BVA9421426
DOCKET NO.  90-02 964     )       DATE
          )
          RECONSIDERATION )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Seattle,
Washington

THE ISSUE

The Board construes the issue to be:  Whether the veteran's post-
traumatic stress disorder (PTSD) was properly rated during the
period from June 3, 1986, to April 30, 1991.

REPRESENTATION

Appellant represented by: Paralyzed Veterans of America,
Inc.

WITNESS AT HEARINGS ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

R. E. Smith, Counsel

INTRODUCTION

The veteran had active military service from February 1967 to
August 1970.  The veteran also had approximately 18 months'
unverified prior reserve military service.

This matter originally came before the Board of Veterans' Appeals
(Board) on appeal from a November 1987 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO), in
Seattle, Washington, which granted the veteran entitlement to
service connection for PTSD and assigned a 10 percent disability
evaluation for this disorder, effective June 3, 1986.
Thereafter, the veteran appeared and offered testimony at a
personal hearing on appeal before a hearing officer at the RO in
August 1989.  The hearing officer's decision, which increased the
disability evaluation for the veteran's service-connected PTSD to
30 percent disabling, effective March 1, 1989, was rendered in
September 1989.  The veteran had been, since August 24, 1988,  in
receipt of a temporary total rating pursuant to the provisions of
38 C.F.R. § 4.29.

The Board determined, in a decision dated in August 1990, that
the veteran was entitled to a 30 percent evaluation for PTSD from
June 3, 1986, through August 23, 1988, the day before hospital
admission.  The issue of entitlement to an increased evaluation
for PTSD under the revised rating criteria that became effective
on February 3, 1988, was then remanded to the RO.  Subsequent
rating decisions in August 1990 and June 1991 determined that the
veteran's PTSD was properly rated at 30 percent under the
aforementioned revised rating criteria and that the veteran was
entitled to a 50 percent disability evaluation for this disorder
effective April 30, 1991, based on a VA examination provided to
him on that date.

In September 1991, the veteran's representative, the Paralyzed
Veterans of America, Inc. (PVA), acting in the veteran's behalf,
submitted a notice of disagreement to the June 1991 rating
decision.  The notice of disagreement expressed the veteran's
belief that the evidence of record supported a 70 percent
disability evaluation for his service-connected PTSD.  Following
further evidentiary and procedural development, the veteran was
afforded an RO hearing in March 1992.  The hearing officer's
decision, rendered in February 1993, increased the disability
evaluation for the veteran's service-connected PTSD to
100 percent disabling pursuant to the provisions of 38 C.F.R.
§ 4.16(c).  The hearing officer's decision awarded the veteran a
100 percent disability evaluation, effective April 30, 1991, and
was implemented by the RO in a February 1993 rating action.

Following procedural development and entry into the record of
additional written argument from local and national
representatives of PVA, the case was again returned for further
appellate review.

In response to argument advanced by PVA, the Board, on August 4,
1994, entered an Order for Reconsideration of the Board's
decision of August 14, 1990, by an expanded panel pursuant to
38 U.S.C.A. § 7103(b) (West 1991).  It was noted therein that the
reconsideration decision of the expanded panel, once promulgated,
would become the final decision of the Board on that issue.  In
so doing, the reconsideration decision effectively subsumes the
appeal pending before the Board which originated with the claim
for increase filed by the veteran in June 1986, as well as
replaces the August 14, 1990 Board determination.

At this juncture, the Board emphasizes that consideration will
not be given to the period from August 24, 1988 through February
28, 1989 inasmuch as the veteran's psychiatric disability was
rated 100 percent disabling under 38 C.F.R. § 4.29.

In June 1990, the veteran's representative in a presentation
before this Board requested service connection for psoriasis
based on scalp treatment in service in October 1969.  This issue
has not been adjudicated by the RO and it is referred to the RO
for action deemed appropriate.

