Citation Nr: 1324401 Decision Date: 07/31/13 Archive Date: 08/07/13 DOCKET NO. 06-31 677 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUES 1. Entitlement to service connection for a skin disorder of the back and neck. 2. Entitlement to service connection for a seizure disorder. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD D. M. Casula, Counsel INTRODUCTION The Veteran had active service from September 1998 to September 2002. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2006 rating decision of the above Department of Veterans Affairs (VA) Regional Office (RO) which, in pertinent part, denied service connection for a skin disorder of the back and neck, and for a seizure disorder. In February 2008, the Veteran at the RO testified at a Board hearing before the undersigned Veterans Law Judge in Washington, D.C. In May 2008, the Board remanded this case to the RO for further development, to include issuing a corrective VCAA notice letter; requesting that the Veteran provide information regarding injures he incurred in service; and scheduling him for VA examinations with opinions. Although notification of the VA examinations was sent to the Veteran, he failed to report for such examinations. He reported he had moved to a new address and had notified VA of the change of address in July 2008, but notice of the VA examinations was sent to his prior address. Thereafter, in July 2011, the Board again remanded this matter in order to schedule the Veteran for the requested VA examinations with opinions. The record reflects he underwent such VA examinations in August 2011 and nexus opinions were offered; thus, the Board is satisfied that there was substantial compliance with its July 2011 remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). In December 2012, the Board issued a decision, denying several issues that were on appeal, and also remanded the claims for service connection for a skin disorder of the back and neck and for seizures to the RO via the VA's Appeals Management Center (AMC) in Washington, DC, in order to obtain updated treatment records, including VA treatment records dated since 2009, and to schedule the Veteran for a VA examination to determine the nature and etiology of his skin complaints. The record reflects that attempts were made to obtain the outstanding treatment records and the Veteran underwent the requested VA examination in June 2013. Thus, there was substantial compliance with the Board's December 2012 remand directives. See Stegall v. West, supra. FINDINGS OF FACT 1. The Veteran incurred two episodes of a skin rash during active service that resolved prior to separation; he has competently and credibly reported intermittent symptoms of a skin disorder since active service; and the competent medical evidence is equipoise as to whether the Veteran's recurrent skin disorder may be related to his active service. 2. A seizure disorder was first shown many years after the Veteran's period of active service, and has not been found by competent medical evidence to be related to his period of active service. CONCLUSIONS OF LAW 1. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for a skin disorder have been met. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2012). 2. A seizure disorder was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Duty to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) enhanced VA's duty to notify and assist claimants in substantiating a claim for VA benefits, as codified in pertinent part at 38 U.S.C.A. §§ 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.159, 3.326(a). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his representative of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice from VA must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide. 38 C.F.R. § 3.159(b)(1), as amended, 73 Fed. Reg. 23,353 (April 30, 2008). This notice must be provided prior to an initial decision on a claim by the RO. Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006); Pelegrini v. Principi, 18 Vet. App. 112 (2004). The VCAA notice requirements apply to all five elements of a service connection claim: (1) veteran status; (2) existence of disability; (3) connection between service and the disability; (4) degree of disability; and (5) effective date of benefits where a claim is granted. Dingess v. Nicholson, 19 Vet. App. 473, 484 (2006). If complete notice is not provided until after the initial adjudication, such a timing error can be cured by subsequent legally adequate VCAA notice, followed by readjudication of the claim, as in a Statement of the Case (SOC) or Supplemental SOC (SSOC). Moreover, where there is an uncured timing defect in the notice, subsequent action by the RO which provides the claimant a meaningful opportunity to participate in the processing of the claim can prevent any such defect from being prejudicial. Mayfield v. Nicholson, 499 F.3d 1317, 1323-24 (Fed. Cir. 2007); Prickett v. Nicholson, 20 Vet. App. 370, 376 (2006). The U.S. Court of Appeals for the Federal Circuit (Federal Circuit) held that any error in VCAA notice should be presumed prejudicial, and that VA bears the burden of proving that such an error did not cause harm. Sanders