Citation Nr: 18141901 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 13-30 941 DATE: October 11, 2018 ORDER A compensable rating for pseudofolliculitis barbae, tinea barbae is denied. FINDINGS OF FACT 1. The record reflects that the Veteran’s pseudofolliculitis barbae, tinea barbae has not been manifested by disfigurement or disfiguring scars of the head, face, or neck. 2. The record does not reflect that the Veteran’s pseudofolliculitis barbae, tinea barbae or any other service-connected skin condition has required systemic therapy or corticosteroids. 3. The record reflects that the Veteran’s pseudofolliculitis barbae, tinea barbae, as well as his combined skin disabilities, affect less than five percent of exposed skin and less than five percent of total body surface area. CONCLUSION OF LAW The criteria for a compensable rating for pseudofolliculitis barbae, tinea barbae have not been met. 38 U.S.C. § 1155, 5107 (2012); 38 C.F.R. § 4.1, 4.2, 4.10, 4.118, Diagnostic Code 7806 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION At the outset, the Board notes that the Board prior remand requirements in May 2016 have been substantially fulfilled. This included obtaining indicated treatment records and a VA skin examination addressing not only the Veteran’s pseudofolliculitis barbae, tinea barbae, but also his other service-connected skin disabilities and their scope and impacts on functioning. This has been substantially accomplished. Only substantial, and not strict, compliance with the terms of a Board remand is required pursuant to Stegall v. West, 11 Vet. App. 268 (1998). D’Aries v. Peake, 22 Vet. App. 97 (2008). The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104 (a). Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C. § 5107 (b). When a reasonable doubt arises regarding service origin, such doubt will be resolved in the favor of the claimant. Reasonable doubt is doubt which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. 38 C.F.R. § 3.102. The question is whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which event the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990). Claim for a higher (compensable) rating for pseudofolliculitis barbae, tinea barbae. The appeal arises from an October 2014 rating action granting service connection for pseudofolliculitis barbae, tinea barbae. The appeal originated from a November 2011 supplemental claim for service connection for folliculitis. The Veteran contends, in effect, that his service-connected pseudofolliculitis barbae, tinea barbae, warrants a compensable (greater than zero percent) initial rating. In a notice of disagreement filed in November 2014 the Veteran informed that he was seeking a 100 percent disability rating for his pseudofolliculitis barbae. At his hearing before the undersigned in October 2015, the Veteran described having a skin condition with recurring boils, and having to treat his condition with a cream and shampoo which he had to use three or four times per week, as well as a plastic cap to wear to sleep. However, the medical record does not reflect any such skin condition manifested by recurring boils, and the Veteran has not presented any corroborating evidence to support his having recurring boils associated with his pseudofolliculitis barbae, tinea barbae, or his having special treatments for his pseudofolliculitis barbae, tinea barbae involving creams and plastic caps worn to sleep at any time during the claim period. When an unlisted disease, injury, or residual condition is encountered, the disability is rated by analogy under a diagnostic code for a closely related disability that affects the same anatomical functions and has closely analogous symptomatology. 38 C.F.R. 4.20, 4.27. The Board notes that, during the entire appeal period, the competent, credible evidence of record does not demonstrate that there has been disfigurement of the head, face, or neck due to the pseudofolliculitis barbae or tinea barbae. This was confirmed upon VA examinations in October 2016, and is consistent with findings upon prior skin examiner in April 2013 as well as treatment records. Hence, a compensable rating on such basis is not warranted. See 38 C.F.R. § 4.118, Diagnostic Code 7801 (criteria for rating disfiguring scars of the head, face, or neck). The Board accordingly finds that the pseudofolliculitis barbae, tinea barbae, is appropriately evaluated under the criteria for dermatitis or eczema under DC 7806, as a similar recurrent condition affecting the skin. Under DC 7806, a noncompensable disability rating is warranted where the skin disability covers less than 5 percent of the entire body or less than 5 percent of the exposed areas affected; and no more than topical therapy was required over the past 12-month period. A 10 percent disability rating is warranted where the skin disability covers at least 5 percent, but less than 20 percent of the entire body, or at least 5 percent, but less than 20 percent of the exposed areas affected; or intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs were required for a total duration of less than six weeks during the past 12-month period. 