BVA9507894 DOCKET NO. 93-16 859 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Boston, Massachusetts THE ISSUE Entitlement to an increased evaluation for anxiety reaction, currently rated 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD S. L. Kennedy, Counsel REMAND The veteran served on active duty from February 1952 to March 1954. This appeal arises from a February 1993 rating decision of the Department of Veterans Affairs (VA), Boston, Massachusetts, Regional Office (RO). In that decision, the RO denied the veteran's claim of entitlement to an increased evaluation for anxiety reaction. The Board of Veterans' Appeals (Board) notes that the veteran's accredited representative in this case has requested that the Board remand this case to the RO for additional development. Specifically, it is requested that the veteran be afforded a VA examination as he has not been afforded such an examination for rating purposes in many years. Moreover, it is asserted that not only does the most recent evidence of record reflect an increase in the symptomatology associated with the veteran's service- connected anxiety reaction, but also demonstrates that this combat veteran may now have elements of post-traumatic stress disorder (PTSD) which are related to the service-connected psychiatric disorder at issue. It is asserted that since recent VA outpatient treatment records are supportive of this position, the veteran should be afforded a VA examination for rating purposes to evaluate his service-connected anxiety reaction as well as to determine the existence of PTSD and any relationship to the disability at issue. The VA has a duty to assist a claimant in the development of facts pertinent to his or her claim under 38 C.F.R. § 3.103(a) (1994). The United States Court of Veterans Appeals has held that fulfillment of the VA's duty to assist the veteran includes providing him with a thorough and contemporaneous medical examination. Littke v. Derwinski, 1 Vet.App. 90, 92 (1990). The Board has carefully reviewed the evidence of record, including the history of the veteran's service-connected anxiety reaction as documented in the claims folder as well as records of recent outpatient treatment for anxiety. Additionally, the Board has considered the veteran's recent complaints of increased anxiety due to intrusive thoughts about his military service in Korea, nightmares, and insomnia. In light of all of these factors, the Board has determined that the RO should afford the veteran a current VA psychiatric examination for rating purposes. Fulfillment of the duty to assist the appellant includes the procurement and consideration of any relevant VA or other medical records. Ferraro v. Derwinski, 1 Vet.App. 326 (1991). The record reflects that the veteran receives regular medication for the service-connected disability at issue as well as occasional counseling at the Bedford, Massachusetts, VA Medical Center. The RO should ensure that all available current records from that facility are associated with the assembled records. In view of the foregoing, and in order to fully and fairly adjudicate the veteran's claim, the case is REMANDED to the RO for the following action: 1. The RO should obtain any available treatment records from the Bedford, Massachusetts, VA Medical Center, regarding treatment from October 1992 through the present. 2. The veteran should be afforded a VA psychiatric examination to determine the nature and severity of service-connected anxiety reaction as well as all psychiatric pathology which may be present. This examination should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. The claims folder should be made available to the examiner prior to the examination and the examiner should review that file prior to the examination. Any psychological testing deemed necessary to make a complete diagnostic evaluation and to differentiate symptoms attributable to anxiety reaction from those due to other conditions should be accomplished. The examiner should integrate any previous psychiatric findings and/or diagnoses with the current findings. The examination report should include a numerical and narrative assessment of the veteran's level of functioning as measured by the Global Assessment of Functioning (GAF) scale. Additionally, the examiner should comment on the manner and extent to which each diagnosed psychiatric disability results in social and industrial inadaptability, and provide an opinion as to whether the disability precludes substantially gainful employment. 3. Thereafter, the RO should readjudicate the veteran's claim of entitlement to an increased evaluation for anxiety reaction and adjudicate the claim of entitlement to service connection for PTSD. The rating should reflect consideration of the provisions of 38 C.F.R. § 3.321(b)(1) (1994). If the veteran's claim is not resolved to his satisfaction, the RO should issue a supplemental statement of the case which addresses all issues for which a notice of disagreement has been received. The supplemental statement of the case should include a summary of additional evidence, pertinent laws and regulations, and the reasons for the decision. The veteran and his representative should be afforded the applicable time to respond. The case should then be returned to the Board for further appellate review. The purpose of this REMAND is to obtain additional evidence and ensure that the veteran is afforded all due process of law. The Board intimates no opinion, either factual or legal, as to the ultimate conclusion warranted in this case. 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 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) (1994).