BVA9505086 
DOCKET NO.  92-10 107     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Indianapolis, Indiana

THE ISSUES

1.  Entitlement to service connection for a back disability.

2.  Entitlement to an increased rating for post-traumatic stress
disorder (PTSD), currently evaluated as 30 percent disabling.

3.  Entitlement to a total disability rating based on individual
unemployability due to service-connected disability.

4.  Entitlement to secondary service connection for substance
abuse.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

Sabrina Tilley, Counsel

INTRODUCTION

The veteran served on active duty from November 1965 to November
1968.  This matter came to the Board of Veterans' Appeals (Board)
originally from a February 1991 rating decision, which reflects
the disability evaluation for PTSD was increased from 10 percent
to a 30 percent.  In its current status, the case returns to the
Board following completion of development made pursuant to its
February 1993 remand.

REMAND

Based on its review of the record, the Board is of the opinion
that further development is indicated prior to appellate handling
of this case.  In light of the adjudicatory action taken by the
RO, the Board finds that the issue of secondary service
connection for substance abuse is one which is "inextricably
intertwined" with the developed issues on appeal.  This matter
requires further action as indicated hereinbelow.  Also, the
Board finds that an orthopedic examination is warranted in order
to determine the likely etiology of the veteran's claimed back
disorder.  Finally, the Board finds that further evidentiary
development is required in order to obtain pertinent treatment
records.

To ensure that VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the RO for the following development:

1.  The RO should take appropriate steps in
order to obtain copies of all clinical
documents referable to all treatment
received by the veteran at the Vet Center
since May 1990.  In addition, copies of all
VA treatment records for the veteran since
1993 should be obtained for review.  After
securing these documents, the RO should
incorporate these in the record.

2.  The veteran should be afforded a VA
orthopedic examination to ascertain the
current nature and likely etiology of any
claimed back disorder.  All indicated
testing should be done in this regard.  The
claims folder should be made available to
the examiner for review before the
examination.  Based on her/his evaluation
and review of the record, the examiner
should offer an opinion as to the medical
probability that any clinically identified
back pathology is the result of injury
suffered in service, as claimed by the
veteran.

3.  The veteran should be afforded further
VA psychiatric examination to ascertain the
current nature and likely etiology of all
current substance abuse.  All indicated
testing should be done in this regard.  The
claims folder should be made available to
the examiner for review before the
examination.  This should include all
records concerning treatment received by
the veteran at the Vet Center.  Based on
her/his evaluation and review of the
record, the examiner should offer an
opinion as to the medical probability that
any clinically identified substance abuse
is the result of his service-connected
disabilities.  The examiner should provide
supporting reasons for the opinion.

4.  After the development requested above
has been completed to the extent possible,
the RO should again review the veteran's
claims.  This should include appropriate
development of the issue of service
connection for substance abuse.  If any
benefit sought on appeal remains denied,
the veteran and his representative should
be furnished a supplemental statement of
the case and given the opportunity to
respond thereto.

Thereafter, the case should be returned to the Board, if in
order.  The Board intimates no opinion as to the ultimate outcome
of this case.  The veteran need take no action unless otherwise
notified.

          STEPHEN L. WILKINS
          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).