38 C.F.R. § 4.118, Diagnostic Code 7806. In every instance where the schedule does not provide a noncompensable evaluation for a diagnostic code, a noncompensable evaluation will be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. The Board in its May 2016 remand raised the possibility that the Veteran’s pseudofolliculitis barbae, tinea barbae, could be rated together with other skin disability as a skin disability covering a compensable percentage of total body area or exposed body area. Upon VA skin examination in October 2016, the examiner noted a history of multiple skin conditions, including eczema dermatitis diagnosed in 1985, tinea pedis diagnosed in 1967, pseudofolliculitis barbae diagnosed in 1967, and lichen simplex diagnosed in 1985. A history of difficulties with pseudofolliculitis barbae in the military when he began shaving in the military was noted, with a ‘no shave’ waiver granted in service. The Veteran’s other noted skin conditions were not found to be related to his pseudofolliculitis barbae. Besides finding that the pseudofolliculitis barbae to have resulted in no disfigurement of the head, face, or neck, the October 2016 examiner also found that it did not resulted in other manifestations such as malignant skin neoplasms or systemic conditions. The examiner did note a “few scattered follicular papules over the beard area.” The Veteran currently used an electric razor to minimize irritation caused by shaving. The examiner did not find the Veteran’s few scattered macular papules over the beard area associated with his pseudofolliculitis to cause scarring or other disfigurement. The Board in its May 2016 remand required that a VA examiner address the total body surface area affected by the Veteran’s service-connected skin conditions, as well as address whether the Veteran used systemic therapy such as corticosteroids and the frequency of any such usage, based on the Veteran’s report that he used steroidal creams to relieve itchiness due to his skin disorders. See Johnson v. McDonald, 27 Vet. App. 497, 504 (2016). The October 2016 examiner did not find that the Veteran used corticosteroids. Rather, the Veteran used only medicated foot powder for his tinea pedis, Vaseline for dry itchy patches associated with his eczema dermatitis, and an electric razor rather than a razor blade when shaving to control his pseudofolliculitis barbae. The examiner additionally found that the Veteran’s dermatitis covered a total of less than 5% of exposed areas and less than 5% of total body area. The Veteran’s infectious skin conditions also affected less than 5% of total body area and no exposed area. These findings are consistent with other findings over the claim period, in not reflecting 5% or more of exposed or total body surface affected by his skin conditions, and not reflecting systemic therapy or corticosteroid use for his skin conditions. While the prior skin examiner in April 2013 noted a history of requiring use of the antihistamine hydroxyzine for six weeks or more in the past year for treatment of pruritus, this was not noted to be a systemic or corticosteroid treatment. That examiner also found that the Veteran’s dermatitis affected less than 5% of total body area, and described the Veteran’s pseudofolliculitis barbae, tinea barbae condition as “mild follicular hyperpigmentation [of the] bearded neck area, with few small follicular scars and minimal inflammation.” That examiner observed “[n]o patches of alopecia or signs of fungal infection.” No active pseudofolliculitis barbae or associated skin infection was then observed. Hence, with the preponderance of the evidence against, the Board does not find that the Veteran’s pseudofolliculitis barbae, tinea barbae, or his combined skin conditions, meet the criteria for a compensable disability rating under Diagnostic Code 7806. Rather, the pseudofolliculitis barbae, tinea barbae, and combined skin disabilities do not warrant more than the noncompensable rating assigned. The Veteran is competent to address observable conditions such as his pseudofolliculitis barbae, tinea barbae, and their effect on his functioning. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). However, the Board finds that medical findings upon examination, as contrary to the Veteran’s reports of debilitating boils and impairment of such severity as to result in unemployability, to be the more credible. Unlike the Veteran’s assertions, the January 2013 and October 2016 VA examiners are consistent with each other and with treatment records over the claim period in finding no boils as the Veteran described and observing no history of any significant disability or impairment associated with the Veteran’s pseudofolliculitis barbae, tinea barbae. The noted self-care requirement of having to use an electric razor is not found to be such an impairment and does not reflect systemic or corticosteroid treatment. A history of topical treatment in the past for skin infection does not inform of disability during the claim period. In determining the weight to be assigned to evidence, credibility can be affected by inconsistent statements, internal inconsistency of statements, inconsistency with other evidence of record, facial implausibility, bad character, interest, bias, self- interest, malingering, desire for monetary gain, and witness demeanor. Caluza v. Brown, 7 Vet. App. 498, 511, 512 (1995), aff'd per curiam, 78 F.3d. 604 (Fed. Cir. 1996). Here, based on inconsistence and absence of corroboration with other evidence of record, the Board finds the Veteran’s statements concerning his pseudofolliculitis barbae, tinea barbae, to be less credible than the more objective findings of VA examiners in January 2013 and October 2016, with regard to the status of his pseudofolliculitis barbae, tinea barbae during the claim period. While the Veteran may have experienced boils and need for significant dermatological care long in the past, the record does not reflect boils or such a need for care at any time during the claim period. The Board has considered staged ratings. However, because the weight of the evidence is against a compensable rating for pseudofolliculitis barbae, tinea barbae for the entire claim period, with no interval reflected wherein a compensable rating would be warranted, no staged ratings are warranted. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119 (1999). The Board has considered the benefit-of-doubt rule, but because the preponderance of the evidence is against the claim, the benefit-of-doubt rule does not apply. Gilbert v. Derwinski, 1 Vet. App. at 54. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Schechter