Citation Nr: 0710992 Decision Date: 04/13/07 Archive Date: 04/25/07 DOCKET NO. 05-09 204 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Missouri Veterans Commission WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD A. W. Harley, Associate Counsel INTRODUCTION The veteran had active service from August 1965 through June 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2004 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. 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 The veteran is seeking service connection for post-traumatic stress disorder (PTSD). During the pendency of this appeal the United States Court of Appeals for Veterans Claims (Court) issued a decision in the appeal of Dingess v. Nicholson, 19 Vet. App. 473 (2006), which placed two additional duties upon the VA. Under Dingess, VA must also provide proper notice of the evidence required to establish the degrees of disability and the effective date of an award. The notice provided to the veteran in this case is not in conformity with the Court's Dingess decision. As such, this matter must be remanded for proper notice under 38 C.F.R. § 3.159(b)(1) (2006), including corrective notice under Dingess. At his September 2005 hearing, the veteran clarified the treatment history for his claimed disability. The veteran reported treatment at the VA Medical Center in St. Louis, including from Doctors Oruwari and Kerr, as recent as one month prior to the hearing. The most recent VA treatment records in the claims folder are dated April 2004, nearly 18 months prior to the hearing. Under 38 C.F.R. § 3.159(c)(2) (2006), VA has a duty to assist the veteran and obtain all relevant VA treatment records. As such, this matter must be remanded so that all VA treatment for the veteran's claimed condition can be associated with the claims folder. The veteran's September 2005 testimony also made clear the extent to which he has been treated by private physicians. He submitted an August 2005 statement by a Dr. Hingst that notes that the doctor is treating the veteran for anxiety and believes that the anxiety is associated with PTSD. The doctor's treatment records, however, are not of record, so the basis for his opinion is unclear. Under 38 C.F.R. § 3.159(c)(1) (2006), VA has a duty to assist the veteran and obtain relevant records from private medical care. As such, this matter must be remanded so that all relevant private treatment records can be obtained and associated with the claims folder. Once VA affords all proper notice to the veteran and associates all relevant treatment records with the claims folder, an updated VA examination is warranted. The October 2003 VA examination report is rather unclear. The examiner noted PTSD symptoms, but diagnosed panic disorder with agoraphobia. The examiner also remarked that the veteran's GAF score is 65, but that "if only the PTSD were considered, the GAF would be 70." This suggests that there may, in fact, be a PTSD diagnosis. Also, the August 2005 statement by Dr. Hingst suggested a PTSD diagnosis, but provided no basis for the opinion. Also, at the September 2005 hearing, the veteran's representative remarked that the veteran answered in the affirmative when asked about the symptoms listed in the DSM-IV Diagnostic Criteria book that is used to diagnose PTSD. Because there is a multitude of evidence to suggest that PTSD may be present, but a clear medical diagnosis has not been made, an updated medical examination is warranted under 38 C.F.R. § 3.159(c)(4) (2006). Accordingly, the case is REMANDED for the following action: 1. Ensure that VA has met its duty to notify the veteran under 38 C.F.R. § 3.159(b), including issuing corrective notice that is compliant with Dingess v. Nicholson, 19 Vet. App. 473 (2006). 2. Ensure that VA has met its duty to assist the veteran under 38 C.F.R. § 3.159(c)(2) by obtaining and associating with the claims folder all non-duplicative medical evidence from any VA treatment facility, including the VA Medical Center in St. Louis, Missouri. 3. Ensure that VA has met its duty to assist the veteran under 38 C.F.R. § 3.159(c)(1), by obtaining fully executed authorizations to obtain records from all private doctors with which the veteran has treated for his claimed disabilities, including Dr. Hingst. Once authorization is received, obtain all relevant private treatment records and associate them with the claims folder. 4. Once the above development takes place, afford the veteran a VA examination. The examiner should review the entire claims folder and state that such a review occurred. The examiner is asked to clarify the veteran's current diagnosis, in particular as to whether a diagnosis of post-traumatic stress disorder is warranted. The examiner should point to any information in the claims folder that is relied upon as the basis for the diagnosis, or lack thereof. 5. Readjudicate the veteran's claim. If the benefits sought on appeal remain denied, the veteran and his accredited representative should be issued a supplemental statement of the case (SSOC) and given a reasonable opportunity to respond. The veteran has the right to submit additional evidence and argument on the matter 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. 2006). _________________________________________________ MARJORIE A. AUER 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) (2006).