CONTENTIONS OF APPELLANT ON APPEAL

The appellant contends that the clinical evidence in its entirety
supports a finding that his service-connected PTSD has been more
disabling than indicated by the schedular disability evaluations
assigned by the RO during the period June 3, 1986, to April 30,
1991.  It is specifically contended on reconsideration that the
revised rating criteria for psychiatric disorders which became
effective on February 3, 1988, was not properly applied in this
case by the RO and that there is sufficient evidence to warrant a
finding that the veteran's industrial capacity during this entire
period has been significantly underrated.

DECISION OF THE BOARD

The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991), has reviewed and considered all of the
evidence and material of record in the veteran's claims file.
Based on its review of the relevant evidence in this matter, and
for the following reasons and bases, it is the decision of the
Board that the preponderance of the evidence supports the
assignment of a 30 percent rating for PTSD from June 3, 1986,
through February 2, 1988, a 50 percent evaluation for PTSD from
February 3, 1988, to August 24, 1988, and a current 100 percent
schedular rating pursuant to 38 C.F.R. § 4.16(c), effective
March 1, 1989.

FINDINGS OF FACT

1.  From June 3, 1986, through February 2, 1988, the veteran's
PTSD was manifested by depression, anxiety, intrusive thoughts,
distrust of others, and anger which produced definite social
impairment and considerable industrial impairment.

2.  From February 3, 1988, through August 23, 1988, the veteran's
service-connected PTSD was not shown by the weight of the
evidence to be productive of more than considerable impairment of
social and industrial adaptability.

3.  Since March 1, 1989, the veteran's PTSD has severely impaired
his social and industrial adaptability and all forms of
substantially gainful employment have been precluded thereby.

CONCLUSIONS OF LAW

1.  The criteria for a 30 percent evaluation and no more for PTSD
from June 3, 1986, through February 2, 1988, have been met.
38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321, 4.3,
4.7, 4.129, 4.130 and Part 4, Code 9411, as in effect before
February 3, 1988.

2.  The criteria for a 50 percent evaluation and no more for PTSD
from February 3, 1988, through August 23, 1988, have been met.
38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321, 4.3,
4.7, 4.129, 4.130 and Part 4, Code 9411, as in effect since
February 3, 1988 (1989).

3.  Since March 1, 1989, the schedular criteria for a rating of
100 percent for PTSD have been met.  38 U.S.C.A. §§ 1155, 5107
(West 1991); 38 C.F.R. §§ 4.7, 4.16(c), 4.129, 4.130 and Part 4,
Code 9411, as in effect since February 3, 1988 (1993).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Board has considered the merits of the issue on appeal
because we find that the veteran's contentions and argument, and
the pertinent evidence on file, suffice to constitute evidence of
a well-grounded claim, within the meaning of 38 U.S.C.A.
§ 5107(a) (West 1991).  The contentions and argument concerning
the severity of the veteran's psychiatric disorder are pertinent
to the legal criteria for the benefits sought on appeal, and they
are not implausible.

I.  Duty to Assist

There is no specific allegation that there exists additional
evidence not already on file which would furnish facts to support
the material contentions which have been offered in this case.
The veteran's representative in his written arguments of August
1994 has specifically indicated that the veteran's claims file
contains ample evidence to resolve the issues currently before
the Board.  Accordingly, we find that the record is sufficient
for us to render a fair and equitable determination of the matter
at hand.  VA has no further duty to assist the veteran in
connection with his claim.  38 U.S.C.A. § 5107(a).

II.  Evidence

It is noted that the veteran's active military service included
service as a helicopter pilot in the Republic of Vietnam from
March 1968 to February 1969.

Regarding the history of the veteran's psychiatric problems,
service medical records show no relevant complaints or pertinent
findings.  On a post-service psychological evaluation provided to
the veteran in May 1974, while a member of the Washington State
Air National Guard, it was reported that the veteran showed no
indications of a serious thought or mood disorder and, generally,
related as a productive and levelheaded man.  A Minnesota
Multiphasic Personality Inventory administered to the veteran at
that time reportedly revealed a profile well within normal
limits.  The veteran was described as an "essentially normal
personality."

