Citation Nr: 0813007 Decision Date: 04/18/08 Archive Date: 05/01/08 DOCKET NO. 03-11 787 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Togus, Maine THE ISSUE Entitlement to service connection for a skin disorder, claimed as fungal infections, to include mucocutaneous candidiasis, skin blotches, and moles, also claimed as secondary to service-connected post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD S. Layton, Associate Counsel INTRODUCTION The veteran had active military service from April 1970 to December 1971. This matter comes before the Board of Veterans' Appeals (Board) from an August 2002 rating decision by the Togus, Maine Regional Office (RO) of the Department of Veterans Affairs (VA), which denied the veteran service connection for fungal infections. In June 2004, August 2005, and August 2006, the Board remanded the veteran's case to the RO for further development. The case was recently returned to the Board in March 2008. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify you if further action is required on your part. REMAND The Veterans Claims Assistance Act of 2000 (VCAA) was enacted and is codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002). This law redefines the obligations of VA to the appellant with respect to claims for VA benefits and applies to this remand. The Board notes that the August 2006 Board remand directed the RO to schedule the veteran for a VA examination for an opinion by a physician to determine whether the veteran's skin disorders were related to his service or related to his service-connected disabilities. In September 2006, the RO scheduled the veteran for a VA examination at the VAMC in Providence, Rhode Island. However, the veteran informed the RO that he would not go to Providence and requested an examination in Togus, Maine. The RO attempted to schedule the veteran for a VA examination in Togus and was informed that the Togus facility did not have the capability for dermatology examinations. The RO was also informed that Togus did not have a provider that had the necessary expertise in skin conditions. The RO scheduled the veteran for an examination at VAMC Boston in March 2007. The veteran responded that he was too ill to keep the appointment, and he would call the VA when he was well enough for an examination. The claims file contains no other correspondence from the veteran indicating that he was well enough to attend a VA examination. Consequently, the RO issued a Supplemental Statement of the Case in November 2007 and returned the claims file to the Board for adjudication. The Board notes the efforts the RO has made to schedule the veteran for an appropriate examination. The Board advises the veteran that he Court of Appeals for Veterans Claims has held that the duty to assist is not a one-way street. If a veteran wishes help in developing his claim, he cannot passively wait for it in those circumstances where he has information that is essential in obtaining evidence. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). However, the Board finds that the veteran should be given one more opportunity to attend a VA examination to determine whether the veteran's skin disorders are related to his service- connected disabilities or his service. Accordingly, the case is REMANDED for the following actions: 1. The RO should arrange for the veteran to undergo a VA dermatology examination in order to determine the nature and etiology of all existing skin disorders, to include fungal infections, skin blotches, and moles. The claims folders must be made available to and reviewed by a physician familiar with skin disorders in conjunction with the examination. A notation to the effect that this record review took place should be included in the report of the physician. All necessary tests should be accomplished. All clinical findings should be reported in detail in the examination report. In particular, the physician is requested to do the following: (a) elicit from the veteran a history of all skin complaints and treatment; (b) furnish a diagnosis of any currently present skin disability, to include fungal infections; and, (c) render an opinion as to the likely date of onset and etiology of each diagnosed skin disability. In so doing, the examiner should render an opinion as to whether any identified skin disability is at least as likely as not (i) related to the veteran's period of active service from April 1970 to December 1971; or (ii) whether such skin disability was caused by or worsened in severity (aggravated) due to any service-connected disability (PTSD, irritable bowel syndrome, or otitis externa) or treatment, to include medications. A complete rationale for all opinions expressed should be provided. 2. The veteran must be given adequate notice of the date and place of any requested examination. A copy of all notifications must be associated with the claims folders. The veteran is to be advised that failure to report for a scheduled VA examination without good cause shown may have adverse effects on his claim. 38 C.F.R. § 3.655 (2007). Specifically, the veteran is to be informed that if he fails to report for this VA examination and does not attend a re-scheduled examination, his case will be adjudicated on the basis of the evidence of record. 3. Thereafter, the RO then review the claims folders to ensure that all development actions have been conducted and completed in full. If any development is incomplete, appropriate corrective action is to be implemented. 4. Then, the RO should readjudicate the issue on appeal based on a de novo review of all pertinent evidence. If the benefit sought on appeal is not granted to the veteran's satisfaction, the RO should issue a Supplemental Statement of the Case and afford the veteran and his representative the requisite opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action, if indicated. The appellant has the right to submit additional evidence and argument on the matter or matters 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. 2005). _________________________________________________ RENÉE M. PELLETIER 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) (2007).