BVA9505177 DOCKET NO. 93-12 177 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to a disability evaluation in excess of 10 percent for chronic low back strain. 2. Entitlement to a disability evaluation in excess of 10 percent for post-traumatic stress disorder. 3. Entitlement to an increased (compensable) evaluation for hearing loss, bilateral. 4. Entitlement to an increased (compensable) evaluation for hemorrhoids. 5. Entitlement to an increased (compensable) evaluation for residuals of fracture of the left foot and leg injury. WITNESS AT HEARING ON APPEAL Appellant REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Christopher B. Moran, Counsel INTRODUCTION The veteran served on active duty from June 1964 to August 1972. The veteran and/or his representative have raised the issues of entitlement to service connection for tinnitus and entitlement to a total disability rating based on individual unemployability. In the context of this case, those issues are inextricably intertwined with the issues certified on appeal and must be addressed concurrently. REMAND The Board is of the opinion that additional development is needed to supplement the record with sufficient medical evidence to enable the Board to render a legal determination on all of the underlying medical issues in question. Colvin v. Derwinski, 1 Vet.App. 171 (1991). Specifically, we note that the veteran needs a current VA examination by a specialist in psychiatry to determine the current severity of his service-connected post- traumatic stress disorder. All treatment records should also be available for review. Additionally, in view of the passage of years since he was last examined by the VA, the Board notes that the veteran needs a current VA orthopedic examination to determine the current severity of his service-connected residuals of fracture of the left foot and leg injuries. The current severity of his service connected hemorrhoids and hearing loss is, likewise, not clear from the record. Under the circumstances of this case, we are of the opinion that additional assistance is required. The case is REMANDED to the RO for the following: 1. The RO should obtain all outstanding VA outpatient and hospital records pertaining to the disabilities at issue herein, and specifically including all psychotherapy and Vietnam group therapy reports. Any data obtained should be associated with the claims folder. 2. The veteran should be afforded a comprehensive examination by a specialist in psychiatry to determine the current severity of his service-connected post- traumatic stress disorder. The psychiatric examiner should assign the veteran a score on the Global Assessment of Functioning Scale (GAF) provided in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. The examiner should be asked to provide a GAF score solely for the service-connected post-traumatic stress disorder and asked to explain the meaning of the numerical score assigned. All indicated tests and studies should be undertaken. The examiner must be provided with the complete claims folder, to include evidence requested in the foregoing paragraph, for review prior to consultation with the veteran. 3. The veteran should be afforded an examination by a specialist in orthopedics in order to determine the current severity of his service-connected residuals of fracture of the left foot and leg injury and low back strain. All indicated studies should be undertaken, including range of motion studies measured in degrees. The examiner should have access to (and review) the veteran's claims folder in conjunction with the examination. 4. The veteran should be afforded a proctology examination to determine the current severity of his service-connected hemorrhoids. All indicated studies should be undertaken. The examination should be conducted in accordance with the provisions of the VA Physician's Guide for Disability Evaluation Examinations. 5. The veteran should be afforded an official VA audiometric examination in order to determine the severity of his service-connected hearing loss. 6. The RO should adjudicate the issues of entitlement to service connection for tinnitus and entitlement to a total disability rating based on individual unemployability. Arrangements should be made for all development needed to adjudicate these issues. The veteran should be advised of the determinations and (if they are adverse) of his appellate rights. When this development has been completed to the extent possible, the RO should consider the issues on appeal in light of the total history of disabilities and all potentially applicable regulations as discussed in Schafrath v. Derwinski, 1 Vet.App. 589 (1991). If any benefit sought for which there is a notice of disagreement is not granted, the veteran and his representative should be given an appropriate supplemental statement of the case. They should also be given an opportunity to respond. The case should then be returned to the Board for further consideration, if in order. No action by the veteran is required unless he is notified. GEORGE R. SENYK 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).