BVA9503035 
DOCKET NO.  93-12 633     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Philadelphia,
Pennsylvania

THE ISSUE

Entitlement to an increased rating for post traumatic stress
disorder (PTSD), currently evaluated as 10 percent disabling.

REPRESENTATION

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

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

REMAND

The veteran had active service from April 1966 to March 1969.
This appeal arises from an April 1992 rating decision of the
Philadelphia, Pennsylvania, Regional Office (RO).

The Department of Veterans Affairs (VA) has a duty to assist the
veteran in the development of facts pertaining to his claim.  38
U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993).  The
United States Court of Veterans Appeals (Court) has held that the
duty to assist includes obtaining available records which are
relevant to the claimant's appeal.  The duty to assist is neither
optional nor discretionary.  Littke v. Derwinski, 1 Vet.App. 90
(1990).  The veteran has been receiving continuing treatment for
his psychiatric disorder at the Harrisburg VA outpatient clinic;
complete records should be obtained from that facility.

The duty to assist also includes, when appropriate, the duty to
conduct a thorough and contemporaneous examination of the veteran
that takes into account the records of prior medical treatment.
Green v. Derwinski, 1 Vet.App. 121 (1991).  This is to ensure
that the evaluation of a disability is a fully informed one.  The
severity of psychiatric disability is based upon actual
symptomatology as it affects social and industrial adaptability.
See 38 C.F.R. §§ 4.129, 4.130 (1993).  Since the August 1992 VA
psychiatric examination, extensive VA treatment records have been
added to the record.  The veteran contends that his
psychoneurotic disability has increased in severity.  He has
reported losing time from employment, and being separated from
his wife.  In view of the foregoing, following the gathering of
all medical records, the Board is persuaded that the veteran
should be afforded a further VA psychiatric examination in
connection with this appeal.

Under the circumstances of this case, the Board finds that
further assistance is required.  Accordingly, the case is
REMANDED to the RO for the following actions:

1.  The RO should contact the veteran and
obtain the names and addresses of all
mental health care providers where he has
received treatment for PTSD in recent
years.  Thereafter, the RO should obtain
legible copies of all records which have
not already been obtained, to include those
from the Harrisburg VA outpatient clinic
from September 1992 to the present.  Once
obtained, all records must be associated
with the claims folder.

2.  Following completion of the above
development, the veteran should be afforded
a comprehensive VA examination in
psychiatry.  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, should be conducted if
determined to be warranted by the examining
physician.  The claims file must be made
available to and reviewed by the examiner
prior to the examination.  The disability
should be evaluated in relation to its
history, with emphasis upon the limitation
of activity imposed by the PTSD.  The
examiner should 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.
To the extent possible, disability
attributable to PTSD and its effect on
employability should be distinguished from
other disabling conditions.  A complete
rationale for any opinion expressed should
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, appropriate corrective action
should be implemented.
The veteran and his representative then
should be furnished with a supplemental
statement of the case which includes
consideration of 38 C.F.R. §§ 4.7, 4.129,
and 4.130.  They should then be afforded
the applicable time to respond.

Thereafter, subject to current appellate procedures, the case
should be returned to the Board for further appellate
consideration, if appropriate.  The veteran need take no action
until he is further informed.  The purpose of this REMAND is to
obtain additional information and to ensure due process of law.
No inference should be drawn regarding the final disposition of
the claim as a result of this action.

          CHARLES E. HOGEBOOM
          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 action has been taken in
accordance with the Veterans' Benefits Improvements Act of 1994,
Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and 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).