BVA9503253 DOCKET NO. 91-49 164 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUES 1. Whether new and material evidence has been submitted to reopen the claim for service connection for a chronic acquired psychiatric disorder. 2. Entitlement to service connection for post-traumatic stress disorder. 3. Entitlement to service connection for a cardiovascular disorder secondary to the veteran's service-connected shell fragment wound residuals. 4. Entitlement to an increased compensable rating for the residuals of a shell fragment wound to the left hand. 5. Entitlement to an increased compensable rating for the residuals of a shell fragment wound to the left knee. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD A. D. Jackson, Associate Counsel INTRODUCTION The veteran served on active duty from May 1942 to November 1945. This matter came before the Board of Veterans' Appeals (Board) on appeal from a February 1991 rating decision of the St. Louis, Missouri, Regional Office (RO). That rating decision denied service connection for a heart condition, a nervous condition and gunshot wound residuals. In June 1992, this case was remanded for further development. A rating decision dated in September 1992 granted service connection for gunshot wound residuals to the left hand and left knee and assigned noncompensable evaluations. The veteran submitted his disagreement to the assigned evaluations for gunshot wound residuals to the left hand and left knee. In February 1993, this case was again remanded for further development. Subsequently, a rating decision dated in May 1994 denied those claims listed on the title page. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends service connection for a chronic acquired psychiatric disorder recently diagnosed as generalized anxiety disorder is warranted. It is argued that evidence submitted is new and material evidence sufficient to reopen the veteran's claim and also grant service connection for a chronic acquired psychiatric disorder. He further contends that he suffers from post-traumatic stress disorder as result of his active military service. The veteran points out that fellow servicemen have stated that during service he was confined to the dispensary and treated for high blood pressure, stress and tension. He claims that he eventually developed heart problems as a result of his gunshot wounds; and the tension and stress he suffered during service. He also maintains that he should be granted increased ratings for the residuals of shell fragment wounds to the left hand and left knee. He asserts that he suffers from pain and swelling of the left knee. He also reports that he has limited use of the left hand. REMAND It is noted that the VA examiner at the veteran's June 1993 examination related that the veteran had symptoms similar to post-traumatic stress disorder; however, further testing was recommended including psychological testing. In Hyder v. Derwinski, 1 Vet. App. 221 (1991), the United States Court of Veterans Appeals (Court) held that the VA's failure to conduct further evaluations and studies as recommended by the VA's own examiner constituted a breach of its statutory duty to assist the veteran as provided by the provisions of 38 U.S.C.A. § 5107(a) (West 1991). Accordingly, further psychological evaluation is needed. To ensure that the 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 developments: 1. The RO should schedule the veteran for a psychiatric examination by a Board of two psychiatrists who have not previously examined him to determine the nature of his psychiatric impairment. Psychological testing is also to be accomplished, prior to the psychiatric evaluations, and the results made available to the examining psychiatrists. More specifically, the Board wishes to determine if he has post- traumatic stress disorder, as defined in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM- III-R). If so, the specific symptoms that establish this particular diagnosis and exclude other diagnoses should be itemized in detail. The precipitating stressors should be fully identified. The examiners should also comment as to the etiology of any other diagnosed psychiatric disorder, if found, in particular, a generalized anxiety disorder. The claims folder should be made available to the examining physicians for review prior to conducting the requested examination. 2. After the development requested above has been completed to the extent possible, the RO should again review the record and consider the issues on appeal. In evaluating the increased rating claims, 38 C.F.R. § 3.324 (1994) should specifically be considered. If any benefit sought on appeal, for which a notice of disagreement has been filed, remains denied, the appellant and 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 appellant need take no action unless otherwise notified. E. W. SEERY 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).