BVA9506063 DOCKET NO. 93- 10 582 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. An increased disability rating for residuals of fracture of T7 -8 with arthritis, currently evaluated as 10 percent disabling. 2. Service connection for an acquired psychiatric disorder, claimed as post-traumatic stress disorder. REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Barry F. Bohan, Counsel INTRODUCTION The appellant served on active duty in the United States Air Force from March 1957 to August 1968. Service in Vietnam is indicated by the evidence of record. In an October 1971 rating decision, the Department of Veterans Affairs Regional Office in St. Petersburg, Florida (VARO) granted the appellant service connection for residuals of a fracture of the thoracic spine, which was sustained in a March 1965 motor vehicle accident. A 10 percent disability rating was assigned. Service connection was also granted for a scar, residual of left scalp laceration, and a noncompensable disability rating was assigned. Service connection was denied for residuals of fractures of the sternum and the right tenth rib. In August 1991, the appellant requested that his claim be reopened. In a December 1991 rating decision, an increased disability rating was denied for the appellant's service- connected fracture of the thoracic spine. Service connection was denied for major depressive disorder, claimed as post-traumatic stress disorder (PTSD). This appeal followed. REMAND The appellant is seeking service connection for PTSD, or, in the alternative, for an acquired psychiatric disorder, diagnosed variously as major depressive disorder and generalized anxiety disorder. He admits that his duties in Vietnam were as a motor pool dispatcher at a Air Force base and did not involve combat. However, he contends that he may have PTSD, and even if he does not, his presently diagnosed psychiatric disorder had its inception in stressful incidents he experienced in Vietnam. The appellant's representative, in a June 1993 informal presentation, raised a number of additional issues, including service connection for fractured sternum, fractured rib, skull injury, organic brain syndrome, left shoulder disorder, cervical spine injury and chest injury, to include possible injuries to the heart and lungs, all of which he attributed, directly or secondarily, to the appellant's March 1965 motor vehicle crash. The appellant's representative requested additional medical testing, to include examination to rule out organic brain syndrome. In the opinion of the Board, the issues raised by the appellant's representative are inextricably intertwined with the two issues presented in this appeal. The appellant's claim should not be adjudicated in a piecemeal fashion. Harris v. Derwinski, 1 Vet.App. 180, 183 (1991). The Board notes that there is little medical evidence covering the period from the date of the appellant's discharge from the Air Force in 1968 until he reopened his claim in 1991, and no medical evidence whatsoever covering the period from 1975 to 1991 has been associated with the appellant's claims folder. The appellant's entire medical history is crucial to a proper determination of his claim. 38 C.F.R. §§ 4.1, 4.41 (1994); Peyton v. Derwinski, 1 Vet.App. 282 (1991). With respect to the issue of service connection for organic brain disease, during the most recent VA psychiatric examination of record, in January 1993, the appellant complained that he had difficulty with his memory. The examiner stated: "generally his memory was intact except when he became aware that I was asking him memory questions he had difficulty focusing and concentrating and was very slow in providing answers." The examiner requested psychological testing, which was completed in February 1993. The testing was invalid due to "excessive endorsement of psychopathology" by the appellant. However, there were no findings consistent with PTSD or with organic brain syndrome. The Board believes that further development of the evidence, to include examination by specialists in orthopedics, neurology and psychiatry, would be helpful in this case. Hyder v. Derwinski, 1 Vet.App. 221 (1991). The case is therefore REMANDED to VARO for the following actions: 1. VARO should contact the appellant, through his representative, and clarify which issues the appellant wishes to pursue. VARO should then appropriately develop such issues, applying all pertinent laws, regulations and court decisions. 2. The appellant should also furnish VARO with a list of all health care providers who treated him since his discharge from military service since 1968. VARO should then contact those health care providers and obtain records pertaining to treatment of the appellant. Such medical records should be associated with the appellant's claims folder. 3. VARO should determine the appellant's dates of service, unit[s] and duty stations in Vietnam. VARO should then contact the United States Army and Joint Services Environmental Support Group, 7798 Cissna Road, Springfield, Virginia, 22150 in order to obtain information concerning enemy activity and unit casualties during the appellant's tour of duty. Such information should be associated with his claims folder. 4. The appellant should be scheduled for examinations by specialists in orthopedics, neurology and psychiatry. The appellant's claims folder should be furnished to the examiners for review prior to the examination. The reports of the examinations should be associated with the appellant's claims folder. After the above development has been completed, VARO should readjudicate the appellant's claim. If the claim remains denied, in whole or in part, the case should be returned to the Board after compliance with all requisite appellate procedure. The purpose of this REMAND is to procure clarifying data and to satisfy due process requirements. The Board intimates no opinion as to the ultimate conclusion warranted, pending completion of the requested development. No action is necessary on the appellant's part until he receives further notice. C.P. RUSSELL 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).