93 Decision Citation: BVA 93-21692 Y93 BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 DOCKET NO. 90-47 854 DATE THE ISSUE Entitlement to service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Thomas R. Nash, Attorney ATTORNEY FOR THE BOARD Brian J. Milmoe, Counsel INTRODUCTION By a decision entered on September 17, 1991, the Board of Veterans' Appeals (BVA) denied entitlement of the veteran in this case, who served on active duty from February 1959 to February 1979, to service connection for an acquired psychiatric disorder, to include PTSD. In addition, other issues, including the veteran's entitlement to service connection for a right kidney disorder, hematuria, and a skin disorder, were also denied by BVA at that time. The veteran thereafter appealed that portion of the BVA's decision in September 1991 dealing with the issue of the veteran's entitlement to service connection for an acquired psychiatric disorder, to include PTSD, to the United States Court of Veterans Appeals, hereinafter the Court. Both the appellant and appellee then moved the Court to remand the matter to BVA so that additional development of the case could be undertaken, followed by readjudication of the issue presented, and to stay further proceedings. The Court subsequently granted the joint motion for remand, the instructions from which were incorporated by reference into the Court's order, and in so doing, the Court vacated that portion of the September 1991 decision of BVA as to the veteran's entitlement to service connection for an acquired psychiatric disorder, to include PTSD. [citation redacted]. REMAND In the joint motion for remand referred to above, the parties set forth that BVA incorrectly applied the regulations relating to the issue of whether the veteran's claimed stressors were adequate to cause PTSD, that BVA did not address the need for further evidentiary development of the veteran's claim, and that BVA did not articulate sufficiently detailed reasons or bases for its findings and conclusions. BVA was specifically directed to undertake additional evidentiary and procedural development of the veteran's claim of entitlement to service connection for an acquired psychiatric disorder, to include PTSD, so that a complete psychiatric evaluation could be undertaken by the Department of Veterans Affairs (VA) and that the veteran's claim could be readjudicated by the RO, with special consideration being accorded the VA's Adjudication Procedure Manual M21-1, paragraph 50.45(e). In view of the foregoing, and in light of the VA's duty to assist the veteran in the development of all facts pertinent to his claim, as provided by 38 U.S.C.A. 5107(a) (West 1991), we hereby REMAND this case to the RO for completion of the following actions: 1. The RO should contact the veteran through his attorney in writing and request that he provide a list of those health care providers, to include those mental health professionals within the health care system of VA, who have evaluated or treated any psychiatric disorder of the veteran since his discharge from military service. The RO should then obtain all pertinent reports of hospital and outpatient treatment, to include those compiled by VA and non-VA sources. Special efforts should be made to secure complete clinical records with respect to psychiatric treatment afforded the veteran since August 1989 by L. C. Chrones, M.D., at the VA West Side Medical Center in Chicago, Illinois, and, specifically, its PTSD Recovery Program. 2. Arrangements should then be made through the veteran's attorney so that the veteran may be afforded a social and industrial survey by a VA social worker, with such evaluation being conducted at the veteran's residence and otherwise in accordance with the provisions of Section 1.14 of VA's Physician's Guide for Disability Evaluation Examinations. Prior to any direct contact with the veteran, the claims folder should be made available to the examiner for use in the study of this case. In addition, the VA social worker should attempt to interview relatives and neighbors of the veteran in an effort to obtain data with respect to the veteran's current symptoms, daily activities, employment, and other relevant matters. Also, a complete employment history should be compiled. When such are obtained, a written report should be compiled for inclusion in the veteran's claims folder. 3. The RO should undertake all appropriate action as outlined in the VA's Adjudication Procedure Manual M21-1, paragraph 50.45(e), in an effort to obtain supportive evidence of the stressful incidents to which the veteran reportedly was exposed while in Vietnam. This development should include, in part, preparation of a detailed account of claimed stressful events in service and submission of all appropriate materials to the United States Army and Joint Services Environmental Support Group in an effort to verify those incidents. 4. After the foregoing actions are fully accomplished and the requested information is added to the file, arrangements should be made through the veteran's attorney so that the veteran is afforded a VA psychiatric examination by a board of two psychiatrists, to assist in determining whether or not the veteran has an acquired psychiatric disorder, to include PTSD, related to his military service. Such examination should be conducted in accordance with Chapters 1, 13, and 14 of the VA's Physician's Guide for Disability Evaluation Examinations, for the purpose of determining the nature and extent of any acquired psychiatric disorder, to include PTSD, and the relationship, if any, between any existing acquired psychiatric disorder and the veteran's period of military service. Any and all indicated tests, to include all pertinent PTSD scales, should be undertaken. The claims folder in its entirety should be made available to each examiner for review of all data of record, including service medical records and post service medical data. 5. Upon the completion of the foregoing actions, the RO should readjudicate the veteran's claim of entitlement to service connection for an acquired psychiatric disorder, to include PTSD, with due consideration being accorded all relevant clinical and lay evidence of record, the results of current examination, and all pertinent laws and regulations. Special attention should also be given to M21-1, paragraph 50.45(e), which notes that if the evidence shows that the veteran engaged in combat and the claimed stressor is related to combat, no further development is necessary. If the evidence does not show that the veteran engaged in combat, a thorough discussion of the evidence in support of the claimed stressors should be made. If the benefit sought on appeal is not granted, the veteran and his attorney should be furnished a supplemental statement of the case with regard to the additional development and the subsequent determination. They should also be given a reasonable period of time in which to respond. The record should then be returned to BVA for further appellate consideration. No action is required by the veteran until he receives further notice. Actions herein requested by BVA should be accomplished as expeditiously as possible. BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 NANCY R. ROBIN B. KANNEE ALBERT D. TUTERA 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) (1992).