BVA9505000 
DOCKET NO.  92-05 319     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Boston,
Massachusetts

THE ISSUES

1.  Entitlement to an increased rating for a psychophysiological
gastrointestinal disorder with anxiety symptoms, currently
evaluated as 50 percent disabling.

2.  Entitlement to service connection for impotency, claimed as
secondary to a service-connected psychophysiological
gastrointestinal disorder with anxiety symptoms.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESSES AT HEARING ON APPEAL

The appellant and his spouse

INTRODUCTION

This matter came before the Board of Veterans' Appeals
(hereinafter the Board) on appeal from a rating decision of May
1991 from the Boston, Massachusetts, Regional Office (hereinafter
RO) of the Department of Veterans Affairs (VA).  The veteran had
verified active service  from July 1954 to January 1960.  The
case was remanded by the Board in July 1993 for further
development.  Most of that development has been completed and the
case has been returned to the Board for further consideration.

REMAND

In July 1993, the Board requested further examinations to
ascertain the current severity of the service-connected neurosis,
the current presence or absence of impotence, and, if present,
the etiology of the impotence.  The veteran had contended at the
time that medications he was taking for his service-connected
psychiatric disorder had caused impotence.

Pursuant to the remand order the veteran was given a psychiatric
examination in August 1993, which was completely adequate for
rating purposes.  It appears that he was also accorded VA
gastrointestinal and genitourinary examinations.  On the
genitourinary examination there was a diagnosis of sexual
impotence.  The physician failed to comment on the etiology of
the impotence as requested by the Board.

The Board points out for the RO's guidance that since the
decision of the United States Court of Veterans Appeals in Austin
v. Brown, 6 Vet.App. 547 (1994), the Board is no longer able to
make decisions on appeals on the basis of medical opinions from
its own medical advisors.  As such, the opinions of VA physicians
who examine veterans have become a primary source of answering
medical questions raised by the evidence of record.

The case is remanded for the following action:

(1).  The veteran should be asked which
specific medication(s) that he is taking
for his service-connected neurosis is
believed by him to have caused impotence.
He should further be asked whether any
physician who has treated him expressed the
opinion that such medication caused
impotence.  If he identifies a
physician(s), the RO should request
complete treatment records from such
physician(s) for association with the
claims folder.  Such physician(s) should
also be asked what there opinion(s) is as
to the etiology of the veteran's impotence.

(2).  The complete original VA outpatient
treatment records folder, and, if one
exists, the complete VA hospital clinical
records folder for the veteran should be
obtained for association with the claims
folder.

(3).  The veteran should be accorded a
further VA genitourinary examination to
ascertain the etiology of the impotence
reported on VA examination in October 1993.
The examining physician must completely
review the claims folder including all
records requested above in this remand
order, prior to the examination.  Following
such review and examination of the veteran
he should express an opinion as to whether
the veteran's impotence is caused by his
neurosis or medication which he takes for
his neurosis as distinguished from non
service-connected causes, such as diabetes
mellitus.

Following completion of these actions, the RO should  review the
evidence and determine whether the appellant's claims may now be
granted.  If not, the appellant and his representative should be
provided with an appropriate supplemental statement of the case
and be given a reasonable opportunity in which to respond
thereto.  Thereafter, the case should be returned to the Board
for further appellate consideration.

          BRUCE E. HYMAN
          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).