v. Nicholson, 487 F.3d 881 ( Fed. Cir. 2007). However, the U.S. Supreme Court reversed that decision, finding it unlawful in light of 38 U.S.C.A. § 7261(b)(2). The Supreme Court held that - except for cases in which VA failed to meet the first requirement of 38 C.F.R. § 3.159(b) by not informing the claimant of the information and evidence necessary to substantiate the claim - the burden of proving harmful error rests with the party raising the issue, the Federal Circuit's presumption of prejudicial error imposed an unreasonable evidentiary burden upon VA and encouraged abuse of the judicial process, and determinations on the issue of harmless error should be made on a case-by-case basis. Shinseki v. Sanders, 129 S. Ct. 1696 (2009). In this case, the VCAA duty to notify was satisfied by way of letters sent to the Veteran in July 2005 and May 2008 that fully addressed the notice elements in this matter. These letters informed the Veteran of what evidence was required to substantiate the claim and of his and VA's respective duties for obtaining evidence. The Board also notes that in the May 2008 letter, the Veteran was advised of how disability ratings and effective dates are assigned. See Dingess v. Nicholson, supra. Moreover, he has not demonstrated any error in VCAA notice, and therefore the presumption of prejudicial error as to such notice does not arise in this case. See Sanders v. Nicholson, supra. Thus, the Board concludes that all required notice has been given to the Veteran. Some discussion of the Veteran's video conference hearing is necessary. The individual presiding over a hearing must comply with the duties set forth in 38 C.F.R. § 3.103(c)(2). Bryant v. Shinseki, 23 Vet. App. 488 (2010); see also Procopio v. Shinseki, 26 Vet. App. 76 (2012). These duties consist of (1) fully explaining the issues and (2) suggesting the submission of evidence that may have been overlooked. Such duties were met here. The issues on appeal were identified at the February 2008 videoconference hearing, and information was elicited from the Veteran concerning the nature and cause of his disabilities, as well as information regarding relevant treatment records. Based on that testimony, VA examinations were ordered to obtain opinions regarding the nature and probable etiology of each of the disabilities. The Board also finds VA has satisfied its duty to assist the Veteran in the development of the claims. The RO has obtained all identified and available service and post-service treatment records for the Veteran. In that regard, the Board notes that requests were made, in writing and by phone call, to the Ann Arbor and Cleveland VA Medical Centers (VAMCs), in order to obtain any treatment records for the Veteran dated from 2009. A review of the record shows that both the Ann Arbor and Cleveland VAMCs indicated that no additional treatment records were available. Further, the Veteran was advised of this by letter dated in March 2013, and in May 2013, the AMC issued a formal finding of unavailability of these VA treatment records. The Board also notes that the Veteran underwent VA examinations in August 2011 and in June 2013 pertaining to the claim for service connection for a seizure disorder. The Board notes that each of these examinations included a review of the claims folder and a history obtained from the Veteran, and that examination findings were reported. Further, on the June 2013 VA examination, diagnoses and opinions were stated, which were supported in the record and with appropriate rationale. The 2013 VA examination report is therefore adequate for rating purposes. See Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007). It appears that all obtainable evidence identified by the Veteran relative to his claims has been obtained and associated with the claims folder, and that neither he nor his representative has identified any other pertinent evidence, not already of record, which would need to be obtained for a fair disposition of this appeal. The Board concludes that no further notice or assistance to the Veteran is required to fulfill VA's duty to assist him in the development of the claims. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd 281 F.3d 1384 (Fed. Cir. 2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); see also Quartuccio v. Principi, supra. The Board concludes that VA has satisfied its duty to assist the Veteran in apprising him as to the evidence needed, and in obtaining evidence pertinent to his claims under the VCAA. No useful purpose would be served in remanding this matter for yet more development. Such a remand would result in unnecessarily imposing additional burdens on VA, with no additional benefit flowing to the Veteran. The United States Court of Appeals for Veterans Claims (Court) has held that such remands are to be avoided. