Citation Nr: 1305232 Decision Date: 02/13/13 Archive Date: 02/21/13 DOCKET NO. 09-43 809 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUES 1. Entitlement to service connection for a skin disease, to include chloracne. 2. Entitlement to service connection for neuropathy of the feet and right arm. REPRESENTATION Appellant represented by: Pennsylvania Department of Military and Veterans Affairs ATTORNEY FOR THE BOARD S. Grabia, Counsel INTRODUCTION The Veteran served on active duty from March 1966 to August 1969, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a March 2009 rating decision of the Philadelphia, Pennsylvania Regional Office (RO) of the Department of Veterans Affairs (VA). The Board notes that during the appeal period for the above listed issues, the Veteran was granted service connection for ischemic heart disease and assigned a 100 percent disability rating. The Veteran requested a videoconference hearing before a Board Veterans Law Judge. He failed to report for such a hearing in December 2012, but his motion to reschedule was granted. In January 2013, he again failed to report for a requested hearing, and has offered no explanation for this failure. His hearing request is deemed withdrawn. 38 C.F.R. § 20.704(d) (2012). The appeal is REMANDED to the RO via the Appeals Management Center (AMC). The Veteran will be advised if further action is required on his part. REMAND VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The types of evidence that indicate that a current disability may be associated with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology such as pain or other symptoms capable of lay observation. McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The threshold for finding a link between current disability and service is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon v. Nicholson, at 83. The Veteran's service treatment records show that he was treated on one occasion for an acneform skin condition with scars. In his substantive appeal, he reported that within the year of his discharge from service he started to get a rash and had a problem with black heads that had continued to the present. Recent VA treatment records show that on a number of occasions he was found to have no rash, but it was not reported whether there were black heads or any history of rash. The Veteran also reported that within a year of his discharge from service he began to experience "leg and foot problems." He has currently diagnosed peripheral neuropathy. This evidence crosses the low threshold for triggering VA's duty to provide an examination. Examinations are needed because it is not clear that the Veteran has a current skin condition and even less clear whether such a disability is related to the skin condition identified in service or reported by the Veteran as being present shortly after service. With regard to peripheral neuropathy, it is not clear whether the symptoms the Veteran reports began shortly after service are related to service or to the current disability. Accordingly, the appeal is REMANDED for the following: 1. Afford the Veteran a VA examination to determine whether he has a current skin condition that is related to service. The examiner should review the claims folder including any relevant records stored in an electronic format. The examiner should opine as to whether: a) The Veteran has had a skin disease or disability at any time since December 2008. b) If the Veteran has had such a disability since December 2008, the examiner should opine as to whether the skin disease or disability began in service or is otherwise related to a disease or injury in service (including herbicide exposure and the documented episode of acneform disease). The examiner should provide reasons for these opinions that discuss the Veteran's reports of his history and symptoms. If the examiner discounts the Veteran's reports, he or she must provide reasons for doing so. The absence of supporting clinical evidence is not, by itself, a sufficient reason to discount the Veteran's reports. If an opinion cannot be provided without resort to speculation, the examiner should provide reasons why this is so, and discuss whether the inability to provide the necessary opinion is due to the absence of evidence or the limits of medical and scientific knowledge. 2. The Veteran should be provided an examination to determine whether the current peripheral neuropathy is related to a disease or injury in service. The examiner should opine as to whether it is at least as likely as not that the current peripheral neuropathy began in service or is otherwise related to a disease or injury (including herbicide exposure) in service. The examiner should provide reasons for these opinions that discuss the Veteran's reports of his history and symptoms. If the examiner discounts the Veteran's reports, he or she must provide reasons for doing so. The absence of supporting clinical evidence is not, by itself, a sufficient reason to discount the Veteran's reports. If an opinion cannot be provided without resort to speculation, the examiner should provide reasons why this is so, and discuss whether the inability to provide the necessary opinion is due to the absence of evidence or the limits of medical and scientific knowledge. 3. If any benefit sought on appeal remains denied, the agency of original jurisdiction should issue a supplemental statement of the case; and then return the case to the Board, if otherwise in order. The Veteran and his representative have the right to submit additional evidence and argument on the 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. 2011). ____________________________________________ Mark D. Hindin 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) (2012).