Citation NR: 9600960	
Decision Date: 01/24/96		Archive Date: 02/07/96
DOCKET NO.  94-05 259	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs Regional Office in Fargo, 
North Dakota


THE ISSUE

Entitlement to service connection for a psychiatric disorder, 
to include depression and an eating disorder.


REPRESENTATION

Appellant represented by:	Veterans of Foreign Wars of 
the United States


ATTORNEY FOR THE BOARD

Andrew T. Layton, Associate Counsel






INTRODUCTION

The veteran reportedly served on active duty for training 
from June 1989 to August 1989, and served on inactive duty 
for training from July 1990 to September 1990.  This case 
comes before the Board of Veterans’ Appeals (BVA or Board) on 
appeal from a January 1993, rating decision of the Department 
of Veterans Affairs Regional Office in Fargo, North Dakota 
(RO), which denied the benefit sought on appeal.

The Board notes that the veteran, in statement received in 
April 1993 raised the issue of his entitlement to service 
connection for impotence.  The RO, in a letter dated in June 
1993, advised the veteran that if he wished to claim service 
connection for impotence, he should furnish evidence of 
medical evaluation and treatment for the condition.  No 
response from the veteran is of record.  However, a review of 
the record discloses that during a VA neurological 
examination in July 1993, the examining physician noted that 
the veteran may be suffering from an endocrine/pituitary 
dysfunction due to his obesity, erectile dysfunction and 
depression.  The veteran’s claim is thus referred to the RO 
for appropriate action.


REMAND

In August 1989, the veteran sustained multiple injuries when 
a locker fell on him.  In May 1991, the RO service connected 
and assigned a 20 percent evaluation for a right shoulder 
injury, a 20 percent evaluation for a low back injury, a 10 
percent evaluation for a right hip injury, a 10 percent 
evaluation for facial scars, a 10 percent evaluation for 
neuropathy of facial nerves, and a 10 percent evaluation for 
tinnitus.  The RO service connected and assigned a 
noncompensable evaluation for fractures of the right zygoma 
and orbit.  In January 1993, the RO denied service connection 
for depression with an eating disorder, secondary to service 
connection injuries.

Although the veteran’s service medical records contained no 
evidence of either a psychiatric disorder or an eating 
disorder, he was subsequently diagnosed with these conditions 
on several occasions.  In November 1991, the veteran was 
diagnosed at the VAMC in Minneapolis, Minnesota as having an 
adjustment disorder and bulimia.  The treating physician 
stated that the veteran’s history of trauma contributed to 
his bulimia.  The physician also noted that the veteran 
suffered from mild depression.  In February 1992, the veteran 
was diagnosed at the Minneapolis VAMC as having an adjustment 
disorder with associated depression and an eating pathology.  
Later that month, the veteran visited the Eating Disorders 
Clinic at the University of Minnesota Hospital and was 
diagnosed as suffering from bulimia and depression.  The 
veteran received a VA psychological evaluation in October 
1992 where he was diagnosed as having bulimia nervosa and a 
major depressive disorder.  The veteran was hospitalized for 
treatment of these disorders at the Minneapolis VAMC from 
October 1992 to December 1992.  During a VA neurological 
examination in July 1993, the treating physician stated, “The 
patient has significant depression since the injury which may 
be reactive in nature since he has a significant amount of 
stressors.”  It is not apparent, however, from the evidence 
of record whether the VA examiner had the benefit of a review 
of prior medical records or that the RO considered the VA 
physicians’ statements from November 1991 and July 1993 prior 
to issuing its denials of the veteran’s claim.  In any event, 
the Board believes that a further examination of the veteran 
would be helpful in clearly identifying the etiology of any 
diagnosed psychiatric disorder.

“Where the record is inadequate for the purpose of fairly 
deciding the veteran’s claim, VA’s statutory duty to assist 
requires it to help a claimant develop the facts pertinent to 
his or her claim prior to deciding it.”  Proscelle v. 
Derwinski, 2 Vet.App. 629, 632 (1992).  Therefore, the Board 
remands this case to the RO so that it may more adequately 
develop the evidence as noted below.

The RO shall arrange for the veteran to 
be afforded a psychiatric examination to 
ascertain the nature, severity, and 
etiology of any psychiatric disorders 
which may be present.  Any and all 
evaluations, tests, or studies deemed 
necessary by the examiners should be 
accomplished, but should include 
psychological testing.  The examiner is 
specifically requested to offer comments 
and an opinion as to whether the 
veteran’s psychiatric disorders can be 
related to any injuries the veteran may 
have incurred while in service.  A 
complete rationale for the opinions 
expressed would be beneficial.  Since it 
is important that each disability be 
viewed in relation to its history, all 
pertinent medical records in the 
veteran’s claims file, or, in the 
alternative, the claims file, must be 
made available to the examiner for 
review.

When the above actions have been completed, the case should 
be reviewed by the RO.  If the issues remain denied, a 
supplemental statement of the case should be provided to the 
veteran and his representative.  After the veteran has had an 
adequate opportunity to respond to the supplemental statement 
of the case, the appeal should be returned to the Board for 
appellate review.  No action is required by the veteran until 
he receives further notice.



		
	CONSTANCE B. TOBIAS
	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).


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