BVA9502106 
DOCKET NO.  93-11 539     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Huntington,
West Virginia

THE ISSUE

Entitlement to an increased disability evaluation for an anxiety
disorder, currently evaluated as 50 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Anna Bryant, Counsel

REMAND

The appellant had active military service from July 1942 to
January 1946 and from November 1948 to May 1954.  This matter
came before the Board of Veterans' Appeals (Board) on appeal from
a July 1991 rating decision of the Huntington, West Virginia,
Regional Office (RO) of the Department of Veterans Affairs (VA).

On the occasion of a VA psychiatric examination in December 1991,
the appellant pointed out that he was unable to cope with daily
events or tolerate others because of symptoms associated with his
psychiatric disability.  He stated that he suffered from
depression and chronic irritability, as well as insomnia and a
poor appetite.  Generalized anxiety disorder, moderately severe,
was the diagnosis.  However, subsequent VA medical records
reflect that the appellant was hospitalized in October and
November 1992 and that diagnoses included organic brain syndrome,
major depression, and passive/aggressive personality disorder.
At discharge from the hospital, it was reported that the
appellant was not competent.

The accredited representative has advanced contentions that the
appellant should be afforded a current psychiatric examination
for the purpose of determining the degree of severity of his
service-connected anxiety disorder.

Accordingly, further appellate consideration will be deferred and
the case is REMANDED to the RO for the following action:

1.  The appellant should be requested to
identify any recent sources of psychiatric
treatment received by him for his anxiety
disorder and to furnish signed authoriza-
tions for release to the VA of private
medical records in connection with each
non-VA source he identifies.  Copies of the
medical records from all sources he
identifies (not already in the claims
folder) should then be requested.  All
records obtained should be added to the
claims folder.

2.  The appellant should be afforded a VA
psychiatric examination to determine the
nature and severity of all psychiatric
disorders which are present.  The claims
folder should be made available to the
examiner for review in conjunction with the
examination so that pertinent historical
data contained therein may be utilized by
the examiner in obtaining a true picture of
the appellant's psychiatric status.  The
psychiatric examination should be com-
prehensive enough to determine the nature
and extent of all psychiatric symptoms.
Symptoms and impairment attributable to the
service-connected neurosis must be
distinguished from those due to personality
disorders and/or organic brain syndrome.
Personality disorders should be fully
described and classified.  Any relationship
between the service-connected neurosis and
a personality disorder or organic brain
syndrome should be identified.  The
psychiatrist should utilize any
psychological testing deemed pertinent in
making a complete diagnostic evaluation and
in differentiating the service-connected
neurosis from the personality disorder and
organic brain syndrome.  Based upon a
review of the record and the examination,
the physician should provide a Global
Assessment of Functioning (GAF) scale code
and discuss the nature and meaning of the
GAF scale.  In addition, the examiner
should also discuss the impairment of the
appellant's ability to establish and
maintain relationships as well as the
reduction in initiative, efficiency and
reliability levels which may be
attributable to the service-connected
anxiety disorder (as distinct from
impairment attributable to personality
disorder and organic brain syndrome).

3.  When the above development has been
completed the RO should readjudicate the
appellant's claim.  The rating should
reflect consideration of the applicability
of 38 C.F.R. § 3.321(b)(1).

If the determination remains adverse to the appellant, he and his
representative should be furnished a supplemental statement of
the case which summarizes the pertinent evidence, fully cites the
applicable legal provisions and reflects detailed reasons and
bases for the decision reached.  The appellant and his
representative should be given the opportunity to respond
thereto.  Thereafter, the case should be returned to the Board,
if otherwise in order.

          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).