BVA9507199 
DOCKET NO.  91-24 251     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Louisville,
Kentucky

THE ISSUE

Entitlement to service connection for a nervous disorder.

REPRESENTATION

Appellant represented by: Disabled American Veterans

INTRODUCTION

The veteran had active military service from September 1974 to
June 1976.

This matter came before the Board of Veterans' Appeals (Board) on
appeal from a May 1990 rating decision by the Louisville,
Kentucky, Regional Office (RO) of which the veteran was informed
in June 1990.  This determination found that the veteran had not
submitted evidence which was both new and material such as to
reopen his claim seeking entitlement to service connection for a
nervous disorder and, further, that the veteran was not entitled
to a grant of nonservice-connected pension benefits.  The appeal
was remanded to the RO for further development by the Board in
December 1991.

In April 1994, the Board held that new and material evidence had
been submitted to reopen a claim of service connection for a
psychiatric disorder.  After this determination was made, the
case was remanded to the RO for a de novo review of all evidence
of record and for compliance with Bernard v. Brown, 4 Vet.App.
384 (1993).  The case has now been returned to the Board for
further appellate consideration.

The original statement of the case provided to the veteran and
his representative, as indicated above, also addressed the issue
of entitlement to nonservice-connected pension benefits.  By a
rating action in August 1993, the RO granted entitlement to a
permanent and total disability rating for pension purposes and
the issue was withdrawn from appeal.  Accordingly, this issue
will not be addressed in this decision.

REMAND

At the time of the April 1994 decision on the matter of the
submission of new and material evidence and of the remand, the
Board noted that the veteran complained of nervous problems in
service, was examined at separation therefrom and found to have
chronic situational anxiety and/or depression.  The service
medical records also revealed that the veteran had a problem with
insomnia during service.  In July 1975 he made a suicidal gesture
by the ingestion of sleeping pills and was believed to have had a
character disorder.  In addition to noting chronic situational
anxiety and depression, the service discharge examination also
noted that the veteran had an immature personality.  It was
further noted, following a period of Department of Veterans
Affairs (VA) hospitalization in late 1991, that he was diagnosed
as having a borderline personality disorder.

In connection with the veterans attempt to reopen his claim, the
Board noted that a substantial volume of treatment records not
previously considered, including summaries of the veteran's
multiple periods of VA hospitalization, has been submitted.  In
addition, several statements by VA clinicians and a transcript of
the veteran's testimony when he personally appeared before the
rating board in March 1990 have also been included in the record.
The additional evidence included clinical data reflecting
treatment provided to the veteran for an acquired psychiatric
disorder.  The veteran had been diagnosed a having a bipolar
affective disorder separate from his personality disorder and the
clinical data also reveal that the veteran has had recurrent
indications of anxiety and depression on mental status
examinations subsequent to service.  The veteran testified that
he experienced anxiety and depression in service associated with
insomnia and the new evidence reflected that chronic anxiety and
bouts of depression have been clinically identified following
service.

In the remand order we requested that the veteran be scheduled
for a comprehensive psychiatric examination in order to ascertain
the correct psychiatric diagnosis at the current time.  The
examiner was also requested to offer an opinion as to the
relationship, if any, between the veteran's chronic situational
anxiety/depression, noted in service, and any currently
manifested acquired psychiatric disorder.

In response to the remand order, the veteran received an
exceptionally comprehensive psychiatric examination with
indication that the examining physician reviewed the claims
folder prior to the examination.  Diagnoses were made of major
depression with psychotic features and of a borderline
personality disorder.  The examiner failed to offer an opinion as
to the relationship, if any, between the veteran's chronic
situational anxiety/depression, noted in service and the
currently manifested acquired psychiatric disorder (major
depression with psychotic features).

The veteran's representative on reviewing the record in February
1995, requested that the Board obtain an independent medical
expert's opinion with regard to the issue on appeal.  We are not
convinced on the basis of the current record, that this issue is
of sufficient complexity to warrant the opinion of an independent
medical expert.  We will reserve that judgment until such time as
all of the originally requested remand development has been
complied with.

This case is remanded for the following action:

The claims folder should be returned to the
VA physician who examined the veteran in
May 1994, if he is available.  If he is not
available, the claims folder may be
reviewed by another VA psychiatrist.  The
May 1994 report of psychiatric examination
should be reviewed in conjunction with all
other psychiatric findings during and
subsequent to service.  The physician
should then express an opinion as to
whether the current major depression with
psychotic features is related to the
chronic situational anxiety and depression
noted in service, and, in any event,
whether he believes the currently diagnosed
psychiatric disorder developed during
service or within the first post service
year.

When the above development has been completed the case should be
reviewed by the RO.  If the benefit appealed for is not granted,
the veteran and his representative should be furnished with a
supplemental statement of the case and afforded a reasonable time
to reply thereto.  Thereafter the case should be returned to the
Board for further appellate consideration, as required.  No
action is required of the veteran unless notified.  The purpose
of this remand is to procure clarifying data.

          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).