BVA9503570 DOCKET NO. 93-06 806 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Houston, Texas THE ISSUE Entitlement to an increased evaluation for an conversion reaction, currently rated as 30 percent disabling. REPRESENTATION Appellant represented by: Texas Veterans Commission WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. Auer, Counsel REMAND The veteran served on active duty from January 1942 to December 1944. This appeal arises from an April 1989 rating decision of the Department of Veterans Affairs (VA), Houston, Texas, Regional Office (RO). In that decision, the RO denied an increased rating for the veteran's service-connected conversion reaction. By rating decision of July 1991, the RO a 30 percent rating for the veteran's service-connected conversion reaction was granted. The veteran was examined by the VA in June 1991. The examiner reported that he did not have access to the veteran's claims file. Following his examination, the diagnoses included generalized anxiety disorder, moderately severe and organic mental syndrome, minimal severity. The examiner specifically remarked that, in absence of the veteran's claims file, no opinion could be performed regarding any possible etiological relationship between the condition diagnosed as conversion disorder during his military service and the psychiatric disorder for which he is now receiving treatment. Additionally, the Board of Veterans' Appeals (Board) notes that the examiner did not provide a Global Assessment of Functioning (GAF) scale code or otherwise indicate the degree to which the psychiatric disorder results in reduction in initiative, flexibility, efficiency and reliability levels. See Massey v. Brown, No. 93-135 (U.S.Vet.App. Dec. 6, 1994). In a January 1993 statement, the veteran indicated that he had been told that he had Parkinson's disease by someone at the VA in Beaumont, Texas. When examined by the VA in June 1991, it was observed that he was visible tremulous. It was noted that the tremor constituted the veteran's primary complaint and the most prominent symptom of a generalized anxiety disorder. In view of the above, the Board finds that further development is warranted before a final decision in this appeal. Accordingly, the claim is REMANDED for the following actions: 1. The RO should contact the veteran and ask him to furnish the names and addresses of all private medical personnel and facilities from whom he has received treatment for the disability at issue since June 1991. After obtaining the necessary authorization from the veteran, the RO should obtain available records from the named sources, and permanently associate all such records with the veteran's claims folder. 2. The RO should obtain and associate with the claims folder any available treatment records from the VA hospitals or medical centers where the veteran has received treatment since August 1992. Care should be taken by the RO so that duplicate records are not placed in the claims file. 3. Following the above development, a special neurological examination of the veteran should be scheduled for the purpose of determining the nature and extent of any current neurological disorder. The examiner should review the claims folder prior to the examination and express an opinion as to the probable etiology and date of onset of any neurological disorder. All necessary tests should be performed. 4. Following completion of the above development, the veteran should be accorded a VA psychiatric examination to determine the nature and severity of his psychiatric disorder. The claims folder must be made available to the examiner prior to the evaluation so that the examiner may review the pertinent historical data contained therein. The examiner should utilize the pertinent data in the claims folder in order to obtain a true picture of the progress of the veteran's psychiatric disorder. The psychiatrist should conduct any psycho- logical testing deemed pertinent in making a complete diagnostic evaluation. Based upon a review of the record and the examination, the examiner specifically is requested to offer an opinion as to the relationship, if any, between any tremors experienced by the veteran (which are not attributable to a distinct neurological disorder) and his service-connected psychiatric condition. The physician should also provide a Global Assessment of Functioning (GAF) scale code and discuss the nature and meaning of the numerical value assigned. In addition, the examiner should discuss the veteran's ability to perform substantially gainful employment and the factors attributable to the service-connected psychiatric disorder that limit his employment opportunities. The complete rationale for all opinions expressed should be provided. 5. After the above actions have been completed, the case should again be reviewed by the RO, to include consideration of the issue of entitlement to service connection for a neurological disorder, if appropriate. The rating decision should reflect consideration of 38 C.F.R. §§ 3.321(b)(1) and 4.16 (1994) (relating to the assignment of an extra-schedular disability evaluation). If his claim remains denied, the RO must advise the veteran and his representative that, to obtain appellate review of any issue adjudicated but not presently on appeal, a notice of disagreement and substantive appeal must be filed. After provision of a reasonable period of time for response, if necessary, the veteran and his representative should be provided with a supplemental statement of the case, with respect to all issues properly developed for appellate review, that includes any additional pertinent law and regulations and a full discussion of the evidence in this case. The appropriate response time should be allowed. The case should then be returned to the Board, if in order, after compliance with all regulatory appellate procedures. The RO specifically is requested to complete all necessary actions as expeditiously as possible. By its REMAND, the Board does not intimate any opinion as to the ultimate disposition of this case, either favorable or unfavorable, at this time. No action is required of the veteran until notified. JACQUELINE E. MONROE 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).