BVA9513458 DOCKET NO. 91-19 265 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Albuquerque, New Mexico THE ISSUES 1. Whether new and material evidence has been submitted to reopen the veteran's claim for service connection for acne rosacea. 2. Entitlement to service connection for diabetes mellitus, to include cataracts. 3. Entitlement to an increased (compensable) evaluation for diplopia and ophthalmoplegia. 4. Entitlement to an increased (compensable) evaluation for seborrheic and xerotic dermatitis. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD J. W. Loeb INTRODUCTION The veteran served on active duty from November 1949 to February 1953 and from August 1956 to June 1974. This case was remanded by the Board of Veterans' Appeals (Board) to the Department of Veterans Affairs (VA) Regional Office (RO) in Albuquerque, New Mexico, in August 1994 for additional development. It was contended on behalf of the veteran in June 1995 that his service-connected disorders render him unemployable. Since this issue has not been adjudicated by the RO, it is referred to the RO for appropriate action. The issues of entitlement to service connection for diabetes mellitus, to include cataracts, and entitlement to compensable evaluations for diplopia and ophthalmoplegia, as well as seborrheic and xerotic dermatitis, will be addressed in the remand portion of this action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the RO committed error in denying that new and material evidence had been submitted to reopen his claim for service connection for acne rosacea because the evidence of record shows that he has had problems with acne rosacea since service. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the veteran has submitted new and material evidence to reopen his claim for service connection for acne rosacea and that the evidence supports the grant of service connection for acne rosacea. FINDINGS OF FACT 1. A December 1974 rating decision denied service connection for acne rosacea; the veteran was notified of this decision later in December 1974 but did not timely appeal. 2. Evidence received subsequent to December 1974 has not been previously considered and is relevant to whether the veteran has acne rosacea that is related to his military service. 3. Acne rosacea was first diagnosed in service and has been noted periodically since service discharge. CONCLUSIONS OF LAW 1. The veteran has submitted new and material evidence relevant to the issue of entitlement to service connection for acne rosacea, and the claim is reopened. 38 U.S.C.A. §§ 5107, 5108 (West 1991); 38 C.F.R. § 3.156(a) (1994). 2. Acne rosacea was incurred during service. 38 U.S.C.A. §§ 1110, 1131, 5107(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS A December 1974 rating decision denied service connection for acne rosacea, and the veteran was notified of the decision later in December 1974; he did not appeal within the one year time limit. 38 U.S.C.A. § 7105(a). Once a claim has been denied by the RO, and is not timely appealed, it is considered final and will not be reopened unless new and material evidence is submitted in support thereof. 38 U.S.C.A. § 5108; 38 C.F.R. § 3.156(a). To be “new and material,” the evidence must be more than cumulative; there must be a reasonable possibility that consideration of the new evidence, when viewed in the context of all of the evidence, would change the outcome of the prior decision. Colvin v. Derwinski, 1 Vet.App. 171 (1991). Evidence received since the December 1974 rating decision includes VA outpatient records from January 1989 to February 1990 and from February to September 1994. These records contain a diagnosis of acne rosacea on several occasions beginning in February 1989. Acne rosacea was also diagnosed on VA skin examination in January 1995, with the examiner concluding that the veteran’s notation that he began having symptoms of acne rosacea within one or two years after he left Vietnam, and the symptoms involved, were consistent with a diagnosis of acne rosacea, rather than with residuals of exposure to Agent Orange. The Board finds that the above noted evidence submitted since December 1974 shows continued problems with acne rosacea and is new and material evidence. Therefore, the veteran’s claim for service connection for acne rosacea is reopened. 38 U.S.C.A. § 5108; 38 C.F.R. § 3.156(a). Once a claim is reopened, it must be evaluated on the basis of all of the evidence of record, both new and old. Manio v. Derwinski, 1 Vet.App. 140 (1991). The veteran’s service medical records reveal that the veteran complained in December 1965 of multiple skin problems, including chronic dry skin and facial acne; examination in December 1965 revealed diffuse, greasy scaling of the scalp and marked seborrhea with erythematous papules and vesicles of the forehead and face. Several skin disorders were diagnosed, including acne rosacea. On VA dermatology examination in October 1974, the veteran’s symptoms included erythematous papules and some pustules in the central facial area, oiliness, and acne scars; the diagnoses included acne rosacea. Since acne rosacea was first diagnosed in service and it continued to be diagnosed after discharge, including on the most recent dermatologic examination in January 1995, service connection for acne rosacea is warranted. 