Citation Nr: 1323660 Decision Date: 07/24/13 Archive Date: 08/01/13 DOCKET NO. 09-38 720 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUE Entitlement to service connection for a skin disability to include dermatitis. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD T. S. Willie, Counsel INTRODUCTION The Veteran served on active duty from January 1943 to January 1946, and from May 1947 to October 1948. This appeal to the Board of Veterans' Appeals (Board) comes from a rating decision of the Los Angeles, California Regional Office (RO) of the Department of Veterans' Affairs (VA). In March 2012, a Board hearing was held at the RO before the undersigned Veteran's Law Judge. A transcript of the hearing is of record. In October 2012, the case was remanded for further development. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). FINDINGS OF FACT 1. Any skin disorder shown in service was acute and resolved without residual. 2. A skin disability to include dermatitis is not attributable to active service. CONCLUSION OF LAW A skin disability to include dermatitis was not incurred in or aggravated by service. 38 U.S.C.A. § 1110, 1131, 5103, 5103A, 5107 (West 2002 and Supp. 2012); 38 C.F.R. § 3.102, 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veterans Claims Assistance Act of 2000 The requirements of 38 U.S.C.A. §§ 5103 and 5103A have been met. There is no issue as to providing an appropriate application form or completeness of the application. VA notified the Veteran in April 2008 of the information and evidence needed to substantiate and complete a claim, to include notice of what part of that evidence is to be provided by the claimant, what part VA will attempt to obtain. The Veteran was also provided information regarding the assignment of disability ratings and effective dates. The appeal was most recently readjudicated in the June 2013 supplemental statement of the case. VA also fulfilled its duty to assist the Veteran in obtaining identified and available evidence needed to substantiate a claim, and as warranted by law, affording VA examinations. This matter was last remanded by the Board in October 2012 to obtain and associate with the file VA and private treatment records and to obtain a VA opinion. The Board finds that the instructions set forth in its remand were substantially complied with, and that VA fulfilled its duty to assist. Moreover, during the March 2012 Board hearing, the undersigned explained the issue on appeal and asked questions designed to elicit evidence that may have been overlooked with regard to the claim. These actions provided an opportunity for the Veteran and his representative to introduce material evidence and pertinent arguments, in compliance with 38 C.F.R. § 3.103(c)(2) and consistent with the duty to assist. See Bryant v. Shinseki, 23 Vet. App. 488, 492 (2010). Accordingly, the Board will address the merits of the claim. Analysis The Veteran appeals the denial of entitlement to service connection for a skin disability to include dermatitis. According to the Veteran, his current skin disorder was incurred during service. Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C.A. §§ 1110, 1131. Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Service treatment records show that the Veteran was treated for severe unclassified dermatitis of the face, hand, legs, arms and neck during his first period of service from February to July 1945, including a need for hospitalization and convalescent leave. At the January 1946 separation examination, his skin was found to be normal. A March 1946 medical certificate shows findings of pyoderma or dermatitis as manifested by scattered multiple purulent superficial skin lesions. An October 1948 separation examination, again revealed normal findings for the skin. The Veteran filed a claim of entitlement to service connection for jungle rot in January 1979. During the May 1979 VA examination, the Veteran was found to have bilateral non-inflammatory plantar tinea pedis with onychomycosis of the great toes, and mild post inflammatory hyperpigmentation of the groin region. The examiner found no evidence of current dermatitis. In June 1980, the Veteran expressed that his jungle rot was coming back. VA treatment records from 1981 to 1988 show that the Veteran was seen on an intermittent basis for skin disorders including multiple skin tags about the neck, ear and back, a groin rash; onychomycosis and debridement of the toenails; and a rash, which had spread to the ankle and foot. VA treatment records since 1999 show intermittent treatment for skin disorders, including dermatitis. Diagnostic assessments include xerosis, tinea pedis, onychomycosis, an epidermal cyst, seborrheic keratoses, cherry angiomas, acrochordons, chronic intertrigo, post- inflammatory hyperpigmentation, and stasis dermatitis and varicosities. During the March 2012 Board hearing, the Veteran testified that he first noticed having jungle rot in 1945 while in New Guinea. He described the New Guinea jungle as a very humid wet environment. He stated that from 1948, when he separated from service, until 1977, he self-treated his skin condition. He testified that in 1977, after retiring from his civilian job, he began to get regular VA health care, including treatment for his skin problems. Following a February 2013 VA examination statis dermatitis tinea pedis were diagnosed. The VA examiner opined that a skin