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). II. Factual Background Service treatment records (STRs) that in February 2000, the Veteran was seen for complaints of a two day history of a rash to the back of the neck. The assessment was rash, consistent with localized herpetic infection. In February 2001, he was seen for a two day history of a rash. He described an itching and slight burning sensation, and noticed the rash on the trunk area last Friday and the arms and face that day. Objective examination showed urticaria to the trunk and upper extremities. The assessment was drug reaction, and steroids were prescribed. In December 2001, the Veteran struck his head on a pole and cut his left eyebrow. He denied loss of consciousness, and no other injury was reported. The assessment was laceration left eyebrow. Private treatment records include a March 2005 letter from Dr. Mahmood indicating that the Veteran "may have had generalized seizures - etiology not clear." In an April 2005 letter, Dr. Mahmood indicated that the Veteran had "epilepsy better controlled." In April 2005, he underwent an MRI of the brain which was negative. In a May 2005 letter, Dr. Mahmood indicated the Veteran has "seizures well controlled" with medication. VA treatment records showed that in October 2006, the Veteran was seen for an initial visit, and it was noted that he had a history of seizures since 2001, and his last seizure was 6 months ago. The assessment was seizures and that he was stable on medication. On a screen for skin rash/lesions, he reported no persistent skin rash. In December 2006, it was noted that the Veteran had been taking medication for his seizure disorder, prescribed by Dr. Mahmood, but he lost his medical benefit and was not taking any medication for the last three weeks. He denied any seizures since being off of the medication. In January 2007, the Veteran was seen for further management of his seizures. He reported that his seizures started in 2000, while he was in the military, when he would experience increased heart rate, increased respiratory rate, and feelings of déjà vu sporadically throughout the day. He reported that once he started living with his girlfriend, she told him he had episodes of shaking in his sleep for approximately 1 to 2 minutes. His last daytime seizure was approximately 4 to 5 months ago, and his last nighttime seizure was less than a year ago. He had not been taking his medication for approximately 4 to 5 months. It was noted that there was otherwise, no history of head trauma or infection. The assessment was history of partial complex seizures with possible GTC seizures. In February 2008, the Veteran testified that his seizures "could be" related to the head injury he sustained in service. He testified he hurt his head in service by walking into a large wood beam that was supporting the GP tent. He claimed it knocked him down and split the skin above his eyebrow. He claimed the first inclination of seizures was when he would have "daydreams" and "déjà vu" and loss of concentration, and that he reported this to the medical corpsman at the site, who advised him he was dehydrated. He testified that after service he explained the "déjà vu" and "emptiness of thought" to a neurologist who advised him it was a perfect example of a daytime seizure. He also testified that he had never received a diagnosis for the rash that occasionally appears on his neck and back. On a VA skin disease examination in August 2011, it was noted that the condition being examined was a rash on the back and neck. It was noted that the Veteran had lesions that came every two months, and intermittent lesions on the back, neck, and legs. Currently, he had the lesions on his left leg only, and had not been given a diagnosis. It was noted that the lesions got red, then white, and lasted for months. It was noted that he had skin disease treatment twice in the last 12 months, consisting of oral antibiotic and cream. The diagnosis was unknown intermittent skin condition, and it was noted that in service he had a drug rash and what was thought to be a herpes infection. He had insufficient symptomatology presently to make a current diagnosis to link his current intermittent complaints to service. On the VA examination for seizures, in August 2011, the examiner noted that the Veteran had a seizure disorder, which reportedly had an onset in 2001. It was noted that the Veteran did not believe that the head injury in service caused the seizures, but the Veteran did believe that the seizures started in service. The examiner opined that the Veteran did not have epilepsy, and that there was a history of diagnosis of seizures, but that diagnosis was not confirmed in the examiner's opinion. The examiner further opined that the Veteran's history of seizure disorder was not related to any incident of service to include a December 2001 head injury, or related to any symptoms that the Veteran identified as having had in service that might not be reflected in the STRs. For rationale, the examiner did not believe that a diagnosis of seizure disorder was well supported, noting that the Veteran was not actively having seizures and was off medication. With regard to the December 2001 incident in service, the examiner noted that the Veteran sustained what had been called a "head injury", but found that this was a very minor injury and would not have caused any brain trauma and would not have caused him to have seizures. The examiner noted that the Veteran reported subjective symptoms that were not reflected in the STRs, and the examiner opined