BVA9508118 DOCKET NO. 93-09 124 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to an increased evaluation for an anxiety reaction, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: AMVETS ATTORNEY FOR THE BOARD Bobbiretta E. Jordan, Associate Counsel REMAND The veteran had active military service from November 1939 to September 1945. This appeal to the Board of Veterans' Appeals (Board) arises from December 1992 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, which denied an increased evaluation for an anxiety reaction. It is contended, in essence, that the RO did not consider medical evidence pertinent to the veteran's claim for increased evaluation for an anxiety reaction. The veteran's representative asserts that the RO ignored Dr. Graybeal's August 1992 statement concerning the veteran's psychiatric disability and that the RO failed in its duty to assist the veteran by not obtaining the doctor's clinical findings. Also, the veteran's representative calls attention to Dr. Lipsett's September 1992 statement. In addition, the veteran in his Substantive Appeal and the veteran's wife in a January 1991 statement maintain that the November 1992 VA examination was inadequate because the examiner interviewed the veteran for less thirty minutes. The veteran asserts that his anxiety reaction results in total social isolation. Therefore, it is requested that this matter be remanded to the RO for a more in-depth VA examination, to include a period of observation and evaluation and indicated psychological testing. A social and industrial survey is also requested. By a rating decision dated in June 1950, a 10 percent evaluation was assigned for the service-connected anxiety reaction effective in August 1950. Between August 1957 and October 1992, compensation payments were suspended because the veteran was found to have abandoned his claim and because his level of disability was found to be static. In a December 1992 rating decision, a 10 percent evaluation was assigned effective in October 1992, and it was also determined that there was insufficient evidence to evaluate the service-connected psychiatric disability between August 1957 and October 1992. In February 1993, the RO informed the veteran that he could reopen his claim for benefits during the period from August 1957 to October 1992 by submitting evidence from doctors who had treated him during this period. Subsequent to the issuance of a Statement of the Case in March 1993, the veteran's wife forwarded a September 1992 statement from Dr. Lipsett, who claimed to have treated the veteran for schizophrenia and other psychiatric disorders between 1960 and 1970. The Board notes that during service in 1945, the veteran was found to exhibit ideas of reference, allotropic tendencies and lack of insight, and he was diagnosed with a schizoid personality, leading to his separation from service. Therefore, these matters require further development. The record contains an August 1992 letter from Dr. Graybeal regarding the veteran's mental status. Notably, the physician indicated that the veteran is disabled by depression, paranoid ideation, and schizoid personality that have been aggravated by coronary heart disease and multiple strokes. Dr. Graybeal also noted that the veteran had discontinued recreational activities including painting and writing, that he vegetates, and that he has ceased to interact with other persons. In November 1992, the veteran was seen at a VA facility for a psychiatric examination. The examiner provided a detailed account of the veteran's history of depression and other anxiety related behavior. The examiner described the veteran's mood as anxious and indicated that he displayed some memory deficits. The examiner's impressions were that the veteran had a history of depression and that he had not required psychiatric care for a while. He further opined that the veteran's stroke approximately four years ago caused some memory problems and that the memory deficit may represent cognitive decline secondary to his stroke. No Axis I or Axis II diagnosis was given. The findings on recent VA and private psychiatric evaluations are at variance. Accordingly, the Board is of the opinion that further development of the evidence is appropriate to afford the veteran every possible consideration. See Littke v. Derwinski, 1 Vet.App. 90 (1990); Green v. Derwinski, 1 Vet.App. 121 (1991). Accordingly, the case is REMANDED to the RO for the following actions: 1. The RO should contact the veteran and request that he identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who have treated him for all psychiatric problems, including anxiety, schizophrenia, and depression, since April 1950. With any necessary authorization from the veteran, the RO should attempt to obtain copies of pertinent treatment records identified by the veteran which are not currently of record, including the clinical records of Robert Graybeal, M.D., 2650 Bahia Vista Street, Suite 107, Sarasota, Florida 34239. 2. Thereafter, the veteran should be afforded a VA examination by a board certified psychiatrist, if available, who has not examined the veteran previously, to determine the current severity of the service-connected anxiety reaction. All indicated tests, including psychological testing, should be performed. All psychiatric symptoms should be reported in detail. The symptoms of the service- connected anxiety reaction that cannot be disassociated from nonservice-connected disability should be identified to the extent possible. A complete rationale should be given for all opinions and conclusions expressed. 3. In light of the additional evidence obtained pursuant to the requested development, the RO should readjudicate the claim for an increased evaluation for an anxiety reaction. In addition, the RO should adjudicate the issue of entitlement to a compensable evaluation for an anxiety reaction from August 1957 to October 1992, if appropriate. If the benefit sought on appeal is not granted to the satisfaction of the veteran, or if a timely Notice of Disagreement is received with respect to any other matter, a Supplemental Statement of the Case should be issued, and the veteran and his representative provided an opportunity to respond. Thereafter, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to the final outcome warranted. No action is required of the veteran until notified by the RO. ROBERT E. SULLIVAN 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).