Citation Nr: 0813005 Decision Date: 04/18/08 Archive Date: 05/01/08 DOCKET NO. 04-28 522 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Reno, Nevada THE ISSUE Entitlement to service connection for a skin disorder to include Schaumberg's disease, including as a result of exposure to herbicide. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Bridgid D. Cleary, Associate Counsel INTRODUCTION The veteran served on active duty from June 1966 to March 1969, including service in Vietnam from July 1967 to August 1968. This matter has come before the Board of Veterans' Appeals (Board) on appeal from a January 2003 rating decision of the Reno, Nevada, Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the veteran's case for further development in July 2006 and August 2007. FINDINGS OF FACT 1. The veteran served in Vietnam during the Vietnam era. 2. The medical evidence of record shows that the veteran has Schaumberg's disease, which is related to his active service; additionally diagnosed skin conditions of granuloma faciale, Grover's disease and skin cancer have not been related to his active service. CONCLUSION OF LAW Schaumberg's disease was incurred in active service. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. § 3.303 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veterans Claims Assistance Act The VCAA, codified at 38 U.S.C.A. §§ 5100, 5102, 5103A, 5106, 5107, 5126, was signed into law on November 9, 2000. Implementing regulations were created, codified at 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326 (2007). The legislation has eliminated the well-grounded claim requirement, has expanded the duty of VA to notify the appellant and the representative, and has enhanced its duty to assist an appellant in developing the information and evidence necessary to substantiate a claim. See generally VCAA. Given the disposition reached in this case, the Board finds that VA has met its duty to assist the veteran in the development of the claim on appeal under VCAA. Pertinent Law and Regulations In general, service connection may be granted for disability resulting from a disease or an injury incurred or aggravated by active military service. 38 U.S.C.A § 1110; 38 C.F.R. § 3.303(a). In addition, service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may be presumed for certain diseases if a veteran has been exposed to certain herbicide agents. 38 C.F.R. § 3.309(e). A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era, from February 28, 1961, to May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii). In order to establish a service connection for the claimed disorder, there must be (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of the in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). Analysis The veteran served in the Republic of Vietnam during the Vietnam era and is therefore presumed to have been exposed to certain herbicide agents, such as Agent Orange. However, the various skin disorders with which he has been diagnosed, Schaumberg's disease, granuloma faciale, Grover's disease and skin cancer, are not listed as diseases associated with exposure to certain herbicide agents which are subject to presumptive service connection. See 38 C.F.R. § 3.309(e). Therefore the Agent Orange presumption of service connection is not applicable. Even though the veteran is not entitled to service connection on a presumptive basis, he is not precluded from establishing service connection for any current skin disorder with proof of actual direct causation. See Combee v. Brown, 34 F.3d 1039, 1041-42 (Fed. Cir. 1994). As such, the Board has considered whether the veteran is entitled to service connection for a skin disorder on a direct basis. The medical evidence of record shows that the veteran has been treated for granuloma faciale, Grover's disease and multiple skin cancers since at least 1990 and is currently undergoing treatment for these conditions. During a VA examination in October 2007, an additional skin disorder, Schaumberg's disease, was noted. Therefore, Hickson element (1), current disability, has been met. With respect to Hickson element (2), in-service injury or incurrence, the veteran's service treatment records include a reference to a rash on his lower leg in June 1966. This in- service skin condition satisfies Hickson element (2). In regard to Hickson element (3), medical nexus, no medical evidence of a causal relationship between the veteran's active service and his current granuloma faciale, Grover's disease or skin cancer has been offered. The Board notes however, that following VA examination in October 2007, the VA examiner opined that "it is likely that his [Schaumberg's disease] is service connected." The Board finds that this opinion satisfies Hickson element (3), medical nexus for Schaumberg's disease. The other skin conditions have not been related to the veteran's military service by competent medical evidence. Having satisfied all three of the Hickson elements, the veteran is entitled to service connection for Schaumberg's disease. ORDER Entitlement to service connection for Schaumberg's disease is granted. ____________________________________________ DEBORAH W. SINGLETON Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs