Citation Nr: 1321193 Decision Date: 07/02/13 Archive Date: 07/12/13 DOCKET NO. 09-38 877 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Boston, Massachusetts THE ISSUE Entitlement to a disability evaluation in excess of 50 percent for service-connected posttraumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD J. T. Sprague, Counsel INTRODUCTION The Veteran had active service in the United States Army from August 1967 to August 1969, to include duty in Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. The entire claims folder, to include the portion contained in the electronic "Virtual VA" system, has been reviewed. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran in this case served in Vietnam, and in a December 2002 rating decision, was awarded service connection for his combat-related PTSD. At that time, a 50 percent disability evaluation was assigned. He has, since that time, come forth with the current claim for a higher rating. Essentially, the Veteran contends that his PTSD is more severe than what is contemplated in the assigned 50 percent evaluation, and that he should be entitled to a higher degree of compensation. The Veteran was last examined by VA, on a "fee basis," in June 2008. After reviewing the findings of this examination, the RO determined that an increase in evaluation was not warranted. In positing his notice of disagreement, the Veteran stated that his PTSD has "continuously and progressively gotten worse." He specifically requested to be "reevaluated" for his PTSD. The record contains several clinical consultations for mental health complaints following the 2008 examination, and there is some noted fluctuation in severity. Indeed, a December 2008 clinical note describes a "short fuse" that is becoming "increasingly frequent." There were additional added life stressors noted to be complicating the Veteran's disability picture (issues with his son's employment and a death in the family). There is also at least one instance of the Global Assessment of Functioning (GAF) score dipping a full 10 points to 45 in August 2009, with additional episodes of GAF slipping to 46 as due to further complicating factors in 2010. A review of the claims file, to include the electronic portion contained in the "Virtual VA" system, demonstrates that the Veteran has consistently received counseling for his PTSD from at least 2006 to the present. The Veteran's representative has noted that the most recent VA examination was afforded in June 2008, and is thus approximately five years old. In noting the Veteran's assertions of worsening, it was asked that the Board consider a remand for a new examination to adequately consider the severity of the current service-connected psychiatric disability picture. In claims for an increase in rating, it is first and foremost paramount to have an accurate and complete understanding of the service-connected disability picture. While the date of an examination is not, in itself, a necessary reason to remand the claim, in this case, the age of the examination, when coupled with the allegation of continual worsening from 2008 forward, leads to a conclusion that the most accurate representation of the disability picture is not, in fact, of record. Accordingly, in order to assure that a rating is based on the most current evidence possible, the Veteran is to be scheduled for a new, comprehensive VA examination for the purposes of determining the severity of service-connected PTSD. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991); Hyder v. Derwinski, 1 Vet. App. 221 (1991). The Board apologizes for the delay in the adjudication of this case. Accordingly, the case is REMANDED for the following action: 1. Obtain all outstanding VA mental health treatment reports which address the severity of the Veteran's service-connected PTSD and associate them with the claims file. Should no records exist, so annotate the record. 2. Schedule the Veteran for a comprehensive VA psychiatric examination for the purposes of determining the severity of service-connected PTSD. The examiner should conduct a mental status examination, provide a GAF score, and report all clinical findings in a narrative report. All conclusions must contain supporting rationales. 3. Following the above-directed development, re-adjudicate the Veteran's claim. Should the claim not be granted in its entirety, issue an appropriate supplemental statement of the case and forward the claim to the Board for adjudication. The appellant 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). _________________________________________________ JOHN J. CROWLEY 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).