Citation Nr: 18141347 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 11-05 192 DATE: October 10, 2018 REMANDED Entitlement to service connection for skin disorder is remanded. REASONS FOR REMAND The appellant is the surviving spouse of a veteran (the Veteran) who had active duty service from October 1966 to October 1968. The Veteran died in May 2017. This appeal comes before the Board of Veterans’ Appeals (Board) from a December 2017 decision of the United States Court of Appeals for Veterans’ Claims (Veterans Court). The appeal originated from a January 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana. In June 2016, the Veteran presented testimony at a Board hearing, chaired via videoconference by the undersigned Veterans Law Judge and accepted such hearing in lieu of an in-person hearing before a Member of the Board. See 38 C.F.R. § 20.700(e) (2017). A transcript of the hearing is associated with the claims file. In a decision dated in September 2016, the Board denied service connection for diabetes mellitus, neuropathy of the lower extremities, a skin disorder, hypertension, erectile dysfunction, and a dental disorder. After the Veteran’s death, the appellant appealed that portion of the Board’s decision that denied service connection for a skin disorder to the Veterans Court. In a memorandum decision dated in December 2017, the Veterans Court vacated the Board’s denial of service connection for a skin disorder and remanded this issue back to the Board for additional development. In a footnote, the Veterans Court noted that the appellant does not raise any contentions of error with respect to the Board’s denial of compensation for diabetes mellitus, a dental disorder, hypertension, peripheral neuropathy, and erectile dysfunction. Therefore, “the Court will not address them on appeal,” citing Pederson v. McDonald, 27 Vet. App. 276, 283 (2015) (stating that “this Court, like other courts, will generally decline to exercise its authority to address an issue not raised by an appellant in his or her opening brief”). The Board acknowledges that status as a substitute claimant was denied by the RO in August 2017 (Record 08/08/2017). However, the determination of the Veterans Court is the law of the case and takes precedence over this determination. See Breedlove v. Shinseki, 24 Vet. App. 7, 20-21 (2010) (If substitution is sought in the Court, it remains within the Court’s discretion to permit substitution). Entitlement to service connection for skin disorder is remanded. In the December 2017 memorandum decision, the Veterans Court found that the 2009 medical opinion relied upon by the Board to deny service connection for a skin disorder was inadequate. The Veterans Court noted that the examiner offered the following rationale for his determination that the Veteran’s skin disorders were not related to service: Currently rash [is] under control. Groin rash appears to be very consistent with fungus. Facial lesions are sporadic and currently minimal. They are not diagnoses that are correlated with service. The Veterans Court found that this explanation does not address whether the disabilities the Veteran suffered during the appeal period were incurred in or aggravated by service. Furthermore, to the extent that the examiner’s statement that the “diagnoses... are [not] correlated with service” is a negative etiology opinion, the examiner did not provide any rationale to support this conclusion. The examination therefore lacked enough detail to inform the Board’s decision or for the Board to weigh against contrary opinions. The Board is bound by the findings of the Court. See Chisem v. Gober, 10 Vet. App. 526, 527-8 (1997) (under the “law of the case” doctrine, appellate courts generally will not review or reconsider issues that have already been decided in a previous appeal of the same case, and therefore, Board is not free to do anything contrary to the Court's prior action with respect to the same claim). As the pertinent medical evidence has been found to be inadequate, the Board finds that a remand is necessary to obtain another medical opinion. The matter is REMANDED for the following action: 1. Obtain a medical opinion based on evidence review to determine the nature and etiology of the Veteran’s skin disorders. The relevant documents in the claims file should be made available to the VA examiner. The VA examiner is requested to review the Veteran’s service treatment records, which reflect treatment for various blisters and rashes attributed to dermatitis, fungus, eczema, and dry skin. The post-service records also reflect treatment for rashes, dermatitis, folliculitis, and acne. The VA examiner is requested to offer an opinion as to whether it is at least as likely as not (i.e., to at least a 50-50 degree of probability) that any of the Veteran’s post-service skin disorders represent a chronic disability that is causally or etiologically related to the Veteran's active service. If any of the claimed skin disorders is found to have predated service, please also addresses whether such disorder was at least as likely as not aggravated (permanently worsened beyond natural progress) by service. Note: The term “at least as likely as not” does not mean merely within the realm of medical possibility, but that the medical evidence for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. All opinions are to be accompanied by a rationale consistent with the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is requested. If the examiner cannot provide an opinion without resorting to speculation, he or she shall provide complete explanations stating why this is so. In so doing, the examiner shall explain whether any inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 2. Readjudicate the remanded claim. If the benefit sought on appeal is not granted, the Veteran and his representative should be provided a supplemental statement of the case and an appropriate time period for response. The case should then be returned to the Board for further consideration, if otherwise in order. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Cramp