Citation Nr: 1000953 Decision Date: 01/07/10 Archive Date: 01/15/10 DOCKET NO. 07-00 248A ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina THE ISSUE Entitlement to an initial rating higher than 30 percent for a skin rash. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD S. D. Regan, Counsel INTRODUCTION The Veteran had verified active duty from May 1966 to March 1970 and from January 1991 to June 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2006 RO rating decision that granted service connection and a 30 percent rating for a skin rash, effective November 30, 2004. An August 2007 RO rating decision (implementing an August 2007 Board decision) granted an earlier effective date of November 29, 2002, for the Veteran's service-connected skin rash. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Board finds that there is a further VA duty to assist the Veteran in developing evidence pertinent to his claim. 38 U.S.C.A. § 5103A (West 2002); 38 C.F.R. § 3.159 (2009). The Veteran was last afforded a VA skin diseases examination in December 2007. It was noted that the Veteran's claims file was not available. The diagnosis was eczema, involving 0 percent of the Veteran's exposed skin and 11.8 percent of his total body area. The Veteran reported that he was taking Triamcinolone, Fluocinonide, and Clobetasol topical creams, all with a good response. It was noted that the Veteran had been using corticosteroids on a "regular" basis. The Board observes that the examiner did not specifically address such information as whether the Veteran required systemic therapy such as corticosteroids or other immunosuppressive drugs for a total duration of six weeks or more, but not constantly, during the past 12-month period, or whether he required constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs during the past 12-month period. Findings in this regard are necessary for properly rating the Veteran under 38 C.F.R. § 4.118, Diagnostic Code 7806 (2009). Additionally, in a January 2008 VA Form 9, the Veteran specifically reported that he had been using corticosteroids on a regular basis over the last 12 months. He stated he was taking Clobetasol Propinate, Fluocinonide, and Triamcinolone Acetonide creams. The Board observes that there is simply not enough recent medical evidence of record in order to properly address the Veteran's claim. Further, the Veteran has not been afforded a VA examination as to his service-connected skin rash in two years. The Board also notes that the Veteran's representative has specifically requested that he be afforded a new examination. Therefore, the Board finds that a current examination is necessary. See Caffrey v. Brown, 6 Vet. App. 377, 381 (1995) (VA was required to afford a contemporaneous medical examination where examination report was approximately two years old); see also Green v. Derwinski, 1 Vet. App. 121, 124 (1991). Prior to the examination, any outstanding records of pertinent treatment should be obtained and added to the record. Accordingly, the case is REMANDED for the following: 1. Ask the Veteran to identify all medical providers who have treated him for skin problems since January 2008. After receiving this information and any necessary releases, contact the named medical providers and obtain copies of the related medical records which are not already in the claims folder. Specifically, VA treatment records since January 2008 should be obtained. 2. Schedule the Veteran for a VA examination to determine the severity of his service-connected skin rash. The claims folder must be provided to and reviewed by the examiner in conjunction with the examination. All signs and symptoms necessary for rating the veteran's skin rash should be reported in detail, including all information necessary for rating the condition under 38 C.F.R. § 4.118, Diagnostic Code 7806. The examiner is specifically requested to indicate: a) the percent of the Veteran's entire body, and the percent of his exposed areas that are affected; b) whether systemic therapy such as corticosteroids or other immunosuppressive drugs are required for a total duration of six weeks or more, but not constantly, during the past 12-month period; c) whether he required constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs during the past 12-month period. 3. Thereafter, review the Veteran's claim for entitlement to an initial rating higher than 30 percent for a skin rash. If any benefit sought on appeal remains denied, issue a supplemental statement of the case to the Veteran and his representative, and provide an opportunity to respond before the case is returned to the Board. The purposes of this remand are to ensure notice is complete, and to assist the appellant with the development of his claim. 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). No action is required of the appellant until further notice. However, the Board takes this opportunity to advise the appellant that the conduct of the efforts as directed in this remand, as well as any other development deemed necessary, is needed for a comprehensive and correct adjudication of his claim. His cooperation in VA's efforts to develop her claim, including reporting for any scheduled VA examination, is both critical and appreciated. The appellant is also advised that failure to report for any scheduled examination may result in the denial of a claim. 38 C.F.R. § 3.655. 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. 2007). _________________________________________________ DENNIS F. CHIAPPETTA 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) (2009).