disorder was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in service injury, event or illness. The VA examiner noted that the Veteran argued that his current skin disorder was related to the diagnosis of jungle rot while in service. According to the examiner, jungle rot is slang term used to describe a fungal infection of the feet commonly seen in soldiers deployed to tropical regions. The examiner states that it was also known as athlete's foot. The examiner stated that the Veteran had a second period of service and that there is no indication on his separation exams or on his second induction exams of a skin condition. It was not without reason, the examiner stated, to believe that this evidence indicates the resolution of the previous skin condition demonstrated in service. The examiner also noted a several year gap between his separation from service and the seeking medical attention for the skin disorders. Based on the evidence of record, the Board finds that the evidence preponderates against entitlement to service connection for a skin disability. Service treatment records reveal that the Veteran was treated for dermatitis during his first period of service. The evidence, however, shows that the Veteran's separation examination during his first period of service, his reenlistment examination, and separation examination from his second period of service each revealed that he had normal skin. As such, and as the February 2013 examiner found, the record shows that the Veteran's in service manifestations were acute and resolved prior to separation. There is no competent evidence showing that any current skin disorder is related to service. To the extent that the Veteran argues that his disability is related to service, objective evidence of skin problems are not shown in the record until over three decades following the Veteran's discharge from service. The passage of many years between discharge from active service and the medical documentation of a claim disability is a factor that weighs against a claim for service connection. See Maxson v. West, 12 Vet. App. 453 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330 (Fed. Cir. 2000). The February 2013 VA examiner opined that the Veteran's current skin disability was less likely than not (less than 50 percent probability) incurred in, or caused by the claimed in service injury, event or illness. The VA examiner noted the normal skin findings during the Veteran's separation examination from his first period of service and second period of service, and that there was a several year gap between his separation from service and seeking medical attention for the skin conditions. The VA opinion was rendered by a medical professional with the expertise to opine on the matter at issue in this case. The examiner addressed the Veteran's contentions and based his opinions on a review of the claim folders as well as a complete physical examination. The opinion is well reasoned, and it is supported by and consistent with the historical record. There is no competent evidence to the contrary. Hence, the February 2013 opinion is assigned greater probative weight than the lay assertions of the Veteran that are presented in support of a claim for monetary benefits. Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (While VA cannot ignore a veteran's testimony simply because he is an interested party; personal interest may, however, affect the credibility of the evidence). The Veteran is competent to report skin problems. To the extent that the appellant claims a history of skin problems since separation, however, the Board finds such an assertion not credible. Simply put, if the Veteran truly was having skin problems since service, it is more believable to conclude that he would have sought treatment for the disorder sometime within the three decades following discharge from service. Buczynski v. Shinseki, 24 Vet. App. 221, 226-27 (2011) (where there is a lack of notation of medical condition or symptoms where such notation would normally be expected, the Board may consider this as evidence that the condition or symptoms did not exist). The VA medical opinion, service treatment records, and historical record preponderate against the claim, and they are assigned greater probative weight. The Board acknowledges that the Veteran's sister maintains that she saw the jungle rot on her brother. His brother also contends that he caught the disease from the Veteran when he came home from service. While the Board finds that the siblings are competent to report what they saw and/or experienced, the statements are not competent medical evidence addressing the etiology of the Veteran's current skin disability. There is no indication that the appellant's siblings have the knowledge and/or expertise to render a medical opinion addressing the etiology of any skin disorder. In sum, the most probative evidence of record preponderates against showing that the Veteran's skin disability is related to service. Hence, entitlement to service connection for a skin disability to include dermatitis is denied. In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the claim the doctrine is not for application. 38 U.S.C.A. § 5107. ORDER Entitlement to service connection for a skin disability to include dermatitis is denied. ____________________________________________ DEREK R. BROWN Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs