BVA9500702 DOCKET NO. 93-01 277 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Des Moines, Iowa THE ISSUE Entitlement to permanent and total disability rating for non- service connected pension purposes. REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD J. Sherman, Counsel INTRODUCTION The veteran had active military duty from January 1974 to February 1975. This appeal arises from an April 1992 rating decision of the Des Moines, Iowa, regional office (RO) that denied entitlement to non-service connected pension. The veteran's representative, in a written presentation dated in February l993, has raised the issue of entitlement to service connection for hearing loss. This issue, which is not inextricably intertwined with the issue before us, is refered to the RO for appropriate action. REMAND The veteran contends that he suffers from depression, stress, and sinus pain and that he is unable to maintain employment as a result of his disabilities. He has applied for non-service connected pension based on permanent and total disability pursuant to 38 U.S.C.A. § 1521 (West 1991). Eligibility depends on meeting two tests: service during a period of war, and permanent and total disability. The veteran may show permanent and total disability in one of two ways: 1) he is unemployable as a result of a lifetime disability (unemployability standard), or 2) the lifetime disability is one that would render it impossible for the average person with the same disability to follow a substantially gainful occupation (average person standard). 38 U.S.C.A. § 1502(a) (West 1991). See Brown v. Derwinski, 2 Vet.App. 444 (1992). Further development will be required to determine whether the veteran demonstrates a permanent and total disability pursuant to either of the above standards. The RO obtained medical and domiciliary treatment notes and counseling notes relating to the veteran from Knoxville VA medical center and from Des Moines VA medical center. The veteran was scheduled for general medical and mental disorders examinations. The veteran failed to report for his mental disorders examination. Although there is no indication in the file that the veteran attempted to notify the facility that he would be unable to make the examination, counseling notes made by a social worker in Des Moines indicate the veteran told her after the fact that he had been unable to make the examination because of car trouble. When entitlement to a benefit cannot be established without a current VA examination and a claimant fails to report for examination without good cause, the claim shall be denied. 38 C.F.R. § 3.655 (1993). In this case, the veteran may have had good cause for missing his mental disorders examination, and he did notify the RO subsequently that he was willing and ready to report for his examination. Although substantial treatment notes are on file for the veteran, a mental disorders exam to determine the exact diagnosis of his mental disorder and prospects for improvement should be obtained. In addition, the veteran testified at his hearing that he is now in receipt of Supplemental Security Income from the Social Security Administration. The RO is required by the VA Adjudication Procedures Manual, M21-1, part VI, paragraph 7.51 (June 21, 1993) to obtain Social Security Administration records relating to a determination of eligibility for social security disability benefits if available evidence is insufficient to award pension benefits. The evidence in this veteran's file is insufficient to award pension, and the RO must make some effort to obtain the Social Security Administration records on the basis of which the veteran was awarded SSI. The veteran's representative has alleged that the veteran should be considered for service connected hearing loss, a claim the veteran has never raised. Furthermore, the VA general medical examination report dated September 1992 contains a notation that the veteran's auditory acuity is normal. In view of the allegation made by the service representative, however, a special VA audiological examination to determine whether the veteran has a hearing disability should be conducted. Accordingly, to ensure that the Department of Veterans Affairs (VA) has met its duty to assist the claimant in developing the facts pertinent to the claim and to ensure full compliance with due process requirements, the case is REMANDED to the RO for the following development: 1. Obtain all further VA outpatient, domiciliary, and/or hospital treatment records for this veteran since September 1992 from Des Moines VAMC and Knoxville VAMC. Determine whether a CAT scan noted to be scheduled for June 1992 at Iowa City was done and obtain a copy of the results. Determine whether the veteran has received any medical care from other VA facilities or private providers whose treatment records are not currently in the file. If so, obtain those treatment records. Associate all medical records received with the file. 2. Contact the Social Security Administration to obtain copies of its determination awarding Supplemental Security Income to the veteran. All records on which the SSI award was based should be obtained and associated with the file. 3. Afford the veteran VA general medical, audiological and psychiatric examinations to determine the diagnosis and extent of disability of the veteran's current conditions. The veteran's claims folder should be made available to the examiners for review before the examinations. All indicated tests, to include psychological testing, should be performed. Each examiner should render an opinion as to what effect the disabilities found have on the veteran's ability to work, and state whether the veteran's disabling conditions are susceptible to improvement through appropriate treatment. Furthermore, the general medical examiner should diagnosis any skin condition and describe all manifestations referable thereto. The psychiatric examiner should discuss any impairment in social relationships as it affects industrial adaptability. He or she should also discuss abnormalities of conduct, judgment and emotional reactions which affect economic adjustment. The GAF should be set forth. The factors upon which the opinions are based must be indicated. 4. Provide the veteran an opportunity to submit an up-to-date Employment Statement. 5. When the above development has been completed, review the case and prepare a rating action which lists all the veteran's disabilities and the percentage evaluation assigned to each disability. If the decision remains adverse to the veteran, he and his representative should be furnished a Supplemental Statement of the Case (SSOC) which includes a recitation of the percentage rating for each diagnosed disability, citing the appropriate diagnostic code for each and providing a discussion of applicability to the veteran's disabilities. The SSOC must discuss the veteran's disabilities in terms of both the unemployability standard and the average person standard. 38 U.S.C.A. § 1502(a)(1) (West 1991); 38 C.F.R. §§ 3.321, 4.15, and 4.17 (1993). Whether an extraschedular rating is appropriate should be discussed. The veteran must be afforded an opportunity to respond and to file a substantive appeal. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action unless otherwise notified. I. S. SHERMAN 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).