Citation Nr: 9901688 Decision Date: 01/22/99 Archive Date: 02/01/99 DOCKET NO. 98-07 956 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Buffalo, New York THE ISSUES 1. Entitlement to service connection for vitiligo. 2. Entitlement to a total rating based on individual unemployability due to service-connected disabilities. (The issues of entitlement to service connection for residuals of malignant melanoma of the left foot with groin metastases, due to exposure to Agent Orange, and to an evaluation in excess of 30 percent for the veteran’s service- connected post-traumatic stress disorder (PTSD), will be the subject of a separate decision of the Board.) REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Steven D. Reiss, Associate Counsel INTRODUCTION The veteran served on active duty from September 1965 to November 1967, including service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 1996 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Buffalo, New York, which denied service connection for vitiligo and to a total disability rating based on individual unemployability due to service-connected disabilities. The veteran disagreed with these determinations, and this appeal ensued. With respect to the veteran’s claim of entitlement to a total disability rating based on individual unemployability due to service-connected disabilities, the Board notes that, in light of the Board’s separate decision establishing entitlement to a 100 percent schedular evaluation for his service-connected PTSD, this claim is moot. In April 1997, the veteran and his representative appeared at a hearing before the undersigned, sitting in Washington, D.C. FINDINGS OF FACT 1. All available evidence necessary for an equitable disposition of this appeal has been obtained. 2. The veteran developed vitiligo as a result of treatment for the service-connected residuals of his malignant melanoma of the left foot with groin metastases. CONCLUSION OF LAW Vitiligo is proximately due to or the result of a service- connected disability. 38 U.S.C.A. §§ 1110, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.310 (1998). REASONS AND BASES FOR FINDINGS AND CONCLUSION Background The service medical records are negative for complaint or treatment of vitiligo. Indeed, the veteran does not contend that his vitiligo began during service. Rather, in numerous statements, in his April 1997 hearing testimony and in a videotape of a television interview concerning his reaction, as a Vietnam veteran, to the viewing of the film, Saving Private Ryan, the veteran maintained that that he suffers from this skin disorder as a result of his inservice exposure to Agent Orange. Alternatively, he argues that he has vitiligo as a result of the chemotherapy treatments he received for his malignant melanoma of the left foot with groin metastases. In March 1996, the veteran submitted an informal claim in which he asserted entitlement to service connection for vitiligo. A careful review of the voluminous evidence of record shows that, since 1983, the veteran has been diagnosed as suffering from severe vitiligo that it covers his entire body. Because there is no question that the veteran suffers from this skin disorder, the only issue before the Board is whether his vitiligo is etiologically related to either his inservice exposure to Agent Orange or to the treatment he received for his service-connected residuals of malignant melanoma of the left foot with groin metastases. As such, for the sake of brevity, and to avoid redundancy, the Board will discuss only that evidence that bears on these issues. In January 1998, the veteran was afforded VA lymphatic disorders, dermatological and podiatric examinations. Each of the accompanying examination reports reflects that the physicians diagnosed the veteran as having extensive vitiligo. Significantly, in the January 1998 podiatric examination report, the physician opined that the veteran’s melanoma was secondary to his exposure to Agent Orange during service, and diagnosed him as “status post chemotherapy, resulting in extensive vitiligo.” The examiner further explained that “the extensive vitiligo is a consequence of the chemotherapy.” Analysis The Board finds that the veteran’s claim for service connection for vitiligo is plausible and capable of substantiation, and thus well-grounded within the meaning of 38 U.S.C.A. § 5107(a). When a veteran submits a well- grounded claim, VA must assist him in developing facts pertinent to those claims. 38 U.S.C.A. § 5107(a). The Board is satisfied that all relevant evidence has been obtained regarding the veteran’s claim, and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a). Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may also be granted for disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). In a separate decision accompanying this one, the Board established entitlement to service connection for residuals of malignant melanoma of the left foot with groin metastases on the ground that the residuals are etiologically related to his inservice exposure to Agent Orange. In the January 1998 VA examination report, the physician opined that the veteran’s vitiligo is related to the chemotherapy that he received to treat his service-connected melanoma. A careful review of the record reveals that there is no contradictory competent medical evidence. Accordingly, the Board concludes that the evidence supports the claim for service connection, on a secondary basis, for the veteran’s vitiligo. In light of this determination, the Board notes that the veteran’s claim for service connection for vitiligo on a direct basis, i.e., secondary to his inservice exposure to Agent Orange, is moot. ORDER Service connection for vitiligo is granted. M. CHEEK Member, Board of Veterans' Appeals NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1998), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. - 2 -