Citation Nr: 1306445 Decision Date: 02/25/13 Archive Date: 03/01/13 DOCKET NO. 10-40 676 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to an initial compensable rating for a skin disability, to include tinea pedis, tinea cruris and onchomycosis. REPRESENTATION Appellant represented by: Texas Veterans Commission ATTORNEY FOR THE BOARD S. Coyle, Counsel INTRODUCTION The Veteran served on active duty from May 1998 to May 2002. This matter is before the Board of Veterans' Appeals (Board) on appeal of a January 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2012, the Board remanded this issue to the agency of original jurisdiction (AOJ) for further evidentiary development. In February 2012, a VA examiner found that the Veteran's tinea cruris and onchomycosis are the result of his service-connected tinea pedis. The issue has thus been recharacterized to comport with the evidence of record. 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 January 2012 remand directed that the AOJ obtain VA treatment records relating to the Veteran's skin disorder since July 2010. The claims folder contains a document, dated February 7, 2012, showing that records from the Shreveport VA Medical Center (VAMC), dating from September 2010 to April 2011, were added to the Veteran's Virtual VA folder. An October 2012 supplemental statement of the case reflected review of these records. However, they are not contained in the Virtual VA folder or in the paper claims file. Remand is required so that these records, and any additional VA records generated since April 2011, may be obtained and made available for Board review. The Veteran has been treated by a private physician, Dr. J.Y., since May 2009 for his service-connected skin disorder. Clinical notes dated in May 2009, November 2009, and July 2010, as well as a statement from Dr. Y. dated in September 2010, are of record. However, it does not appear that the records are complete, as the notes currently available reflect that the Veteran was to return for treatment every 2 to 3 months. Since a complete set of records from Dr. Y may be useful in deciding the claim, they should be obtained, pending any necessary release from the Veteran. 38 C.F.R. § 3.159(c)(2); Bell v. Derwinski, 2 Vet. App. 611 (1992). The Veteran underwent a VA skin disorders examination in February 2012. The examiner noted a history of tinea pedis, tinea cruris, and onchomycosis; however, there were no active manifestations of the Veteran's skin disorder during the examination. Consequently, the examiner found that zero percent of the Veteran's body and zero percent of exposed areas were affected by his skin disorder. Although there were no active symptoms during the examination, the examiner's findings do not take into account the Veteran's medical history during the appeal period, which includes treatment for persistent symptoms of tinea pedis, tinea cruris, and onchomycosis by Dr. Y. The report also does not comment on the nature and duration of antifungal and antibiotic therapies prescribed to the Veteran by Dr. Y., or indicate whether systemic therapy was warranted but not prescribed, as directed by the Board in its January 2012 remand. As a result, the examination report is inadequate for rating purposes. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); see also Stegall v. West, 11 Vet. App. 268, 271 (1998)( the Board errs as a matter of law when it fails to assure substantial compliance with remand orders). A new skin examination must be scheduled upon remand. Accordingly, the case is REMANDED for the following action: 1. Obtain the VA treatment records dated from September 2010 to April 2011, which were considered in an October 2012 supplemental statement of the case, as well as any VA treatment records related to the Veteran's skin disorder since April 2011. If any records cannot be obtained after reasonable efforts have been made, notify the Veteran and allow him the opportunity to provide such records, as provided in 38 U.S.C.A. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. After securing any necessary authorization, obtain all treatment records since May 2009 from Dr. Y. If any records cannot be obtained after reasonable efforts have been made, notify the Veteran of the attempts made and allow him the opportunity to obtain the records. 3. Schedule the Veteran for a VA skin disorders examination by an appropriate medical professional. The entire claims file (i.e., the paper claims file and any medical records contained in Virtual VA, CAPRI, and AMIE) must be reviewed by the examiner. If the examiner does not have access to Virtual VA, any relevant treatment records contained in the Virtual VA file that are not available on CAPRI or AMIE must be printed and associated with the paper claims file so they can be available to the examiner for review. Any indicated studies must be performed. The examiner must identify the nature, frequency, and severity of all manifestations of the service-connected tinea pedis, tinea cruris, and onchomycosis since the commencement of the appeal period on June 2, 2008. The examiner must provide specific findings as to the percentage of the Veteran's entire body affected, as well as the percentage of the exposed areas of his body that are affected. If there are no active manifestations of the Veteran's service-connected skin disorder noted on examination, the examiner must render an opinion based upon the Veteran's statements as to the history and appearance of the skin disorder and the medical records documenting treatment for tinea pedis, tinea cruris, and onchomycosis. The examiner is advised that the Veteran's statements as to his observations of a skin disorder are competent and must be considered. The examiner must state whether systemic therapy, including, but not limited to, corticosteroids or other immunosuppressive drugs, have been required at any point since June 2, 2008 and, if so, the duration of each period of treatment with systemic therapy. The duration of treatment must be expressed in terms of weeks, if possible. The examiner must also comment as to any functional effects that the service-connected skin disorder has on the Veteran's daily life, activities, and employability. 4. Review the claims file to ensure that all of the foregoing development is completed, and arrange for any additional development indicated. Then readjudicate the claim on appeal. If the benefit sought remains denied, issue an appropriate supplemental statement of the case and provide the Veteran and his representative the requisite period of time to respond. The case is to then be returned to the Board for further appellate review. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This case must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ RONALD W. SCHOLZ Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the Court. 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).