VA outpatient treatment records compiled between May and July
1986 show that the veteran was evaluated and counseled at a VA
mental health clinic during this period for problems related to
anger control.  It was noted that he had been referred by a
Domestic Violence Court.  His anger was recorded to stem from
problems involving his deteriorating marriage and lack of work.
The veteran sought job placement assistance.  A May 1986
prevocational assessment recorded that the veteran had
transferable skills, no physical disabilities and was functioning
at a competitive level.  Explosive behavior was diagnosed
following a May 1986 VA clinical evaluation during which the
veteran admitted having difficulty holding down his anger.  A
July 1986 VA consultation records that the veteran, who was
scheduled to attend a VA job club, reported taking an employment
position on June 23, 1986.  He was described as being clam,
alert, appropriate, and motivated to work on improving
interpersonal relationships.  In November 1986, on an outpatient
visit, he reported that he was working up to 70 hours a week and
could not find the time to work on PTSD treatment issues.

A VA social and industrial survey accomplished in January 1987
records that the veteran was going through the process of
divorcing his wife.  This divorce process reportedly followed a
separation in May 1986 that was precipitated by threats that the
veteran made against his wife and her two children by a prior
marriage.  The veteran reported that after he was discharged from
the Army in 1970 he entered the National Guard for approximately
six years.  He also said that he had several different jobs which
included flying helicopters in the Yukon and flying commercial
aircraft.  He also reported resigning from the National Guard in
1976 and then becoming an experienced plumber working with an oil
company in Alaska before obtaining his current employment which
he indicated required him to install office furniture.

On file is a report of a VA special psychiatric evaluation for
possible PTSD accomplished in February 1987.  On this evaluation
the veteran related that he was significantly affected by his
experiences in Vietnam and that he continued to suffer flashbacks
of his Vietnam experiences.  On this evaluation it was reported
that the veteran appeared rather tense, nervous, very unsure of
himself and inarticulate.  There was, however, no evidence of
delusions or hallucinations.  It was reported that he was rather
friendly but distant and very difficult to engage.  The examiner
noted that the veteran did not appear to have been significantly
affected by his Vietnam experiences.  He did however indicate
that it was indeed possible that the veteran suffered from a mild
chronic post-traumatic stress disorder, but added that the degree
of this disorder could not adequately be assessed as the veteran
was rather guarded, vague, wary and anxious.

On a VA examination in April 1987, the veteran related that
following service he was employed at various jobs including some
involving flying.  He reported current employment since October
1986 as a truckdriver.  On mental status examination the veteran
was noted to be pleasant and cooperative.  The veteran indicated
that he went in and out of depression in stressful situations and
felt that his wife was trying to destroy him.  He indicated that
he did not have any suicidal ideations and that he slept poorly
due to concerns about himself, the future and thoughts of the
past.  The veteran was noted to be oriented satisfactorily and
his judgment was characterized as fair.  The examiner indicated
that the veteran sounded rather paranoid and psychotic at times
but that his predominant symptoms were anxiety, depression and
self-deprecation.  Generalized anxiety reaction was the pertinent
diagnosis.

VA outpatient records compiled in 1987 reflect continued
employment, with the veteran described as calm, alert and
appropriate, although he reported nightmares of Vietnam.

On a following VA examination in October 1987, the veteran
reported that difficulty getting along with his wife had led him
to a divorce in 1986.  He also added that he had experienced
difficulty in work situations since coming back from Vietnam.  He
noted that most recently he worked as a truckdriver, but that
trouble with his back had caused him to be fired.  He added that
he was currently unemployed and looking for work.  With respect
to his past marriage, the veteran noted that his former wife was
hypoglycemic, had mood swings and that he had difficulty in
relating to her.  He also added that his wife had filed a
domestic violence charge against him because he had threatened to
kill her and her children.  With respect to his psychiatric
history, the veteran indicated that he had been receiving
treatment at the American Lake VA Medical Center but was not on
any psychotropic medications and had not had any psychiatric
hospitalizations.

