BVA9503785 
DOCKET NO.  93-09 431     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Chicago,
Illinois

THE ISSUE

Entitlement to an evaluation in excess of 50 percent for post
traumatic stress disorder (PTSD).

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

G. Wm. Thompson, Counsel

INTRODUCTION

The veteran had active service from October 1968 to October 1970.

This appeal arises from an August 1989 Department of Veterans
Affairs (VA) Chicago, Illinois, Regional Office (RO) rating
action that confirmed and continued a 50 percent rating following
the award of a temporary total rating based on a period of
hospitalization in February and March 1989.

REMAND

In the course of this appeal the veteran has indicated that he is
unable to work because of his PTSD, and there are statements from
physicians to the effect the veteran is unemployable because of
his service-connected PTSD, which is described as severe.  The
veteran's statements could be construed as raising the issue of a
total rating based on individual unemployability due to service
connected disability.

In regard to the increased rating claim, the Board of Veterans'
Appeals (Board) notes that there are diagnoses of a personality
disorder, psychosis, and drug and alcohol abuse for the veteran.
The VA psychiatric examination reports dated in 1990 and 1991 do
not specify the degree of social and industrial impairment
resulting from PTSD or assign a Global Assessment of Functioning
(GAF) score.  An increased rating may be authorized only to the
extent that any current maladjustment is shown to be the result
of a service-connected disability alone.  An analysis of the
degree of social and industrial impairment requires clarification
of the veteran's entire psychiatric status, including his
underlying personality and the existence of other psychiatric
pathology.  The manifestations of any such disorder must be
disassociated for rating purposes.

It is clear that additional development of the evidence is
necessary to clarify the manifestations associated solely with
the PTSD, and the degree of functional impairment.

This case is remanded for actions as follows:

1.  The RO should arrange for the veteran to
undergo complete psychological testing in
accordance with the VA Physician's Guide for
Disability Evaluation Examinations.  A
complete personality profile should be
included.

2.  Following completion of the foregoing,
arrangements should be made for the veteran
to undergo a special psychiatric examination
by a panel of VA psychiatrists who have not
previously examined him to ascertain the
nature and severity of all psychiatric
pathology.  The examination should be
conducted in accordance with the VA
Physician's Guide for Disability Evaluation
Examinations.  If PTSD is found, the
symptoms which support the diagnosis should
be specifically itemized.  If coexisting
psychopathology is also identified, it
should be described in detail.  In addition,
the examiners should be requested to
characterize the overall degree of
psychiatric impairment resulting from PTSD
only, in accordance with the rating
schedule, such as "mild," "definite,"
"considerable," or "severe.".  The claims
folder must be made available to the
examiners, and reviewed in advance.  Lastly,
the examiners must assign a GAF 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.  A complete rationale for any
opinion expressed must be provided.

3.  If a total schedular rating is not
awarded, the RO should determine whether the
veteran is entitled to a total rating based
on individual unemployment due to service-
connected disability.  If the determination
is adverse to the veteran, and he files a
notice of disagreement, the claim should be
developed for appeal accordingly.

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, including if the requested examination
does not include all test reports, special studies or opinions
requested, appropriate corrective action is to be implemented.
Thereafter, the claim should be returned to the Board after the
RO has followed all appropriate procedures, including issuance of
a Supplemental Statement of the Case and affording the veteran
and his representative an opportunity to respond.

          THOMAS J. DANNAHER
          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).