BVA9505078 
DOCKET NO.  93-16 431     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Boston,
Massachusetts

THE ISSUE

Entitlement to an increased rating for post traumatic stress
disorder (PTSD), currently evaluated as 50 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

The appellant

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

REMAND

The veteran had active service from November 1966 to November
1968.  This appeal arises from rating decisions of the Boston,
Massachusetts, Regional Office (RO).

The duty to assist includes affording the veteran a thorough and
contemporaneous examination 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).
Although the veteran was afforded a Department of Veterans
Affairs (VA) psychiatric rating examination in January 1993, the
examination report did not provide a Global Assessment of
Functioning scale or provide her assessment of the impact of the
veteran's psychoneurotic symptomatology on his social and
industrial adaptability by indicating the degree to which the
psychiatric disorder resulted in reduction in initiative,
flexibility, efficiency and reliability levels.  The disability
picture has been complicated by chronic alcohol dependency.

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

1.  The veteran should be afforded a
comprehensive VA examination in psychiatry
by an examiner who has not previously
examined the veteran.  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, to include time lost from
employment, imposed by PTSD.  The examiner
should assign a Global Assessment of Func-
tioning 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 degree of
impairment of initiative, flexibility,
efficiency and reliability due to PTSD as
distinct from impairment attributable to
other conditions.

2.  When the requested development is fully
completed, the RO should readjudicate the
veteran's claim.  The rating decision
should reflect consideration of the appli-
cability 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.

          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
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).