Citation Nr: 18142618 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 08-30 058A DATE: October 16, 2018 REMANDED A compensable rating for tinea pedis and tinea unguium of the bilateral lower extremities and feet, is remanded. An effective date for a 10 percent rating for stasis dermatitis with pigmentation of the legs, prior to February 2, 2012, is remanded.   REASONS FOR REMAND The Veteran served on active duty for training (ACDUTRA) from October 1980 to March 1981 and on active duty from November 1990 to May 1991 (including deployment to Southwest Asia in support of Operations Desert Shield/Desert Storm), from February 1999 to October 1999, and from March 2003 to March 2004. He also served on ACDUTRA and inactive duty training (INACDUTRA) with the Army Reserve and National Guard. This matter comes to the Board from October 2007 and March 2016 rating decisions. In March 2011, the Veteran appeared at a Board hearing with respect to an increased (compensable) rating for tinea pedis and tinea unguium of the bilateral lower extremities and feet. The case was most recently before the Board in October 2017. At that time, the Board remanded the case for additional development and the issuance of a statement of the case (SOC). 1. A compensable rating for tinea pedis and tinea unguium of the bilateral lower extremities and feet. Initially, the Board notes the February 2018 rating decision reflects inconsistencies. More specifically, the rating for tinea pedis and tinea unguium of the bilateral lower extremities and feet for the period from July 5, 2013 to February 1, 2016 appears to have been inadvertently omitted, but was included in a prior January 2018 rating decision. In addition, the rating for neurodermatitis of the neck is listed as noncompensable, prior to February 1, 2016, whereas an October 2014 rating decision reflects that a 10 percent rating was assigned. Further, the decision reflects that on February 1, 2016, both the combined 30 percent rating for tinea pedis and tinea unguium of the bilateral lower extremities and feet, stasis dermatitis with pigmentation of the legs, and neurodermatitis of the neck, and, the separate 10 percent rating for stasis dermatitis with pigmentation of the legs, were in effect. On remand, the RO should reconcile the February 2018 rating decision with the record and prior rating decisions. In addition, effective August 13, 2018, VA amended its regulations governing skin disabilities. Claims pending prior to the effective date, as in this case, will be considered under both old and new rating criteria, and whatever criteria is more favorable to the veteran will be applied. As such, the rating for the condition should be considered under the new rating criteria by the RO. The Board notes that under the post-August 13, 2018 rating criteria, dermatitis or eczema is to be evaluated under the General Rating Formula for the Skin. See 38 C.F.R. § 4.118, Diagnostic Code (DC) 7806. As is any dermatophytosis under DC 7813. Under that formula, a zero percent rating is assigned when there is no more than topical therapy required over the past 12-month period and characteristic lesions involving less than 5 percent of the entire body affected; or characteristic lesions involving less than 5 percent of exposed areas affected. A 30 percent rating is assigned for characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy retinoids, biologics, photochemotherapy, (psoralen with long-wave ultraviolet-A light (PUVA) or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period. A 60 percent rating is assigned for characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or, constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required over the past 12-month period. 38 C.F.R. § 4.118. For the purposes of the section, systemic therapy is treatment that is administered through any route (orally, injection, suppository, intranasally) other than the skin, and topical therapy is treatment that is administered through the skin. See 38 C.F.R. § 4.118, Note (a). However, because the Veteran’s claim was pending at the time of the revised rating criteria, topical treatment can potentially be akin to systemic therapy if it is a corticosteroid that affects the entire body system, such as through the bloodstream, or if it is non-corticosteroid but operates “like” a corticosteroid. See Burton v. Wilkie, 2018 U.S. App. Vet. Claims LEXIS 1314 (Sep. 28, 2018); cf. Johnson v. Shulkin, 862 F.3d 1351, 1354-56 (Fed. Cir. 2017). The most recent November 2017 VA examination of the skin notes that the Veteran treats the condition(s) with topical corticosteroids as needed. Thus, another VA examination should be scheduled to more fully address this aspect of the claim. 2. An effective date for a 10 percent rating for stasis dermatitis with pigmentation of the legs, prior to February 1, 2012. In the October 2017 decision, the Board remanded the issue of entitlement to an effective date for a 10 percent rating for stasis dermatitis with pigmentation of the legs, prior to February 1, 2016. The remand was for issuance of an SOC as the Veteran had filed a notice of disagreement (NOD) with the effective date assigned in the March 2016 rating decision. When the case was in remand status, in a February 2018 rating decision, the RO granted an earlier effective date for the 10 percent rating to February 2, 2012. Although this appears that it may have satisfied the Veteran’s contention on the matter, an SOC is still warranted because it cannot be definitely said that the benefit sought has been granted in full. See Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following action: 1. Issue an SOC with respect to an effective date prior to February 2, 2012, for the award of a 10 percent rating for stasis dermatitis with pigmentation of the legs. The Veteran should be informed that he must file a substantive appeal to perfect his appeal of this issue to the Board. If, and only if, a timely substantive appeal is received, then the matter should be returned to the Board for appellate review. 2. Schedule the Veteran for a VA examination to assess the severity of the service-connected tinea pedis and tinea unguium of the bilateral lower extremities and feet, and any other now-combined service-connected skin condition. In doing so, the examiner should address which type of treatment the Veteran uses, if any. If topical medications, including topical corticosteroids are used, the examiner should then provide a medical opinion as to whether the topical medication affects the entire body like a systemic therapy, such as through the bloodstream. If not, please explain why this is so. 3. In readjudicating the claim, consider both the old and new rating criteria (effective August 13, 2018), whichever is more favorable to the Veteran. Also, reconcile the February 2018 rating decision with the record and prior rating decisions as necessary. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Taylor