BVA9501528 
DOCKET NO.  93-08 917     )       DATE
          )
          )

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

THE ISSUES

1.  Entitlement to an increased rating for conversion reaction,
currently evaluated as 10 percent disabling.

2.  Entitlement to an increased (compensable) rating for a right
wrist disorder.

REPRESENTATION

Appellant represented by: The American Legion

ATTORNEY FOR THE BOARD

Jeffrey A. Pisaro, Counsel

INTRODUCTION

The veteran had active service from August 1966 to April 1967.
This appeal arises from a July 1992 rating decision of the
Pittsburgh, Pennsylvania, Regional Office (RO).

REMAND

The duty to assist includes affording the veteran a thorough and
contemporaneous examination that takes into account the records
of prior medical treatment.  Green v. Derwinski, 1 Vet.App. 121
(1991).  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).  The July
1992 VA psychiatric examination is inadequate to evaluate the
veteran's psychoneurosis.  First, it appears that the veteran's
medical records were not available for review by the examiner.
Also, the report of examination fails to adequately assess the
degree of social and industrial inadaptability present.
Multiaxial assessment V: global assessment of functioning with
respect to psychological, social and occupational functioning was
not provided.

In addition, the veteran was not afforded a VA orthopedic
examination to evaluate the degree of disability present relative
to his right wrist.  Additionally, the provisions of 38 C.F.R.
§ 4.59 provide that actually painful joints due to healed injury
are recognized as productive of disability entitled to at least a
minimal compensable rating for the joint.  It is clear that the
role of pain in the evaluation of disabilities of the
musculoskeletal system must be taken into consideration and the
veteran's disability must be evaluated in light of the provisions
of 38 C.F.R. §§ 4.40 and 4.45 (1993).  In view of the foregoing,
the veteran should be afforded VA orthopedic and psychiatric
examinations.

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
health care providers where he has received
treatment for the disabilities at issue
since separation from service, particularly
any recent medical treatment.  Thereafter,
the RO should obtain legible copies of all
records and associate them with the claims
folder.

2.  The veteran should be afforded VA
examinations in psychiatry and orthopedics
to determine the nature and extent of all
psychoneurotic and right wrist disability.
All indicated tests, to include x-rays of
the right wrist, should be accomplished.
The examiners must review the entire claims
folder prior to the examinations.
Disability should be evaluated in relation
to its history, with emphasis upon the
limitation of activity imposed by the
disabling condition in light of the whole
recorded history.  In particular, the
psychiatric examination report must contain
all five multiaxial assessment levels as
provided in DSM-III to include an
assessment of the veteran's social and
industrial inadaptability using the global
assessment of functioning scale.  The
orthopedic examination report should
include complete range of motion studies
for the right wrist; the examiner should
note any complaint of pain or limitation of
function of the right wrist; and painful
motion should be carefully noted and
definitely related to the affected joint.

3.  When the above developments have been
completed, the case should be reviewed by
the RO.  If the decision remains adverse to
the veteran, he and his representative
should be furnished with a supplemental
statement of the case which includes
consideration of 38 C.F.R. §§ 3.321(b)(1),
4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.129,
and 4.130.  They should then be afforded
the applicable period of 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).