BVA9500430 DOCKET NO. 93-12 549 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an increased evaluation for post-traumatic stress disorder (PTSD), currently rated as 50 percent disabling. 2. Entitlement to a total rating based on individual unemployability due to service-connected disabilities. 3. Entitlement to an extension beyond July 31, 1991, of a temporary total convalescence evaluation assigned pursuant to 38 C.F.R. § 4.30 (1993). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD M. Auer, Counsel REMAND The veteran served on active duty from April 1967 to April 1971. This appeal arises from rating decisions of the Department of Veterans Affairs (VA), Montgomery, Alabama, Regional Office (RO). In a February 1992 decision, an increased evaluation of 50 percent for PTSD was granted. By rating decision of August 1992, entitlement to a total rating based on individual unemployability due to service-connected disabilities was denied. By rating decision of October 1992, entitlement to a temporary total convalescence evaluation from June 4, 1991, to July 31, 1992, assigned pursuant to 38 C.F.R. § 4.30 (1993), was granted. The determination that the veteran was receiving a temporary total convalescence evaluation from June 4, 1991, to July 31, 1992, appears to reflect a typographical error in the RO decision of October 1992. It appears from the claims file that the veteran actually received this benefit from June 4, 1991, to July 31, 1991. In his statement, received by the RO in October 1992, the veteran argues that he should be paid a temporary 100 percent for July and August following his June 1992 surgery. The RO should ask the veteran to clarify whether he is referring to the surgery performed on his leg in June 1991, or whether he is referring to additional surgery. The veteran and his representative have alleged that the veteran's symptoms associated with service-connected PTSD are so severe that he is prevented from working. The claims file contains a letter from a VA social worker, dated in April 1993, who reported that the veteran is unemployable due to his PTSD symptoms. Although the veteran was given a psychiatric examination by the VA in December 1991, further evaluation would be helpful, especially on the specific issue of whether the symptoms of PTSD are totally incapacitating, or whether there is demonstrable inability to maintain employment. The veteran has been receiving outpatient treatment for PTSD on a regular basis since the VA examination in December 1991. The claims file contains outpatient treatment records through January 1993. It is possible that additional records may be available. The symptoms associated with his service-connected disorder should be distinguished from any other psychiatric disorder, including alcohol and drug abuse. The Board finds that further development is warranted before a final decision in this appeal. Accordingly, the claim is REMANDED for the following actions: 1. The RO should contact the veteran and ask him to furnish the names and addresses of all medical personnel and facilities from whom he has received treatment for the disability at issue since April 1993. After obtaining the necessary authorization from the veteran, the RO should obtain available records from the named sources. 2. The RO should obtain any available treatment records from the VA hospitals or medical centers where the veteran has received treatment since April 1993. Care should be taken by the RO so that duplicate records are not placed in the claims file. 3. The veteran should undergo a VA social and industrial survey to ascertain the manner and extent to which the service-connected disorder impairs his ability to work and relate to other people. Comprehensive information should be obtained and reported in accordance with Paragraph 1.14 of the VA Physician's Guide for Disability Evaluation Examinations (1985). Complete information concerning the veteran's work history and the reasons for his discontinuation of work should be obtained. 4. The veteran should then be scheduled for a VA psychiatric examination to determine the nature and extent of all current psychiatric pathology. The examination should be conducted in accordance with the requirements of the VA Physician's Guide for Disability Evaluation Examinations, specifically Chapter 14. All necessary psychological testing should be conducted. The examiner should express an opinion as to the veteran's level of functioning as measured by the Global Assessment of Functioning Scale (GAF Scale) as stated in the Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised l987) (DSM-III- R), and the degree of impairment of the veteran to perform substantially gainful employment due to PTSD. It is essential that the claims folder should be provided to the examiner for review in connection with the examination. 5. The veteran then should be scheduled for a general VA physical examination. The examiner(s) should comment on the social, industrial, and functional impairment associated with each of the veteran's service- connected disorders and, to the extent possible, the functional impairment caused by any nonservice-connected disorder(s). The examiner(s) should be provided with a copy of this REMAND as well as the claims folder for review prior to the examination. The reports of the examinations should be associated with the veteran's claims folder. 6. After the above actions have been completed, the case should again be reviewed by the RO, to include the adjudication of the issue of entitlement to a total rating under 38 C.F.R. § 4.16(a)(b) (1993), if in order, as well as all applicable legal criteria. 7. The RO should ask the veteran and his representative to clarify whether he is asking for an extension beyond July 31, 1991, of a temporary total convalescence evaluation assigned pursuant to 38 C.F.R. § 4.30 (1993) or, whether he is referring to a claim for temporary total convalescence for additional surgery performed in June 1992. The RO should then review the veteran's claim in light of all the evidence and applicable legal criteria. If his claim remains denied, the veteran and his representative should be provided with a supplemental statement of the case that includes any additional pertinent law and regulations and a full discussion of the evidence in his case. The appropriate response time should be allowed. The case should then be returned to the Board, if in order, after compliance with all regulatory appellate procedures. No action is required of the veteran until he is so informed. The Board intimates no opinion as to the ultimate decision warranted in this case pending completion of the requested development. ALBERT D. TUTERA 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).