BVA9506365 DOCKET NO. 93-16 319 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to an increased rating for post-traumatic stress disorder, currently rated 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Mark J. Swiatek, Counsel INTRODUCTION The veteran had active military service from April 1943 to December 1945. This appeal comes before the Board of Veterans' Appeals (Board) from a January 1993 decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia that granted service connection for post-traumatic stress disorder (PTSD) and rated the disorder 10 percent disabling. The veteran currently is in receipt of a combined rating of 60 percent for service-connected disabilities. In a February 1993 notice of disagreement with the decision on appeal, the veteran raised the issues of increased ratings for anterior metatarsalgia and nose and throat conditions. In March 1993, he submitted to the RO a completed application for increased compensation based on unemployability. Thereafter, the RO initiated development of these issues, but they had not been adjudicated at the time of the transfer of the case to the Board. They are referred to the RO for further action. REMAND The veteran contends, in essence, that his psychiatric disability is more disabling than reflected in the current 10 percent rating. The record of recent medical treatment consists of a report of VA hospitalization from October to November 1991 for post-traumatic stress disorder and outpatient treatment records. The veteran was reported to be unable to work when discharged from the hospital in late 1991. The record reflects that the veteran has several nonservice-connected disabilities, including coronary atherosclerotic heart disease. The Board observes that the most recent examination, completed in October 1992, did not provide a Global Assessment of Functioning scale code or otherwise indicate the degree to which the psychosis results in reduction in initiative, flexibility, efficiency and reliability levels. Additional medical evidence received at the RO in May 1993 concerns recent treatment for a cardiovascular disorder. In view of the foregoing, it is the opinion of the Board that further development, as outlined below, is warranted. Accordingly, the case is REMANDED to the RO for the following action: 1. The veteran should be requested to identify all sources of recent treatment for his service-connected psychiatric disability. With any necessary authorization from the veteran, the RO should attempt to obtain copies of all indicated records which have not been previously secured. 2. Following completion of the above development, the veteran should be accorded a VA psychiatric examination to determine the severity of the psychiatric disability. The claims folder must be made available to the examiner prior to the evaluation so that the examiner may review the pertinent historical data contained therein. The examiner should obtain a social and industrial history and the examination should be comprehensive enough to determine the nature and extent of all psychiatric symptoms. Any relationship between the post-traumatic stress disorder and any other psychiatric disorder found should be identified. The psychiatrist should utilize any psychological testing deemed pertinent in making a complete diagnostic evaluation and in differentiating the service-connected psychoneurotic symptoms from those attributable to other conditions. 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 meaning of the GAF scale code assigned. 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 post- traumatic stress disorder (as distinct from impairment attributable to other conditions). The examination should be performed and reported in accordance with the VA Physician's Guide for Disability Evaluation Examinations. 3. When the above development has been completed the RO should readjudicate the veteran's claim. If it has not been rendered moot, the claim for a total rating based on individual unemployability on account of service-connected disability should also be adjudicated. The rating should reflect consideration of the applicability of the provisions of 38 C.F.R. §§ 3.321(b)(1) and 4.16(b), whichever is applicable. If any benefit sought on appeal is not granted to the veteran's satisfaction, a supplemental statement of the case addressing all issues in appellate status should be prepared and furnished to the veteran and his representative. They should be provided the applicable period in which to respond. Thereafter, in accordance with the proper appellate procedures, the case should be returned to the Board for further appellate review, if otherwise in order. In taking this action, the Board implies no conclusion, either legal or factual, as to any final outcome warranted. No action is required of the veteran until he is otherwise notified by the RO. CHARLES E. HOGEBOOM 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. 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).