BVA9502839 DOCKET NO. 93-10 486 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Pittsburgh, Pennsylvania THE ISSUES Entitlement to service connection for a chronic stomach disorder to include peptic ulcer disease, residuals of neck injury, a chronic low back disorder, a chronic eye disorder, chronic depression and systemic lupus erythematosus. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. B. Weiss, Associate Counsel INTRODUCTION The veteran had active duty from October 1978 to September 1982. The veteran originally claimed a compensable rating for residuals of coccygectomy, status post fracture of the coccyx, which was granted by a November 1992 rating decision. The veteran was notified of this decision, and, as she did not indicate a desire to continue her appeal of this issue, the claim is considered granted and no longer for appellate review. We note that the veteran is receiving Social Security disability benefits based on having been adjudged totally unemployable. It is unclear whether the veteran desires a nonservice-connected pension. She has not formally claimed such benefit but has attempted to put forth, to the Department of Veterans Affairs (VA), evidence of her permanent unemployability. Therefore, the veteran should be asked whether she desires a nonservice- connected pension, and, if so, the claim should be developed. REMAND The veteran initially claimed service connection for depression. The veteran perfected her appeal of her claim for service connection for an acquired psychiatric disorder by her September 1991 substantive appeal. However, it does not appear that the entire treatment records for her mental disorder have been sought or that the regional office (RO) considers this issue for appellate review. The veteran reported in her original claim that she had been treated by Dr. Leonore Farmer, 4719 Wallingford Street, Pittsburgh, Pennsylvania 15213, and Patty Kerestes for mental problems, at Mon Valley Health Center (MVHC), Eastgate 8, Monessen, PA, 15062, and that she had been hospitalized several times for biological depression, including at Western Psychiatric Institute and Clinic in April 1988. She added that her hysterectomy of July 1980 was the beginning of her depression and insomnia. In her notice of disagreement, she reported that she had been treated by Paul I. Weiss, M.D., P.O. Box 5173, Pittsburgh, PA, 15206, for a mental disorder, and that she had received treatment from Dr. Weiss at Jefferson Hospital and at Mon Valley Community Health Center, which is apparently the same entity as MVHC. She also reported that she had received therapy from Chris Garrett at MVHC. It does not appear that any of these records have been sought, although we note that a letter directed to Dr. James Lanagan at MVHC was sent, requesting that doctor's treatment records. The letter yielded no response. A letter from R. Ramsey-Goldman, M.D., of July 1989, indicates that attached thereto was a letter of "Dr. Kahl's" dated August 24, 1987, which reportedly summarized the veteran's case history of systemic lupus erythematosus (SLE), among other things. However, a copy of Dr. Kahl's letter is not of record. Dr. Ramsey-Goldman has not been asked to re-supply the letter, and the RO's letter to Dr. Kahl has gone unanswered. To ensure full compliance with due process requirements and the duty to assist, the case is REMANDED to the RO for the following development: 1. The RO should obtain the names and addresses of all medical care providers who treated the veteran for the claimed disorders since January 1992. After securing the necessary medical record authorization release, the RO should attempt to obtain copies of these records, including records of hospitalization at Western Psychiatric Institute and Clinic, as well as all of the records identified herein above pertaining to the veteran's mental health and SLE treatment. This would include asking Dr. Ramsey-Goldman to re-supply Dr. Kahl's letter dated August 24, 1987, and asking Chris Garrett, Patty Kerestes, and Drs. Leonore Farmer and Paul I. Weiss for pertinent records. 2. After the above records have been secured, the RO should schedule the veteran for a special VA psychiatric examination to determine the nature of all of the veteran's psychiatric disorders. The examiner should comment upon the causal or etiological relationship, if any, between the veteran's hysterectomy of July 1980 and any psychiatric disorder diagnosed. The claims folder must be provided to the examiner prior to the examination. 3. The veteran should be afforded a VA gastrointestinal examination to determine whether a chronic gastrointestinal disorder, independent of SLE, is present, the etiology and the date of onset thereof. The claims folder should be made available to the examiner for review before the examination. Any indicated diagnostic tests should be performed. The examiner should note that in April 1980 the veteran was shown to have duodenal irritability and spasm with coarsening of the mucosal folds without finding of acute ulcer crater, that in June 1980 a series of gastrointestinal X-rays were normal and that she had duodenitis in November 1983, gastritis in June 1989, and acute duodenitis in May and June 1991. 4. A VA rheumatologist should be asked to review the claims file and provide an opinion as to the date of onset of SLE. If this is not possible, then the rheumatologist should explicitly so state. Comment should be made as to any rheumatoid arthritis being shown to be present. 5. The veteran should be accorded another VA eye examination to determine the presence and etiology of any chronic eye pathology. Any indicated testing should be done and the claims file should be made available to the examiner. 6. After the development requested above has been completed to the extent possible, the RO should again review the record. 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 of Veterans' Appeals (Board), if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action until otherwise notified. SAMUEL W. WARNER 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).