38 U.S.C.A. §§ 1110, 1131, 5107. ORDER New and material evidence having been submitted, the veteran’s claim for service connection for acne rosacea is reopened and granted. REMAND The veteran is also seeking service connection for diabetes mellitus, to include cataracts. It was contended by, and on behalf, of the veteran prior to August 1991 that Chlorthaladone, a medication he was taking for his service- connected arteriosclerotic heart disease with hypertension, contributed to his diabetes mellitus and cataracts, and an August 1991 Board remand directed that an endocrinologist review the veteran’s medication history and provide an opinion regarding the etiology of the veteran’s diabetes mellitus. According to a February 1992 examination report from an endocrinologist, Chlorthaladone might make it harder to control the veteran’s diabetes; it was recommended that the Chlorthaladone be discontinued. The Board notes that the United States Court of Veterans Appeals (Court) has recently provided guidance that may affect the veteran's secondary service connection claim noted above. The Court held in Allen v. Brown, 7 Vet.App. 439 (1995) that the term "disability" as used in 38 U.S.C.A. § 1110 (West 1991) refers to impairment of earning capacity, and that such definition of disability mandates that any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, shall be compensated. Thus, pursuant to 38 U.S.C.A. § 1110; 38 C.F.R. § 3.310(a) (1994), when aggravation of a veteran's nonservice-connected condition is proximately due to or the result of a service-connected, such veteran shall be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. The Board also notes the contentions on behalf of the veteran in April 1995 that the January 1995 skin examination was inadequate because the examiner did not address the veteran’s complaints of scaling over his eyes and did not indicate whether there was dermatitis involving the hands, thighs, trunk, and lower abdomen, which the veteran had had in the past. Consequently, the Board finds that additional development is required prior to final disposition of the issues of entitlement to service connection for diabetes mellitus, to include cataracts, and entitlement to compensable evaluations for service-connected eye and skin disorders. Therefore, those issues are being REMANDED to the RO for the following actions: 1. The veteran should be permitted to submit any additional evidence that is pertinent to the above noted issues. He should also be requested to provide the complete names, addresses, and dates of treatment of any physicians or facilities, including the VA, that have treated him for diabetes mellitus, cataracts, an eye disorder, or a skin disorder since January 1995, which is the most recent clinical evidence on file. Any medical provider identified should be asked by the RO for copies of the veteran's clinical records. Any records obtained should be associated with the claims folder. The veteran should be asked to sign any necessary consent forms for release of his private medical records. 2. Thereafter, the veteran should be afforded VA ophthalmologic and dermatologic examinations, in accordance with the VA Physician's Guide for Disability Evaluation Examinations, to determine the current nature and severity of the service-connected eye and skin disorders noted above. All necessary tests and studies should be conducted and all findings should be reported in detail, to include all manifestations of dermatitis. A complete rationale for any opinion expressed must be provided. The claims folder must be made available to the examiner for review prior to the examination. 3. The RO should then readjudicate the issues still on appeal, with the issues of entitlement to compensable evaluations for service-connected eye and skin disorders evaluated under all appropriate diagnostic codes, to include consideration of the provisions of 38 U.S.C.A. § 5107(b) (West 1991), 38 C.F.R. §§ 3.321(b)(1) and 4.7 (1994). The issue of entitlement to service connection for diabetes mellitus, to include cataracts, should be readjudicated in light of the Court's decision in Allen noted above. When the above actions have been completed, unless the benefits sought are granted to the satisfaction of the veteran, the veteran and his representative should be provided with a supplemental statement of the case and given the applicable time period to respond. The case should then be returned to the Board, if otherwise in order. The veteran need take no action until notified. F. JUDGE FLOWERS Member, Board of Veterans' Appeals (CONTINUED ON NEXT PAGE) 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. The remand portion of the above action 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).