BVA9502208 
DOCKET NO.  93-08 666     )       DATE
          )
          )

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

THE ISSUE

Entitlement to an increased rating for post-traumatic stress
disorder, currently evaluated as 70 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESSES AT HEARING ON APPEAL

Appellant and his wife

ATTORNEY FOR THE BOARD

James A. Pritchett,  Associate Counsel

INTRODUCTION

The veteran served on active duty from July 1967 to October 1970.

This appeal arises from an August 1991 decision by the Boston,
Massachusetts, Department of Veterans Affairs (VA) Regional
Office (RO) that denied an increased evaluation for post-
traumatic stress disorder (PTSD) and a September 1992 rating
decision which increased the evaluation to 70 percent disabling,
pursuant to a decision by a hearing officer, but made the rating
effective in August 1991.

REMAND

By rating decision dated in June 1971, service connection for
schizophrenic reaction was established, evaluated as 30 percent
disabling.  Pursuant to a psychiatric evaluation, a rating
decision in June 1989, changed the diagnosis to post-traumatic
stress disorder, evaluated as 30 percent disabling.  The veteran
has had several hospitalizations for alcohol and/or drug abuse.
While rating actions pertinent to the current appeal have denied
a total rating based on periods of hospitalization because they
were for substance abuse rather than PTSD, the record does not
reflect that there has ever been a medical evaluation of the
possible relationship, or that it has ever been fully and
formally considered by a rating board.

The veteran's testimony at his personal hearing in March 1992 and
VA outpatient treatment notes dated in February 1992, indicate an
ambivalence toward employment.  The veteran's testimony indicates
that he had not decided whether he wanted to continue working or
not.  The VA treatment notes indicate that the veteran was
concerned that he would "go off" again if he went back to work.
Later February 1992 treatment notes indicate that the veteran
felt better but not "good enough" and that he was weighing work
against disability retirement.  His wife testified that the
veteran was getting worse and that he was becoming more withdrawn
and reluctant to leave their home.  The most recent VA
examination was performed in July 1991.  Recent ratings do not
indicate that 38 C.F.R. § 4.16 has been considered.  The matters
noted in the above paragraphs are inextricably intertwined with
the certified issue.

Since the veteran's claim is well grounded, the VA has a duty to
assist in the development of facts pertinent to his claim.  38
U.S.C.A. § 5107 (West 1991); 38 C.F.R. § 3.103 (1993).
Accordingly, the case is remanded to the RO for the following:

1.  The RO should obtain copies of all
VA inpatient and outpatient treatment
records pertaining to the veteran
which are not already part of the
claims file from May 1992 to the
present.

2.  The veteran should be afforded a VA
social and industrial survey to assess the
veteran's recent employment history and
day-to-day functioning.  A written copy of
the report should be inserted into the
claims folder.

3.  The RO should schedule the veteran
for a VA special psychiatric
examination to determine the severity
and extent of the veteran's PTSD and
the relationship between his PTSD and
his substance abuse.  All necessary
tests and studies should be
accomplished, and all clinical
manifestations should be reported in
detail, to include Global Assessment
of Functioning Scale (GAF) results.
The claims file must be made available
to the examiner prior to the
examination.

After completion of the above development, the veteran's claim
should be further reviewed.  Specific rating actions should fully
consider the issues of the effective date of the 70 percent
rating, whether the veteran's substance abuse is a service
connected disability and whether the veteran is employable (38
C.F.R. § 4.16).  If the veteran's substance abuse is found to be
a service connected disability, or part of the existing PTSD the
issue of benefits under 38 C.F.R. § 4.29 should also be
considered.  The veteran should be informed of the results of
these rating actions and afforded an opportunity to file a notice
of disagreement with any denials.  Thereafter, as to the
certified issue and any issue placed in appellate status, the
veteran and his representative should be provided with a
supplemental statement of the case and given the appropriate
opportunity to respond thereto.  Thereafter, the claims file,
including the above requested evidence, should be returned to
this Board for appellate review, if in order.  No action is
required by the veteran until he receives further notice.

The purpose of this remand is to procure clarifying data and
assure full due process with regard to all intertwined issues.
The Board intimates no opinion, either legal or factual, as to
the ultimate disposition of the appeal.

          ROBERT D. PHILIPP
          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) (1993).