that, given that the Veteran did not have the nighttime myoclonus and possible seizure activity until three years after leaving service, it was extremely unlikely that these were early manifestations of a seizure disorder which did not clinically present itself until 2005. On a VA dermatology examination in April 2013, the Veteran reported that when he was in service he received a series of at least six vaccinations for anthrax and that a couple of days after a couple of the vaccinations he developed large painful boils on his neck. He reported that more recently he had boils on his neck, one or two at time, also on his back. He claimed the boils lasted about two weeks and resolved spontaneously without treatment, and were initially painful and then itchy as they began to go away. He was unsure of how many episodes he had per year, but eventually put it at 4 to 5 times a year. Skin examination was normal, except for an erythematous lesion with a pustular center on the posterior right neck. The assessment was that the Veteran had a solitary lesion of folliculitis, and that if the lesion were to grow larger the term boil could be applied. The examiner offered a topical antibiotic, but the Veteran declined and preferred to wait for the lesion to resolve on its own. The examiner indicated that the lesions were likely to occur again, and that it was common for people with folliculitis to get additional episodes. The examiner opined that the Veteran's current condition was unlikely to be related to service, noting that folliculitis was a common condition, presumably the result of intermittent bacterial colonization of the hair follicles, and that even if he had folliculitis during his time in service, it was not medically reasonable to attribute the current episodes to the prior episodes, particularly in view of the gap in time. The examiner also noted that in the paper record, there was a diagnosis of localized herpetic infection (presumably herpes simplex) in February 2000, on the left posterior neck. The examiner indicated that the Veteran's current history of lesions, that eventually go away only to recur, could be consistent with herpes simplex, and that if in the future his presentation is more consistent with herpes (e.g., multiple clustered lesions), a re-examination might confirm this and in that case, a connection could be made to an episode during service. On a VA DBQ (disability benefits questionnaire) examination in June 2013, the diagnoses included tonic-clonic seizures or grand mal (generalized convulsive seizures) diagnosed in 2005, and absence seizures or petit mal or atonic seizures (generalized non-convulsive seizures) also diagnosed in 2005. For medical history it was noted that the Veteran had a mild head injury in service and was treated for a laceration above the left eyebrow, and that the Veteran stated he was not sure that his head injury had anything to do with the beginning of the seizures. He reported that after the incident in service, he began having episodes of déjà vu and "blanking out" while in service, and only he noticed these incidents and was never seen for this in service. After service, his wife noticed him shaking in the bed, but he reported no loss of bladder control. It was noted that he was diagnosed with a seizure disorder in 2005 and placed on anti-seizure medication, but since he was "one seizure away from losing [his] driver's license, he "just stopped talking about". He also stopped seeing his doctor and stopped taking his medication, and had never restarted his medication and had not had an issue with seizures since 2005. The examiner opined that it was less likely than not that the Veteran's previously diagnosed seizure disorder was secondary to service. For rationale, the examiner noted that a review of the records showed no history of seizures in service, and the Veteran admitted to never having been seen for this condition in service. Further, it was noted that the Veteran was not actually diagnosed with this disorder until about three years after service. The examiner noted that in speaking to the Veteran, he was not alleging his seizure symptoms were due to his head injury in service, and that this was consistent with his statement during the 2011 VA examination, and that he had also stated he was not sure why he was having problems. It was also noted that the Veteran suffered a minor head injury, with no loss of consciousness in service, that resulted in a very minor laceration above his left eye in 2001. The examiner opined that it was less likely than not that the Veteran's injury was the cause of his developing the seizure disorder that was diagnosed in 2005, and that there was no medical evidence to show such a nexus. Finally, the VA examiner indicated that any physician venturing such an opinion would be resorting to mere speculation. III. Analysis Service connection may be granted for disability which is the result of disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). If a chronic disease is shown in service, subsequent manifestations of the same chronic disease at any later date, however remote, may be service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b). If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309(a). The