On mental status examination, the veteran's movements and speech
were normal.  He reported that he had thoughts about suicide but
had not attempted it and had no intent.  His thought processes
were goal-directed and without formal disorder.  Hallucinations
and delusions were denied.  Intellect and memory were within
normal range.  The veteran was noted to have problems with
concentration but was oriented to person, place, time and
situation.  He was alert, cooperative and pleasant during the
evaluation and his insight and judgment were classified as fair.
It was noted that the veteran did not have any current flashbacks
but had difficulty relating to people, numbing of responsiveness,
reduced involvement with the external world, detachment,
hyperalertness, increased startle, sleep difficulties, great
feelings of guilt and thoughts that he could have done more, as
well as difficulty with concentration and memory and avoidance of
activities that reminded him of Vietnam.  Moderately severe post-
traumatic stress disorder was diagnosed.  It was added that the
veteran had impairment in occupational and social functioning.

The RO in a November 1987 rating action granted service
connection for PTSD and evaluated this disorder as 10 percent
disabling under Diagnostic Code 9411 of VA's Schedule for Rating
Disabilities (Rating Schedule), effective from June 3, 1986.

On August 24, 1988, the veteran was admitted to the American
Lake, Tacoma, Washington, VA Medical Center for an 11-week PTSD
treatment program which reportedly consisted of intensive
psychoeducational and therapy group activities and supportive
one-on-one counseling with a strong emphasis on peer interaction
and teamwork in a therapeutic milieu.

During this period of hospitalization the veteran overcame part
of his depression and reportedly lessened his anxiety
considerably.  The veteran also worked on problems involving
intrusive thoughts, distrust and anger.  With respect to his
anger, it was noted that the veteran became less angry and
fearful, and although anger did not dissipate it was indicated
that the veteran was gaining some insight into this emotion.  On
discharge in November 1988, it was reported that the veteran
would be treated in a follow-up aftercare group and become
involved in a domiciliary rehabilitation program.  His prognosis
was considered good with continued aftercare.  It was indicated
that the veteran could return to prehospital or work-related
activities in 90 days.  He was discharged on no medication for
his psychiatric disorder.

Thereafter, the veteran was admitted to a VA domiciliary in
November 1988 because of a lack of psychosocial supports and
homelessness.  While at the domiciliary, the veteran reportedly
adjusted quite easily to the ward milieu.  Records compiled in
the domiciliary reflect that the veteran was evasive about income
sources and appeared dependent on the hospital.  It was noted on
December 21, 1988 that an individual identified as the veteran's
caseworker supplied information suggesting that the veteran had
exaggerated his involvement with a vet center and that his
"pattern" was one of vagueness and evasion.  The veteran was
reported to be untruthful at the domiciliary regarding his
income.  After reaching maximum hospital benefits, he was given a
regular discharge on January 31, 1989.  He was discharged without
prescription medication and it was noted that he could
immediately resume his preadmission activities.

In a Financial Status Report dated in early 1989 the veteran
reported that he had been unemployed since October 1987.

In March 1989, the veteran was examined by a VA physician for
compensation purposes.  The examiner noted that the veteran still
related having intrusive memories of the war but that for a time
they had become less frequent.  On mental status examination, it
was noted that the veteran was cooperative, somewhat anxious but
not depressed.  The veteran spoke in a coherent, relevant manner
and was not hallucinating.  He denied delusions.  The veteran was
described as alert and oriented to time and place.  He had fair
retention and recall and appeared to have good insight and good
judgment.  Chronic post-traumatic stress was the diagnostic
impression and the examiner indicated that impairment was mild to
moderate in degree.  The examiner commented that the veteran had
reported having a slight improvement in his mental status but
lacked confidence that he could make it in terms of work and
being able to relate to people and cope with pressures.  He
indicated that the veteran had been unable to make any
significant close relationships and that he still had chronic
anxiety which had become exacerbated by his living alone.

