BVA9502289 DOCKET NO. 93-02 314 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Roanoke, Virginia THE ISSUE Entitlement to an increased rating for post-traumatic stress disorder, currently evaluated as 30 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Milo H. Hawley, Counsel REMAND The veteran had active service from October 1966 to August 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office in Roanoke, Virginia, (RO). It is contended that the veteran's post-traumatic stress disorder is more disabling than currently evaluated. It is asserted that the veteran has flashbacks, nightmares, and is severely impaired as a result of this disability. The record reflects that the veteran receives ongoing mental health care for his post-traumatic stress disorder, as well as having a history of polysubstance abuse, including alcohol and marijuana abuse. A November 1987 VA hospital discharge summary notes that the veteran's problems with alcohol may be self- treatment for post-traumatic stress disorder. The record does not reflect that the issue of service connection for polysubstance abuse, including alcohol and marijuana abuse, secondary to post-traumatic stress disorder, has been adjudicated. The relationship, if any, between post-traumatic stress disorder and polysubstance abuse must be clarified before a determination can be reached regarding the appropriate evaluation for the disability at issue. Service connection for polysubstance abuse, including alcoholism and marijuana abuse, secondary to post-traumatic stress disorder is an inferred issue which is inextricably intertwined. Akles v. Derwinski, 1 Vet.App. 118 (1991); Harris v. Derwinski, 1 Vet.App. 180 (1991). The claims folder must be made available to the psychiatrist prior to the examination requested below to aid in an informed opinion regarding this question. The case is REMANDED to the RO for the following: 1. The RO should contact the veteran and inquire as to where he has been receiving mental health care from April 1994 until the present. The RO should contact the health care provider(s) identified and request copies of all medical records relating to the veteran's mental health care from April 1994 until the present. 2. Thereafter, the veteran should be afforded a special VA psychiatric examination to determine the nature and extent of his post-traumatic stress disorder. This study must be conducted in accordance with the VA Physician's Guide for Disability Evaluation examinations. All indicated tests, including appropriate psychological studies with applicable subscales, must be conducted. The examiner should comment as to the relationship, if any, between the service-connected post- traumatic stress disorder and polysubstance abuse, including alcoholism and marijuana use. The claims file must be made available to and reviewed by the examiner prior to the examination. The examiner must assign a Global Assessment of Functioning Score consistent with the American Psychiatric Association's DIAGNOSTIC AND STATISTICAL MANUAL FOR MENTAL DISORDERS (3d ed. rev., 1987), and explain what the assigned score represents. A complete rationale for any opinion expressed must be provided. 3. Following completion of the foregoing, the RO must review the claims folder and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, including if the requested examination does not include all test reports, special studies or opinions requested, appropriate corrective action is to be implemented. 4. Thereafter, the issue of entitlement to service connection for polysubstance abuse, including alcoholism and marijuana abuse secondary to post-traumatic stress disorder, should be adjudicated. After completion of the above requested development, this claim should be readjudicated by the RO. If it remains denied, the veteran and his representative should be furnished with a supplemental statement of the case and be given the appropriate opportunity to respond thereto. Thereafter, the claims file, including the above requested evidence, should be returned to this Board for further appellate review, if in order. No action is required by the veteran until he receives further notice. The purposes of this REMAND are to procure clarifying data and accord due process. The Board intimates no opinion, either legal or factual, as to the ultimate disposition of this appeal. 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).