Citation Nr: 1304805 Decision Date: 02/11/13 Archive Date: 02/21/13 DOCKET NO. 04-41 832A ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon THE ISSUE Entitlement to an initial evaluation in excess 50 percent prior to January 25, 2005, and in excess of 70 percent from January 25, 2005, for post traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Christopher Maynard, Counsel INTRODUCTION The Veteran had active service from December 1967 to September 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2003 decision by the RO which, in part, granted service connection for PTSD, subsequently rated 50 percent disabling from August 23, 2001, the date of receipt of claim. 38 C.F.R. § 3.400(b)(2). In February 2008, the RO assigned an increased rating to 70 percent, effective from January 25, 2005, the date of VA examination showing increased disability. 38 C.F.R. § 3.400(o)(2). In the Written Brief Presentation, dated in January 2013, the representative raised the additional issues of service connection for hypertension, erectile dysfunction, neuropathy and diabetes secondary to the service-connected PTSD. These issues are not inextricably intertwined with the issue currently on appeal and have not been developed for appellate review. Therefore, these matters are referred to the RO for appropriate development. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND Although further delay is regrettable, the Board finds that additional development is necessary prior to further appellate review. Specifically, in the Written Brief Presentation, dated in January 2013, the representative asserted that the most recent VA psychiatric examination was conducted more than seven years ago (November 2005), and that the medical evidence of record was inadequate to evaluate the current severity of the Veteran's PTSD. The representative requested that the Board remand the appeal for a more contemporary examination. Where a claimant asserts that the disability in question has increased in severity since the most recent rating examination, an additional examination may be appropriate. Caffery v. Brown, 6 Vet. App. 377 (1995); see also VAOPGCPREC 11-95 (1995). Given the representative's expressed contention, a new examination should be scheduled to evaluate the current severity of the Veteran's service-connected PTSD. See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). In addition, the Board notes that the most recent VA psychiatric outpatient reports of record are from January 2009. Although it is not clear whether the Veteran received any psychiatric outpatient treatment since January 2009, the AMC must ensure that all pertinent VA treatment records have been obtained and associated with the claims file. Accordingly, the case is REMANDED for the following action: 1. The AMC should take appropriate steps to obtain all of the Veteran's VA treatment records since January 2009, and associate them with the claims folder. 2. The Veteran should be scheduled for a VA psychiatric examination to determine the current severity and manifestations of his PTSD. All indicated tests and studies should be performed. The claims folder must be made available to the examiner for review, and a notation to the effect that this record review took place should be included in the report. The examiner should provide a response to the following: (a) Provide a detailed description of the Veteran's psychiatric symptomatology and an opinion concerning the degree of social and industrial impairment resulting from the service-connected PTSD. (b) The examiner should include an Axis V assessment in the diagnostic formulation (GAF Scale) pertaining to the symptomatology associated with the Veteran's PTSD, and an explanation of what the assigned score represents. The examiner must provide a clear rationale for all opinions, to include a discussion of the facts and medical principles involved. If a requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion cannot be provided without resort to speculation. 3. Thereafter, the AMC should readjudicate the claim. If the benefits sought on appeal remain denied, the Veteran and his representative should be furnished a Supplemental Statement of the Case and given the opportunity to respond thereto. Thereafter, subject to current appellate procedures, the case should be returned to the Board for further appellate consideration, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The Veteran need take no action unless otherwise notified. The Veteran has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ WAYNE M. BRAEUER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. 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) (2012).