with the claims file, and the statement of the case needs clarification. Since the folder may contain information relevant to this issue, it should be secured. In view of the foregoing, this case is REMANDED to the RO for the following actions: 1. The RO should contact the VA Medical Center in Marion, Indiana, and obtain copies of all of the veteran's hospital and outpatient treatment records, dated from July 1992 to the present, and associate them with the claims file. 2. The RO should contact the SSA and obtain a copy of the decision that granted the veteran SSA disability benefits, together with all medical and other records that were utilized by the SSA in making the determination and not already on file. 3. The RO should forward the case to the VAMC for further development of the transportation reimbursement issue. The statement of the case provided by the VAMC appears to indicate that the veteran is entitled to no reimbursement whatsoever for "local travel" for care of his "non- service-connected condition." However, his PTSD is service connected, and the cited provisions of VA Manual M-1 do not support this conclusion. See VA Manual M-1, Part I, 25.04 a (1) and h (7). In addition, no mention is made of the requirement that transportation costs be approved in advance, except in limited circumstances. 38 C.F.R. § 17.102 (1993). Thus, a separate decision should be made with respect to those transportation costs incurred by the veteran before he claimed reimbursement and those he incurred after such claim. A statement of the case should be prepared addressing these matters, and the veteran and his representative should be given an opportunity to respond. Thereafter the RO should obtain the veteran's hospital administrative folder from the VAMC in Marion, Indiana, and associate it with the claims file. 4. The veteran should undergo a VA social and industrial survey. This should include, in part, a compilation of his work and educational history, and details concerning all health problems. 5. The veteran should undergo a VA psychiatric examination, performed by a psychiatrist other than the examiner who evaluated the veteran in May and November 1992, for the purpose of determining the current severity of his service-connected PTSD. All indicated tests should be accomplished. The claims file must be made available to the psychiatrist for his/her study, and the psychiatrist should review the veteran's entire medical and psychiatric history, including the social and industrial survey, prior to offering an assessment of industrial and social impairment directly due to the PTSD. 6. Thereafter, the RO should readjudicate the veteran's claims for a rating in excess of 10 percent for PTSD and a total compensation rating based on individual unemployability. 7. The RO should also adjudicate the intertwined issue of secondary service connection for residuals of an injury of the left upper extremity under the provisions of 38 C.F.R. § 3.383 (1993) and/or 38 C.F.R. § 3.310(a) (1993), and issue a supplemental statement of the case that includes all of the applicable law and regulations pertaining to the intertwined issues noted above (special monthly compensation for loss of use of the right upper extremity and, if denied, service connection for residuals of a fracture of the left forearm either on a secondary basis (38 C.F.R. § 3.310(a) (1993)) or under the provisions of 38 C.F.R. § 3.383 (1993)). After the supplemental statement of the case is issued, the veteran and his representative should be provided an opportunity to respond. Then the case should be returned to the Board. J. E. DAY 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).