BVA9503613 
DOCKET NO.  93-12 005     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Jackson,
Mississippi

THE ISSUE

Entitlement to an increased (compensable) rating for post
traumatic stress disorder (PTSD).

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

REMAND

The veteran had active service from November 1942 to January 1946
and from July 1948 to October 1953.  This appeal arises from a
July 1992 rating decision of the Jackson, Mississippi, Regional
Office (RO).

The duty to assist includes the duty to conduct a thorough and
contemporaneous examination of the veteran that takes into
account the records of prior medical treatment.  Green v.
Derwinski, 1 Vet.App. 121 (1991).  This is to ensure that the
evaluation of a disability is a fully informed one.  The severity
of psychiatric disability is based upon actual symptomatology as
it affects social and industrial adaptability.  See 38 C.F.R.
§§ 4.129, 4.130 (1993).  Since the last VA psychiatric
examination in April 1992, significant additional private and VA
treatment records have been obtained to include a November 1992
statement from Robert Holbert, M.D., which indicates that the
veteran had continued difficulty with chronic PTSD.  In addition,
the April 1992 VA psychiatric examination report is inadequate to
assess the impact of the veteran's psychoneurotic symptomatology
on his social and industrial adaptability inasmuch as the
examiner did not provide a Global Assessment of Functioning scale
code or otherwise indicate the degree to which the psychiatric
disorder results in reduction in initiative, flexibility,
efficiency and reliability levels.  In view of the foregoing, the
Board is persuaded that the veteran should be afforded a further
VA psychiatric examination in connection with this appeal.

VA has a duty to assist the veteran in the development of facts
pertaining to his claim.  38 U.S.C.A. § 5107(a) (West 1991); 38
C.F.R. § 3.103(a) (1993).  The United States Court of Veterans
Appeals (Court) has held that the duty to assist includes
obtaining available records which are relevant to the claimant's
appeal.  The duty to assist is neither optional nor discre-
tionary.  Littke v. Derwinski, 1 Vet.App. 90 (1990).  The veteran
has been receiving continuing treatment for his psychoneurosis at
the Biloxi VA medical center; complete records should be obtained
from that facility.

Accordingly, the case is REMANDED to the RO for the following
actions:

1.  The RO should contact the veteran and
obtain the names and addresses of all
mental health care providers from whom he
has received treatment in recent years.
Thereafter, the RO should obtain legible
copies of all records which have not
already been obtained, to include those
from the Biloxi VA medical center from
January 1993 to the present.  Once
obtained, all records must be associated
with the claims folder.

2.  Following completion of the above
development, the veteran should be afforded
a comprehensive VA examination in
psychiatry.  This study should be conducted
in accordance with the VA Physician's Guide
for Disability Evaluation Examinations.
All indicated tests, including appropriate
psychological studies with applicable
subscales, should be conducted.  The claims
file must be made available to and reviewed
by the examiner prior to the examination.
The disability should be evaluated in
relation to its history, with emphasis upon
the limitation of activity imposed by the
service-connected psychoneurosis.  The
examiner should assign a Global Assessment
of Functioning Score consistent with the
American Psychiatric Association's
Diagnostic and Statistical Manual For
Mental Disorders, and explain what the
assigned score represents.  In addition,
the examiner should also discuss the
impairment of the veteran's ability to
establish and maintain relationships as
well as the reduction in initiative,
efficiency and reliability levels which may
be attributable to the psychoneurosis (as
distinct from impairment attributable to
other conditions).

3.  Following completion of the foregoing,
the RO must review the claims folder and
ensure that the foregoing development has
been completed in full.  If any development
is incomplete, appropriate corrective
action should be implemented.  When the
requested development is fully completed,
the RO should readjudicate the veteran's
claim.  The rating decision should reflect
consideration of the applicability of the
provisions of 38 C.F.R. §§ 3.321(b)(1),
4.7, 4.129, and 4.130.  If the claim is not
granted to the veteran's satisfaction, he
and his representative should be furnished
with a supplemental statement of the case.
They should then be afforded the applicable
time to respond.

Thereafter, subject to current appellate procedures, the case
should be returned to the Board for further appellate
consideration, if appropriate.  The veteran need take no action
until he is further informed.  The purpose of this REMAND is to
obtain additional information and to ensure due process of law.
No inference should be drawn regarding the final disposition of
the claim as a result of this action.

          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
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 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).