BVA9506262 DOCKET NO. 93-22 226 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to a total rating based on individual unemployability due to service-connected disabilities. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD L. M. Barnard, Counsel REMAND The veteran served on active duty from August 1943 to December 1945. This appeal arises from a January 1993 rating decision of the St. Petersburg, Florida, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to the benefit sought. This was confirmed and continued by a rating action issued in August 1993. The veteran contends, in essence, that he has been rendered unemployable by his service-connected low back and cervical spine disorders. He says that he is in such pain that he cannot work. VA has a duty to assist the veteran in the development of all facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1994). This includes the duty to obtain VA examinations which provide an adequate basis upon which to determine entitlement to the benefit sought. Littke v. Derwinski, 1 Vet.App. 90 (1991). Examinations by specialists are recommended in those cases which present a complicated disability picture. Hyder v. Derwinski, 1 Vet.App. 221 (1991). In the instant case, the veteran was last examined by VA in November 1992. Following this examination, the veteran submitted statements from his private physicians which appeared to suggest that his condition had deteriorated. Despite this, the RO did not schedule the veteran for a current examination to fully evaluate the degree of severity of his service-connected disabilities. Furthermore, the November 1992 VA examination does not include an opinion as to the effect that the veteran's service-connected disabilities have upon his ability to maintain employment. A review of the record suggests that the veteran appears to be raising claims for secondary service connection for depression (May 1993 substantive appeal), and for arthritis in the hands and shoulders (August 1993 substantive appeal). These claims appear to be inextricably intertwined with his claim for a total rating due to service-connected disabilities. According to Harris v. Derwinski, 1 Vet.App. 180 (1991), all issues which are inextricably intertwined with an issue on appeal must be determined before the issues on appeal can be decided. Under the circumstances of this case, the undersigned concludes that additional assistance is necessary, and this case will be REMANDED to the RO for the following: 1. The RO should afford the veteran complete VA orthopedic and neurologic examinations in order to fully evaluate the nature and degree of severity of his service-connected low back and cervical spine degenerative disc disease. All indicated special studies should be accomplished. The examiners should correlate their findings and render opinions as to the effect that the veteran's service-connected disabilities have upon his ability to engage in substantially gainful employment. The claims folder must be made available to the examiners prior to the examinations so that the veteran's entire medical history can be taken into consideration. 2. The RO should afford the veteran a VA psychiatric examination in order to ascertain whether the veteran suffers from depression. The examiner should render an opinion as to whether any such disorder is etiologically related to his service- connected disabilities. All indicated special studies should be accomplished. The claims folder must be made available to the examiner prior to the examination so that his entire history can be taken into consideration. 3. The RO should review the evidence and determine whether the veteran's depression and arthritis in his hands and shoulders can be service-connected as secondary to his service-connected low back and cervical spine disorders. In the event that the veteran's claims remain denied, in whole or in part, he and his representative should be provided with an appropriate supplemental statement of the case, and an opportunity to respond, and the case should be returned to the Board for further appellate consideration if otherwise in order. C. P. RUSSELL 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).