BVA9501718 DOCKET NO. 93-07 407 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Buffalo, New York THE ISSUES 1. Entitlement to service connection for arteriosclerotic heart disease, status post myocardial infarction with paroxysmal atrial fibrillation. 2. Entitlement to service connection for below the knee amputation due to peripheral vascular disease. 3. Entitlement to service connection for benign prostatic hypertrophy with recurrent prostatitis. 4. Entitlement to an increased evaluation for post-traumatic stress disorder, currently evaluated as 50 percent disabling. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Julia M. Kurtz, Associate Counsel REMAND The veteran served on active duty from October 1940 to November 1944. The veteran was a prisoner of war of the German Government from December 1942 to June 1944. This appeal arises from a December 1991 rating decision of the Buffalo, New York, Regional Office (RO) which denied service connection for arteriosclerotic heart disease, status post myocardial infarction with paroxysmal atrial fibrillation, status post right below knee amputation due to peripheral vascular disease, benign prostatic hypertrophy with recurrent prostatitis and an increased evaluation for the veteran's anxiety disorder. In December 1992, the RO reclassified the veteran's psychiatric disorder as post-traumatic tress disorder and assigned a 50 percent evaluation, effective from June 10, 1991. The veteran is represented in his appeal by the American Legion. In his appeal, received in May 1992, the veteran claimed entitlement to service connection for malnutrition and a total disability rating based on individual unemployability. He also asserted that his private and VA doctors have stated that his problems (disorders on appeal) are directly and indirectly caused by the severe malnutrition and treatment as a prisoner of war. In December 1992, the RO denied service connection for malnutrition and noted that the provisions of 38 C.F.R. § 4.16(c) had been considered but were not for application. In his informal hearing presentation dated in October 1993, the veteran's accredited representative notes that the veteran also claims service connection for the disorders on appeal due to his experiences and treatment as a prisoner of war, and malnutrition. He also notes that the RO did not consider the veteran's claim under 38 C.F.R. § 4.16(b). Initially, the Board construes the representative's arguments as a notice of disagreement to the RO's December 1992 denial of service connection for malnutrition. As the veteran has been emphatic in claiming that the basis upon which service connection for the disorders at issue is being sought is as secondary to malnutrition derived as a result of his POW experience, the issue of service connection for malnutrition is inextricably intertwined with those issues which are now properly in appellate status. The fact that the veteran is documented to have been a prisoner of war would seemingly render his claim to service connect malnutrition as well-grounded. The Board also notes that entitlement to a total disability rating for compensation purposes also involves consideration of 38 C.F.R. §§ 3.321, 3.340, 3.341. The VA has the duty to assist the veteran in the development of facts pertinent 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 the veteran in obtaining and developing available facts and evidence to support his claim includes obtaining medical records to which the veteran has referred. Littke v. Derwinski, 1 Vet.App. 90 (1990). In his initial claim, notice of disagreement and substantive appeal, the veteran noted several physicians and hospitals from where he has received treatment since discharge from service, to include Dr. Cummings, Cortland Memorial Hospital, Robert Packard Hospital, Dr. Hassan, Dr. Essen, Dr. Bruerdich, Dr. Dallas, and Dr. Mason. The Board notes that no medical records have been requested from the veteran's private physicians or hospitals. While we regret the delays in reaching a final decision imposed by remanding this case, such action is found to be appropriate in view of the issues on appeal and our efforts to comply with continually evolving doctrine as set forth by the Court. In light of the foregoing, this case is REMANDED to the RO for the following action: 1. The RO should ask the veteran, with the assistance of his representative, to prepare a detailed list of all sources of examination and treatment for the various disorders for which he is seeking service connection since discharge from service. Names and addresses of the medical providers, and dates of examination and treatment, should be listed. After obtaining any needed release forms from the veteran, the RO should directly contact the medical providers or custodian of the medial reports and obtain the records. Any VA outpatient treatment records developed since 1992 should also be obtained and associated with this file for review. 2. While the VA psychiatric examination conducted in October 1992 is viewed as quite comprehensive, it is requested that the veteran be scheduled for another VA psychiatric examination in order to assess the extent and severity of impairment attributable to PTSD. It is specifically requested that the examiner review the file, and also that a Global Assessment of Functioning (GAF) score be assigned. 3. The veteran should also be afforded a social and industrial survey by a VA social worker or psychologist for purposes of obtaining an opinion concerning the extent to which there is impairment of the veteran's social and occupational prospects that is reasonably attributable to his psychiatric pathology. 4. The RO should reconsider all issues subject to this appeal, to include the veteran's claim for entitlement to a total disability rating for compensation purposes under all applicable provisions and issue the veteran and his representative a supplemental statement of the case regarding the pertinent developments to include entitlement to service connection for malnutrition and a total disability rating for compensation purposes. If, upon further review of his claim, it is determined that service connection is in order for malnutrition, development then undertaken by the RO should also include consideration of the previously developed service connection issues on a secondary basis; that is, as derived from the malnutrition. (38 C.F.R. § 3.310) If the decision remains adverse to the veteran, he and his representative should be furnished a supplemental statement of the case, and afforded a reasonable period of time within which to respond thereto. Thereafter, subject to current appellate procedures, the case should be returned to the Board. The veteran need not take any action unless he is further informed. The purposes of this REMAND is to allow for further development of the record and afford due process of law to the veteran. The Board intimates no final disposition by this action. JEFF MARTIN 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. (CONTINUED ON NEXT PAGE) 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).