In connection with his current claim, the veteran appeared and
offered testimony at a personal hearing on appeal before a
hearing officer at the RO in August 1989.  The veteran described
himself on this occasion as anxious, frustrated and depressed and
said that he did not want to be around people.  The veteran
further testified that he was unemployed, was experiencing
nightmares and, in effect, had been unable to return to a normal
existence despite intensive VA PTSD therapy.  The veteran further
said that flying helicopters was his only real skill and that a
recent application for that type of employment had been rejected
due to his neuropsychiatric condition.  The veteran added that he
had tried to seek other employment but believed that he had to
get "back to normal" before he could work.

Based on the above evidence, the hearing officer, in a decision
rendered in September 1989, increased the disability evaluation
for the veteran's service-connected PTSD from 10 percent to
30 percent disabling.  This decision was implemented by the RO in
a September 1989 rating action.  The effective date of the award
was determined to be March 1, 1989, and followed the grant of a
temporary total rating for PTSD from August 24, 1988, to March 1,
1989, due to hospitalization and treatment referable thereto.

On a following VA examination of the veteran's PTSD in April
1991, it was noted, as part of the veteran's past psychiatric
history, that he had begun outpatient treatment for PTSD in 1986
and had successfully completed inpatient treatment for this
disorder in 1988 at the American Lake VA Medical Center.  It was
also recorded that he had continued outpatient treatments after
that time but in November 1990, had to discontinue treatment due
to the expiration of a contract for same with a VA contract
therapist.  It was added that, with the discontinuation of
treatment and the outbreak of the Gulf War, his symptoms markedly
worsened.  He reported a past history of alcohol abuse,
experiencing numerous blackouts while intoxicated.  Reportedly he
stopped drinking in 1980.

On examination, it was noted that the veteran was divorced and
that his divorce had been related to ongoing PTSD symptomatology.
It was also noted that the veteran worked in the past as a
helicopter pilot but had changed his vocation to plumbing due to
difficulty with flying which he indicated was caused by frequent
flashbacks.  It was also noted that this vocation was also
unsuccessful due to ongoing PTSD symptomatology.  It was added
that the veteran had not worked since "1986" and had a current
live-in relationship.  He spent time as a volunteer in local and
national politics and was a block watch captain.

On mental status examination, it was noted that the veteran was
cooperative and that he related his history in a clear steady
voice.  He stated that, since the discontinuation of his therapy
in November 1990 and the outbreak of the Gulf War, his PTSD
symptoms had worsened.  He noted that he had more frequently
impaired sleep and nightmares approximately one night a week.  He
reportedly had flashbacks, approximately once per week.  He
further indicated that he was markedly withdrawn and avoided
contact with people.  He added that he was more angry and
frequently lost his temper over minor incidents.  He further
stated that he actively avoided people, places and things which
reminded him of Vietnam and also continued to complain of
emotional numbing.  It was noted that he was oriented in all
spheres and there was no evidence of delusions or hallucinations
or organic mental deficit.  Post-traumatic stress disorder was
the Axis I diagnosis, and the examiner indicated that there had
been a moderate increase in his overall symptomatology due to the
discontinuation of his treatment and the outbreak of the Gulf War
hostilities.  The examiner added that the veteran appeared to
have moderate to severe occupational and social impairment due to
PTSD.

In October 1991, the veteran was administered psychological
testing which was interpreted by the VA in November 1991 to
suggest that the veteran's intellectual functioning was in the
average range.  Responses on this testing were indicated to
suggest a person who was experiencing a significant degree of
psychological distress.  It was also noted that a review of prior
testing of the veteran in 1986 and 1987 showed that the veteran
had presented himself during that period as making a strong
effort to present himself as having adequate defenses.  His
current testing was noted to reflect that same condition.  It was
indicated that in the past the veteran struggled to keep painful
memories in check and that such defenses were not currently being
used.  It was also reported that the veteran's acknowledgment of
multiple problems suggested a possible historical pattern of a
veteran who, in the past, exerted strong control of his problems
but was experiencing distress.  It was noted that, unfortunately,
it would appear that the "opening up" of the veteran's problems
had not resulted in a lessening of his distress.  Current testing
suggested that his treatment to date was not able to effect a
meaningful integration of past trauma.

