BVA9508092 DOCKET NO. 91-12 743 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Roanoke, Virginia THE ISSUES 1. An increased disability rating for multiple sclerosis, with numbness of the left upper and left lower extremities and seizure disorder, currently evaluated as 30 percent disabling. 2. Service connection for post-traumatic stress disorder. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Barry F. Bohan, Counsel INTRODUCTION The appellant served on active duty in the United States Marine Corps from June 1968 to June 1972 and from November 1972 to June 1974. This appeal arose from a June 1989 rating decision of the Department of Veterans Affairs Regional Office in Roanoke, Virginia which denied the appellant's claim for service connection for multiple sclerosis (MS), seizure disorder, post- traumatic stress disorder (PTSD), personality disorder and residuals of exposure to Agent Orange. The appellant duly appealed to the Board of Veterans' Appeals (the Board). In November 1991, the Board remanded this case so that additional medical evidence could be obtained. In a July 1993 rating decision, service connection was granted for MS. The rating decision, and an August 1993 Supplemental Statement of the Case, stated that the claimed seizure disorder and "paralysis" of the left side were considered to be "secondary" to MS. A 30 percent disability rating was assigned for MS with numbness of the left upper and left lower extremities and seizure disorder. Service connection for PTSD continued to be denied. In November 1993, the appellant filed a claim for an increased disability rating for his service-connected MS with left extremity numbness and seizures. In March 1994, the appellant's representative filed a claim for service connection for organic personality disorder secondary to MS. In a November 1994 rating decision, the Department of Veterans Affairs Regional Office in Columbia, South Carolina (VARO) granted the appellant service connection for organic personality disorder secondary to service- connected MS. A 100 percent disability rating was assigned for organic personality disorder. In December 1994, the appellant was declared to be incompetent by VARO. In February 1995, this appeal was certified by VARO as to the two issues listed above, and the appellant's claims folder was returned to the Board. The issue of service connection for residuals of exposure to Agent Orange was not certified for appeal. REMAND The appellant's service-connected disabilities are MS, with numbness of the left upper and left lower extremities and seizure disorder, currently evaluated as 30 percent disabling, and organic personality disorder, secondary to service-connected MS, currently evaluated as 100 percent disabling. He may still be seeking service connection for PTSD and for exposure to residuals of exposure to Agent Orange, as well as an increased disability rating for MS with allied disorders. However, as noted by his accredited representative in a March 1995 informal presentation, the appellant has not submitted recent statements in rebuttal of VARO's adverse decisions with respect to those issues. Of record is a report of a VA mental disorders examination which was completed in April 1994. MRI studies showed brain lesions. The appellant reported experiencing seizures in which the entire left side of his body was paralyzed. During the interview, the appellant demonstrated choreiform movements, with the jerking of various large muscle groups in his body and inappropriate smiling. The examiner stated that the appellant exhibited hypersexuality, labile mood and poor judgment which were associated with an organic personality disorder. In September 1994, VARO received a letter from the South Carolina Department of Social Services. The appellant had been visited by a social worker at his residence and had been found to found to be virtually without food. He received $769 monthly in government benefits but had no idea where the money went. On November 10, 1994, VARO wrote to the appellant, informing him that he would be receiving disability benefits at the rate of $1,774 per month and that it was proposed that he be rated incompetent for VA purposes. On November 28, 1994, the appellant requested that a custodian be appointed on his behalf. In December 1994, VARO declared the appellant to be incompetent for VA purposes. As of the date this case was returned to the Board, the record did not reflect that a custodian, fiduciary or guardian had been appointed. As noted above, the appellant is currently rated as 30 percent disabling for MS with numbness of the left upper and left lower extremities and seizure disorder. The seizure disorder and the left sided paralysis were found in July 1993 by the Roanoke VA Regional Office to be "secondary" to MS. VA regulations specifically call for multiple disabilities arising from a single disease entity, "e.g. multiple sclerosis", to be rated separately. 38 C.F.R. § 4.25(b) (1994). See also Esteban v. Brown, 6 Vet.App. 259, 261-2 (1993). With respect to the issue of service connection for PTSD, it is noted that in the November 1991 remand, the appellant was specifically requested to provide information concerning alleged stressors in Vietnam. He failed to do so. The Board further notes that there is no clear recent diagnosis of PTSD. 38 C.F.R. § 3.304(f) (1994). The Board believes that further development is necessary in this case. The case is therefore REMANDED to VARO for the following actions: 1. VARO should contact the appellant's representative and his custodian and request that they identify which issues, if any, they wish to pursue for appellate purposes. Any such issues so identified should be appropriately developed by VARO. 2. With respect to the issue of an increased disability rating for MS with numbness of the left upper and lower extremities and seizures, VARO should separately rate all identifiable disabilities which are related to MS pursuant to VA regulations. After the above development has been completed, VARO should readjudicate the appellant's claim. If the claim remains denied, in whole or in part, the case should be returned to the Board after compliance with all requisite appellate procedure. The purpose of this REMAND is to satisfy due process requirements. The Board intimates no opinion as to the ultimate conclusion warranted, pending completion of the requested development. No action is necessary on the appellant's part until he receives further notice. KENNETH R. ANDREWS, JR. 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).