Federal Circuit Court recently held that the theory of continuity of symptomatology under 38 C.F.R. § 3.303(b) does not apply to any condition that has not been recognized as chronic under 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Board notes that skin disorders are noted listed in 38 C.F.R. § 3.309(a). And, while diseases of the nervous system are listed under 38 C.F.R. § 3.309(a), the Board notes that the Veteran has asserted that his seizure disorder is due to a head injury rather than some type of disease. It is thereby questionable as to whether the Veteran's seizure disorder, which is the only possible identified disorder of the nervous system, falls under the rubric of 38 C.F.R. § 3.309(a). Further, service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C.A. § 1113(b); 38 C.F.R. § 3.303(d). In order to prevail on the issue of service connection, there must be medical evidence of a (1) current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. Hickson v. West, 12 Vet. App. 247, 253 (1999). The Court has held that the presence of a chronic disability at any time during the claim process can justify a grant of service connection, even where the most recent diagnosis is negative. McClain v. Nicholson, 21 Vet. App. 319 (2007). Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C.A. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet.App. 428, 435 (2011), as to the specific issue in this case, residuals of a head injury in service falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, supra (lay persons not competent to diagnose cancer). Competency must be distinguished from weight and credibility, which are factual determinations going to the probative value of the evidence. See Rucker v. Brown, 10 Vet. App. 67, 74 (1997). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. In evaluating the evidence in any given appeal, it is the responsibility of the Board to weigh the evidence and decide where to give credit and where to withhold the same and, in so doing, accept certain medical opinions over others. Schoolman v. West, 12 Vet. App. 307, 310-11 (1999). In this regard, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). It is the Board's responsibility to evaluate the entire record on appeal. 38 U.S.C.A. § 7104(a). When there is an approximate balance in the evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the Court held that an appellant need only demonstrate that there is an "approximate balance of positive and negative evidence" in order to prevail. 1. Skin Disorder The Veteran basically contends he has a recurrent rash related to service. He has reported that he had a rash on the neck in service, and that the rash still returns to the same spot every few months. He claims he used creams, but nothing seems to have worked. He contends he made attempts to see a doctor, but the rash dissipates before the examination. The Board initially notes that the Veteran was seen for two instances of a rash in service (in 2000 and 2001), but that the rash(es) resolved prior to separation, as his separation examination report is negative for any report or findings of a skin disorder. Thereafter, there was no written documentation of complaints, treatment, or findings of a skin disorder following service separation - until the VA examination in 2011. However, throughout the course of this appeal, in his testimony in 2008, and on the VA examinations of record, the Veteran has consistently stated that he has experienced recurrences of the skin disorder he had during active service. The Veteran is competent to testify as to the onset and recurrence of the skin disorder, as it is observable by a layperson. See Jandreau v. Nicholson, supra; see also Buchanan v. Nicholson, supra. Moreover, while a VA treatment record dated in October 2006, showed that the Veteran reported no persistent skin rash, he has not otherwise been inconsistent in his statements as to the onset or recurrence of his skin disorder. Thus, there is no reason to doubt the Veteran's statements as to the unremitting nature of his skin disorder since service. Based on the foregoing, and resolving reasonable doubt in the Veteran's favor, the Board finds that the current skin disorder has been chronic since separation from active service. Moreover, the Board finds that the competent medical evidence is at least in equipoise as to whether the current skin disorder began during active service. The Veteran was afforded a VA examination in July 2011, however, he only had lesions on the left leg at that time, and the diagnosis was unknown intermittent skin condition. The examiner opined that the Veteran had insufficient symptomatology presently to make a current diagnosis to link his current intermittent complaints to service. Further, on the VA examination in 2013, the Veteran had an erythematous lesion with a pustular center on the neck, and the assessment was solitary lesion of folliculitis. The examiner indicated that the lesions were likely to occur again, and that it was common for people with folliculitis to get additional episodes, but opined that the Veteran's current condition was unlikely to be related to