At another hearing on appeal before a hearing officer at the RO
in March 1992, the veteran said he had frequent flashbacks to
Vietnam.  He reported continuing counseling at the Vet Center and
stated that he had resisted group therapy for reasons he was
unable to explain.  He testified he had problems interacting with
others and that he  spent his days raising bees and working on
cars.  He noted that he not worked on a steady basis for a long
period of time.  The veteran also testified that while he had
intimate relationships with a member of the opposite sex he does
not consider any of his past relationships to have been either
healthy or normal.  Submitted into evidence on this occasion was
a set of photographs which showed the veteran and an apparently
damaged helicopter.

On an April 1992 VA examination, the diagnosis was chronic post-
traumatic stress disorder with secondary symptoms of depression,
anger and paranoia.  The examiner commented that the veteran
continued to have difficulty in making significant progress,
either socially or occupationally.  He indicated that the veteran
remained vague and guarded about reasons for his difficulties and
that his post-traumatic stress disorder continued to be a
significant problem for him.

Clinical records received from the Social Security Administration
in September 1992 show that in February 1990 the veteran was
awarded monthly Social Security disability benefits beginning in
July 1988.  This award was based on clinical evidence compiled
between 1986 and 1990 which included the VA clinical records
discussed above, private clinical records referable to evaluation
and treatment provided to the veteran for a nonservice-connected
back disorder.  As pertains to this claim, these records show
that the veteran sustained a back injury at work in September
1987, but was advised that he could return to work.  In a January
1989 report, he stated that he had not worked for the past 8
months.

Also received was a report of a January 1990 psychological
evaluation conducted by William Conte, M.D., for the Social
Security Administration's Office of Disability Insurance.  This
psychological evaluation noted that the veteran was presently
living with a woman with whom he was desperately trying to work
out a relationship.  It indicated that the veteran did not
believe that his treatment for PTSD was helpful in terms of
moving himself forward and away from his Vietnam experiences.
Dr. Conte reported that he found the veteran to be of normal
intelligence and to appear anxious, very suspicious and frankly
paranoid.  He noted that the veteran did not appear to be
depressed.  He also added that it was clear that the veteran's
paranoid status was present long before the veteran was sent to
Vietnam.  Dr. Conte indicated that the veteran's preoccupation
with his emotional problems led him to believe that employment
for the veteran would be very difficult.

In January 1993, the veteran was examined by a board of two VA
psychiatrists for the express purpose of addressing the issue of
his PTSD and unemployability.  It was reported that the veteran
continued to express a full spectrum of PTSD symptomatology since
seen in 1991 and that the veteran stated that his symptoms had
worsened.  He reported being severely isolated from people and
that he was continuing to have problems with anger outbursts.  He
added that he last worked in 1986 and had to quit due to his
short temper and inability to control his anger as well as his
inability to get along with employees and employers.  Post-
traumatic stress disorder was the Axis I diagnosis and it was
noted that the veteran appeared to be unemployable.

In a determination effectuated by a February 1993 rating
decision, the VA hearing officer granted an increased rating of
100 percent, effective April 30, 1991.

III.  Evaluation of PTSD from June 3, 1986, to February 3, 1988

38 U.S.C.A. § 1155 (West 1991) and 38 C.F.R. Part 4 (1993)
provide that disability evaluations are determined by the
application of a schedule of ratings which is based on average
impairment of earning capacity.  38 C.F.R. Part 4 refers to the
aforementioned rating schedule.  Separate diagnostic codes of the
rating schedule identify the various disabilities.

