BVA9506122 DOCKET NO. 93-14 144 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUE Entitlement to an increased evaluation for schizophrenia, undifferentiated type, currently evaluated as 50 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Ronald R. Bosch, Counsel INTRODUCTION The veteran served on active duty from September 1972 to September 1974. This appeal arose from a December 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey. The RO denied entitlement to an increased evaluation for schizophrenia, undifferentiated type. The case has been forwarded to the Board of Veterans' Appeals (Board) for appellate review. REMAND The representative has raised the issue of entitlement to service connection for abuse of alcohol as secondary to the veteran's service-connected schizophrenia. In light of the numerous Axis I diagnoses which combine both the service connected schizophrenia, and the currently nonservice connected alcohol abuse (see, e.g., the March and June 1991 VA hospital discharge summaries), this issue is inextricably intertwined with the issue of entitlement to an increased evaluation for schizophrenia. Moreover, if service connection of secondary alcoholism is not warranted, it is vital that the nature and extent of any service connected symptomatology be distinguished from the nonservice connected symptomatology. See, e.g., Shoemaker v. Derwinski, 3 Vet.App. 248, 255 (1992). (It is the obligation of the Board to reconcile the diagnoses, and to determine the degree of disability imposed by each impairment.) Such a distinction cannot, however, be made based on the record presented for review. Accordingly, further development is required. The representative has also raised the issue of entitlement to a total disability evaluation for compensation on the basis of unemployability. While this issue is not at this point in the adjudication process inextricably intertwined with the certified issue of entitlement to an increased evaluation for schizophrenia, it is nonetheless sufficiently relevant as an associated issue for the purpose of the present remand. Hence, further development pertaining to this issue is needed. The Board’s review of the claims folder further discloses that the veteran's complete treatment reports at the local VA medical center are not on file; that a VA Vocational Rehabilitation folder has been constructed for the veteran, but is not associated with the claims file; that an application for increased compensation on the basis of unemployability (VA Form 21-8940) is not of record; and that it is not clear if the veteran is in receipt of Social Security disability benefits. These records would be helpful in assessing the appellant's ability to work, and in determining the nature and extent of his service connected undifferentiated type schizophrenia. Therefore, pursuant to VA's duty to assist the veteran in the development of facts pertinent to his claim under 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1994), this case is REMANDED for the following action: 1. The RO should request and associate with the claims file copies of the veteran's complete treatment reports at the VA Medical Center in East Orange, New Jersey, dated since August 1992. 2. The RO should provide the veteran with an application for increased compensation on the basis of unemployability (VA Form 21-8940) for completion and return. 3. The RO should request and associate with the claims file the veteran's VA Vocational and Rehabilitation folder. 4. The RO should contact the Social Security Administration and request it to advise whether the veteran is in receipt of disability benefits. If such is the case, that agency should be requested to furnish copies of all medical records pertaining to such a benefit award. If medical evidence utilized in processing such claim is not available, that fact should be entered in the claims file. 5. Following the completion of the foregoing, and the association of any records received with the claims file, the RO should schedule the veteran for a psychiatric examination to determine the extent of severity of his schizophrenia, undifferentiated type, and whether abuse of alcohol is a manifestation thereof. The examination should be conducted in accordance with the diagnostic procedures outlined in the VA Physician's Guide for Disability Evaluation Examinations. All indicated studies including psychological studies should be conducted. The examiner must provide an opinion as to whether it is at least as likely as not that abuse of alcohol is causally related to the service- connected schizophrenia. Moreover, the examiner must offer an opinion as to what symptomatology may reasonably be associated with the veteran’s undifferentiated type schizophrenia, and what may be associated with his alcohol abuse. If the symptomatology caused by these disorders cannot be distinguished that fact should be noted, together with an explanation why no distinction is possible. All opinions expressed must be accompanied by a complete rationale. The examiner must assign Global Assessment of Functioning Score, and include a definition of the numerical code assigned which is consistent with the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (3rd. ed. rev., 1987). The claims file must be made available to and reviewed by the examiner prior to the examination. 6. The RO should review the examination report to confirm that it is in accordance with the above directives and if not, the examination should be returned for corrective action. 7. After undertaking any development deemed appropriate in addition to that specified above, the RO should adjudicate the issue of entitlement to service connection for alcohol abuse as secondary to service-connected schizophrenia, readjudicate the issue of entitlement to an increased evaluation for undifferentiated type schizophrenia, and adjudicate the issue of entitlement to a total disability evaluation for compensation on the basis of unemployability. If the benefits requested on appeal are not granted to the veteran's satisfaction, the RO should issue a supplemental statement of the case pertaining to all issues which are properly in an appellate status. A reasonable period of time for a response should be afforded. Thereafter, the case should be returned to the Board for appellate review, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran until he is notified by the RO. DEREK R. BROWN 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). In ordering development to reconcile the symptomatology caused by the various d recognizes that the November 1992 VA compensation examination notes the veteran’ not abused alcohol since 1990. In light of the subsequent diagnoses of alcohol providers in 1991, such a history is obviously inaccurate.