service. The examiner also indicated that the Veteran's current history of lesions, that eventually go away only to recur, could be consistent with the herpes simplex (treated in service in February 2000), and that if in the future his presentation is more consistent with herpes (e.g., multiple clustered lesions), a re-examination might confirm this and a connection could be made to an episode during service. In light of the documented skin problems during service and the Veteran's credible testimony and statements regarding intermittent recurrences of a skin rash, the Board further finds that, although the Veteran's skin disorder is intermittent, it is sufficiently recurrent to be considered a disability for VA benefits purposes. See McClain v. Nicholson, supra; see also Ardison v. Brown, 6 Vet. App. 405, 408 (1994) (recognizing that some disabilities have active and inactive stages or were subject to remission and recurrence). Further, despite the VA examiner's negative nexus opinion in 2013, the Boards notes that that same examiner also indicated that the Veteran's current history of lesions could be consistent with herpes simplex and that a connection could possibly be made to service. Thus, the Board finds that the evidence is at least in relative equipoise as to whether the Veteran's skin disorder had its onset during active service. As noted above, the Veteran is competent to state when his skin disorder began and how often it occurs. See Jandreau v. Nicholson, supra; see also Buchanan v. Nicholson, supra. The Veteran has been consistent in the history he has provided, and there is no conflicting evidence regarding the history of onset or recurrence of the skin disorder. In summary, based on the documented two episodes of a skin rash during active service and on the Veteran's competent statements regarding recurrent skin rashes after active service, with the resolution of reasonable doubt in favor of the Veteran, the Board finds that the criteria for service connection for a skin disorder are met. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. 2. Seizure Disorder The Veteran basically contends that his seizure disorder developed during his active service. He has alternatively contended that he hit his head in service, which could have led to his seizures. Post-service records showing that the Veteran has been diagnosed with and treated for a seizure disorder are arguably sufficient to show a current disability. See McClain v. Nicholson, supra. STRs show that the Veteran hit his head during service, in December 2001, and that he sustained a laceration to the left eyebrow. As noted above, post-service records first show that in March 2005, the Veteran was treated for seizures by a private doctor. Thereafter on a VA examination in 2011, the examiner indicated that there was a history of diagnosis of seizures, but that diagnosis was not confirmed. The examiner opined that the Veteran's history of seizure disorder was not related to any incident of service, noting that a diagnosis of seizure disorder was not well supported as the Veteran was not actively having seizures and was off medication. In 2013, the diagnoses included tonic-clonic seizures or grand mal and absence seizures or petit mal or atonic seizures, diagnosed in 2005. The examiner opined that it was less likely than not that the Veteran's previously diagnosed seizure disorder was secondary to service. The examiner also opined that it was less likely than not that the Veteran's injury in service was the cause of his developing the seizure disorder that was diagnosed in 2005, and that there was no medical evidence to show such a nexus, and that any physician venturing such an opinion would be resorting to mere speculation. Although the VA examiner's medical opinion in 2013 is not perfect, it is probative of the issue of whether the Veteran's seizure disorder may be related to service in any way, included a review of the claims folder, and provided an explanation and rationale for the opinion. Moreover, review of the record shows no competent medical evidence to the contrary. The Board recognizes that the Veteran has sincerely contended that he has a seizure disorder related to service. As noted above, lay statements may be competent to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation, but the Board does not find that the etiology of a seizure disorder to be subject to lay diagnosis. See Kahana v. Shinseki, supra; see also Jandreau v. Nicholson, supra. Moreover, the Veteran's lay contentions of a causal relationship between a seizure disorder and active service are outweighed by the more probative VA examiner's opinion that was provided in 2013. With consideration of the record, the Board finds the preponderance of the evidence is against the claim of service connection for a seizure. Consequently, the benefit-of-the-doubt rule does not apply and the claim for service connection must be denied. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. ORDER Service connection for a skin disorder is granted. Service connection for a seizure disorder is denied. ______________________________________________ FRANK J. FLOWERS Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs