BVA9500202 DOCKET NO. 91-43 249 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUES 1. Entitlement to an increased rating for post-traumatic stress disorder, currently evaluated as 50 percent disabling. 2. Entitlement to an increased rating for acne vulgaris, currently evaluated as 10 percent disabling. 3. Entitlement to an increased rating for dermatitis of the hands and ear, currently evaluated as 10 percent disabling. 4. Entitlement to an increased (compensable) rating for a left knee shrapnel fragment wound scar. 5. Entitlement to an increased (compensable) rating for a right knee shrapnel fragment wound scar. 6. Entitlement to a total rating based upon individual unemployability due to service-connected disabilities. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD C. Lawson, Counsel INTRODUCTION The veteran served on active duty from June 1964 to July 1966. The St. Paul, Minnesota Department of Veterans Affairs (VA) Regional Office (RO) denied the benefits sought. The Board of Veterans' Appeals (Board) remanded the case to the RO in August 1992. REMAND When this case was previously remanded by the Board in August 1992, service connection was in effect for only one skin disorder (acne), evaluated at 10 percent disabling. Since that time the RO granted service connection for dermatitis of the hands and ear and assigned a separate 10 percent rating for it. Inasmuch as both service-connected skin disorders are rated by analogy to eczema (Code 7806), one question that is raised on appeal is, based on current dermatological findings, would it be appropriate to assign one 30 percent rating in lieu of the two 10 percent ratings now in effect. This question cannot be addressed until the remand development on other issues is complete. When this case was previously remanded by the Board, the service- connected post traumatic stress disorder was rated at 30 percent disabling. It is currently rated as 50 percent disabling. Several VA psychiatric examinations since 1991 have classified the PTSD as severely disabling. One question that is raised by the current record is whether the requirements for a 70 percent rating for PTSD are met. This question cannot be addressed until the remand development on other issues is complete. When this case was previously remanded by the Board the issues of entitlement to compensable ratings for shell fragment wound scars of the right knee and left knee were not in appellate status. These issues are before the Board at the current time. The VA examination of these shell fragment wound scars in February 1994 described their size, the fact that they were well healed, and not depressed or contracted. As regards the right knee scar, it was said there was no functional limitation above the patella. What is essential for rating purposes is that the physician state with regard to each scar, whether is tender, painful, ulcerated or broken down. Inasmuch as the scars are in the area of each patella, the physician should described whether there is functional limitation of each patella, and, if so, what that limitation consists of. 38 C.F.R. Part 4, Codes 7803, 7804, 7805 (1993). As regards the unemployability issue, VA social and industrial surveys were conducted in September 1992 and February 1994. At both times the veteran was self employed in the appliance repair business. However, in February 1994 it was reported that a bankruptcy proceeding commenced in November 1993. It was reported that the business was being dissolved and the veteran had no future employment plans. In October 1994 a VA physician and social worker reported that the veteran was still doing minimal appliance repair work. They further reported that the veteran was engaged in litigation with a bank, that his brother was seriously ill, and that all of this was increasing his psychiatric symptoms. Another social and industrial survey is needed with a focus on the veteran's day to day functioning, his current employment status, and the amount of income being earned in his business. Accordingly, the case is REMANDED to the RO for the following action: 1. All clinical records of inpatient and/or outpatient treatment that the appellant has received from the Minneapolis, Minnesota VA Medical Center from May 1994 to present should be obtained and incorporated into the claims folder. 2. A VA social and industrial survey should be conducted. The report thereof should contain details about his recent and current employment and income, the status of the foreclosure and bankruptcy proceedings, and the current social and industrial effects of the appellant's brother's illness on the appellant. 3. The veteran should be accorded a VA orthopedic examination for the purpose of ascertaining whether one or more shell fragment wound scars in the area of each patella is tender, painful, ulcerated, or broken down, or whether it produces functional impairment of the patella involved. All clinical findings should be reported in detail. The claims folder should be made available to the examining physician, prior to examination, for his use in study of the case. Thereafter, the claims affected by this remand should again be reviewed by the RO, and the case should thereafter be returned to this Board in accordance with the usual appellate procedures, if in order. No action is required of the appellant until he is further informed. The purpose of this REMAND is to assist the appellant. BRUCE E. HYMAN 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) (1993).