BVA9507900 DOCKET NO. 91-20 354 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder. 2. Entitlement to service connection for bilateral hearing loss. REPRESENTATION Appellant represented by: Military Order of the Purple Heart WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Siobhan Brogdon, Counsel INTRODUCTION The veteran served on active duty from September 1962 until January 1967. The Department of Veterans Affairs (VA) Board of Veterans' Appeals (Board) denied service connection for post-traumatic stress disorder (PTSD) and bilateral hearing loss in December 1991. The veteran appealed to the United States Court of Veterans Appeals (Court). By a decision dated in March 1993, the Court vacated the Board's determination and granted the Appellee's Motion for Remand and for Stay of Further Proceedings. The case was subsequently remanded by the Board to the VA Regional Office (RO) for further development of the issues on appeal. The case has once again been returned to Board for appropriate disposition. REMAND A review of the record discloses that pursuant to Board remand, the veteran was requested to submit to a VA social and industrial survey as well as to hospitalization for a period of observation and evaluation at a VA facility for the purposes of determining whether PTSD was present. The social and industrial survey was conducted by a VA social worker in February 1994 who noted that a somewhat confusing picture had been presented because the veteran indicated at the onset of the interview that he was not seeking benefits or making a claim for PTSD. It was reported that the appellant's primary concern was obtaining hearing aids through the VA. The record reflects that when the veteran reported for VA hospitalization in September 1994, staff examiners noted that he was apparently going through stages of alcohol withdrawal. [The VA social worker indicated in the social and industrial survey report that the veteran stated that since injuring his heel several years before, he had begun to have three to five alcoholic drinks a day as a means to control the pain.] It was determined that his status required placement on supervised drug withdrawal prior to evaluation, and medication was administered to this end. It was reported, however, that the veteran was unwilling to acknowledge an alcohol problem and apparently refused to comply with the prescribed regimen which was in violation of the ward rules and policies. It was noted that he left the ward, was irregularly discharged, and as such, the period of observation and evaluation was unable to be completed. In a statement dated in February 1995, the accredited representative took strong issue with the VA medical staff's procedures regarding their perceptions of veteran status when he was admitted for evaluation, and indicated that the appellant would not want to return there for further clinical attention. Under the circumstances of this case, the Board is of the opinion that further development would be helpful prior to final disposition of the issues on appeal. The case is therefore REMANDED to the RO for the following actions: 1. The veteran should be written a letter and asked to respond to the VA RO in writing as to whether or not he still wishes to pursue service connection for PTSD. 2. If the veteran responds in the affirmative, he should be given another opportunity to report for a scheduled period of observation and evaluation by a board of at least two VA psychiatrists who have not examined him previously and at a facility to which he has not been admitted previously, if possible, in order to determine the correct psychiatric diagnoses in this instance. Complete psychological testing, to include all PTSD scales, should be undertaken prior to the examination. Each examining psychiatrist and psychologist should be asked to provide his or her professional opinion, with supporting reasons, as to whether the diagnostic criteria for a diagnosis of PTSD related to service have been met. If PTSD is found to be present, the extent of disability relating thereto should be clearly outlined. If more than one psychiatric diagnosis is indicated, the examiners should be requested to clearly delineate the symptoms associated with each disorder. The examination report should be typed. The claims folder and copies of the current and prior remand decisions should be made available to each and every examiner prior to his and/or her evaluation for use in the study of this case. The examiners are specifically requested to carefully review the veteran's and his affiants' statements in the record. Following completion of the requested development, the agency of original jurisdiction should again consider the veteran's claim and determine whether or not it may be granted. If action remains adverse to the appellant, he should be furnished a supplemental statement of the case and be given the opportunity to respond. The case should then be returned to the Board for further appellate consideration. No action on the part of the veteran is required until he receives further notice. The Board intimates no opinion, either legal or factual, as to the ultimate disposition of the issue on appeal. The issue of service connection for bilateral hearing loss will be deferred pending completion of the above. 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 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).