The November 1987 rating decision from which this appeal
originally ensued awarded the veteran a 10 percent evaluation for
PTSD effective June 3, 1986, under Diagnostic Code 9411 of the
Rating Schedule.  Prior to February 3, 1988, this code provided a
10 percent evaluation for PTSD when there was moderate impairment
in social and industrial adaptability.  A 30 percent rating was
provided for PTSD when there was definite impairment in the
ability to establish or maintain effective and wholesome
relationships with people and when psychoneurotic symptoms
resulted in such reduction in initiative, efficiency, and
reliability levels as to produce considerable industrial
impairment.  A 50 percent disability evaluation was assignable
when there was substantial impairment of ability to establish or
maintain effective and wholesome relationships with people and
when there was severe industrial impairment.  A 70 percent
evaluation required that the ability to establish and maintain
effective and favorable relationships with people be seriously
impaired and that psychoneurotic symptoms be of such severity and
persistence that there was pronounced impairment in the ability
to obtain or retain employment.  A 100 percent evaluation
required that attitudes of all contacts except the most intimate
be so adversely affected as to result in virtual isolation in the
community and that there be totally incapacitating psychoneurotic
symptoms bordering on gross repudiation of reality with disturbed
thought or behavioral processes (such as fantasy, confusion,
panic and explosions of aggressive energy) associated with almost
all daily activities resulting in a profound retreat from mature
behavior.  The individual must be demonstrably unable to obtain
or retain employment.  38 C.F.R. Part 4, Code 9411, as in effect
before February 3, 1988.

For the period prior to February 3, 1988, the combination of
psychiatric manifestations documented in the veteran's VA PTSD
evaluation in February 1987 and his subsequent VA examinations in
April and October 1987, as well as the obvious difficulties the
veteran had in maintaining a stable marital relationship and
secure employment and reduced involvement with society, are
considered to be productive of definite social impairment and
considerable industrial impairment.  We find significant the
assessment by the veteran's VA examiner on his October 1987 VA
examination that the level of the veteran's impairment due to his
PTSD was moderately severe.  The examiner's classification of the
degree of disability is not determinative.  38 C.F.R. § 4.130.
However, the Board is of the opinion that the clinical evidence
reflecting problems with anger control and concentration shows
that social and industrial impairment resulting from the
veteran's PTSD during this period most nearly approximates the
criteria indicative of definite social and considerable
industrial impairment.  In this regard, we observe that where
there is a question as to which of two evaluations shall be
applied, the higher evaluation will be assigned if the disability
picture more nearly approximates the criteria required for that
rating.  Otherwise, the lower rating will be assigned.  38 C.F.R.
§ 4.7 (1993).  Because the findings more nearly approximate those
indicative of considerable industrial impairment, a 30 percent
rating is in order.  In making such determination, the Board
notes that the outpatient treatment records, as well as medical
records considered by the Social Security Administration, show
that the veteran was employed during this period, losing some
time from work after sustaining a work-related injury to the back
in September 1987.  The veteran's claim that he stopped working
in 1986 is rejected as not being reliable in light of this
evidence.  (He was in fact described in VA  domiciliary records
as being evasive about his income.)  As late as the February 1987
VA examination the veteran was reported by the examiner to be not
significantly affected by his Vietnam experiences.  His treatment
during this period was on an outpatient basis only; it is
noteworthy that he was not prescribed any medication for his
psychiatric disorder.

Consideration has also been extended to whether the veteran was
entitled to a higher rating on an extraschedular basis and the
Board concludes that he was not.  In exceptional cases where the
schedular evaluations are found to be inadequate, an
extraschedular evaluation commensurate with the average earning
capacity impairment due exclusively to the service-connected
disability or disabilities may be approved provided the case
presents such an exceptional or unusual disability picture with
such related factors as marked interference with employment or
frequent periods of hospitalization as to render impractical the
application of the regular schedular standards.  38 C.F.R. §
3.321(b)(1).  As shown above, the veteran's PTSD symptoms did not
cause marked interference with employment, nor did they require
hospitalization.

IV.  Evaluation of PTSD from February 3, 1988, to August 24, 1988

Effective February 3, 1988, the General Rating Formula for
Psychoneurotic Disorders was revised.  To establish entitlement
to a 30 percent rating under the new criteria, the requirement
that there be considerable industrial impairment was replaced by
the requirement that there be definite industrial impairment.
For a 50 percent rating, the requirement that there be severe
industrial impairment was replaced by the requirement that there
be considerable industrial impairment.  Under the new criteria,
severe industrial impairment warrants a 70 percent evaluation.
See 38 C.F.R. Part 4, Code 9411, effective February 3, 1988.  The
30 percent rating found by the Board to be appropriate above
under the old rating criteria was based on an assessment that the
veteran exhibited, in pertinent part, considerable industrial
impairment.  The Board finds that the evidence prior to the
veteran's hospitalization on August 24, 1988, showed no
improvement in the veteran's psychiatric status and that
considerable industrial impairment was still present.  In fact
there is nothing in the record that suggests other than that the
psychiatric disorder continued to exhibit essentially the same
level of symptomatology during this period as it had prior to the
change in criteria.  The continuance of considerable industrial
impairment warrants an upward revision of the rating to
50 percent to conform to the revised rating standards.  Sabol v.
Derwinski,  2 Vet.App. 228 (1992); O.G.C. Precedent 9-92
(March 25, 1992).  For essentially the same reasons articulated
above, the Board does not find that, for the period beginning
February 3, 1988, such an unusual disability picture was
presented as to warrant the assignment of a rating on an
extraschedular basis.

V.  Evaluation of PTSD since March 1, 1989

There remains a question of a schedular rating higher than
50 percent under the new criteria following the veteran's
assignment of a temporary total (100 percent) rating from
August 24, 1988, to March 1, 1989, pursuant to the provisions of
38 C.F.R. § 4.29 (1993).  Under the new criteria as indicated
above, severe disability warrants a 70 percent rating.

In this case, the objective findings indicate that the veteran,
despite a lengthy period of VA hospitalization for PTSD, has
continued to exhibit anxiety, social isolation and a tendency
towards anger against others.  Significantly, a VA physician
determined in April 1991 that the veteran's ability to work and
adapt socially was moderately to severely compromised by his
ongoing symptoms of PTSD.  Severe occupational and social
impairment due to PTSD was later indicated by a VA examiner in
January 1993.  We note, however, that VA examinations have
consistently reported that the veteran has been oriented to time,
place and person and his reason and judgment have not been shown
to be grossly impaired at any time.  Nevertheless, the veteran
clearly has difficulty in social and industrial settings.  Thus,
the clinical record as a whole reflects that during the period
from March 1, 1989, he has exhibited severe psychiatric
impairment based on his service-connected post-traumatic stress
disorder at a level contemplated by the 70 percent schedular
evaluation of 38 C.F.R. Part 4, Code 9411.

We also conclude that the veteran's mental disorder, his only
compensably rated service-connected disorder, is definitely an
occupational handicap and precludes gainful employment.  Under
the criteria of 38 C.F.R. § 4.16(c), whenever gainful employment
is precluded by a service-connected mental disorder rated
70 percent disabling and there are no other compensably rated
service-connected disorders, a 100 percent rating is to be
assigned under the schedule rather than 38 C.F.R. § 4.16.
Accordingly, a 100 percent rating is warranted under 38 C.F.R.
Part 4, Code 9411, effective March 1, 1989.

ORDER

On reconsideration, a 30 percent rating for PTSD is granted for
the period June 3, 1986, through February 2, 1988; a 50 percent
evaluation is assigned for the period from February 3, 1988,
through August 23, 1988; and a 100 percent schedular rating is
assigned for the period since March 1, 1989, subject to the
criteria governing the payment of monetary awards.  To this
extent, the appeal is allowed.

(CONTINUED ON NEXT PAGE)

          BRUCE E. HYMAN  D. C. SPICKLER

          N. R. ROBIN

          EILEEN M. KRENZER       EUGENE A. O'NEILL

          GORDON H. SHUFELT

NOTICE OF APPELLATE RIGHTS:  Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals within
120 days from the date of mailing of notice of the decision,
provided that a Notice of Disagreement concerning an issue which
was before the Board was filed with the agency of original
jurisdiction on or after November 18, 1988.  Veterans' Judicial
Review Act, Pub. L. No. 100-687, § 402 (1988).  The date which
appears on the face of this decision constitutes the date of
mailing and the copy of this decision which you have received is
your notice of the action taken on your appeal by the Board of
Veterans' Appeals.