Citation Nr: 18143069
Decision Date: 10/18/18	Archive Date: 10/17/18

DOCKET NO. 16-38 649
DATE:	October 18, 2018
REMANDED
The issue of a rating in excess of 10 percent prior to September 15, 2016, and in excess of 30 percent on and after September 15, 2016, for the Veteran’s tinea versicolor is remanded.  
REASONS FOR REMAND
The Veteran had active service from February 2003 to September 2004.  He served in Southwest Asia.  The Veteran had additional duty with the Illinois National Guard.  
The issue of a rating in excess of 10 percent prior to September 15, 2016, and in excess of 30 percent on and after September 15, 2016, for the Veteran’s tinea versicolor is remanded.  
The Veteran asserts that an initial rating in excess of 30 percent is warranted for the service connected tinea versicolor.  The accredited representative advances that the service connected skin disability has increased in severity since the most recent Department of Veterans Affairs (VA) skin examination of record and is now involves “more than 40 percent of the entire body or more than 40 percent of exposed areas” and/or requires “constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12 month period.”  
The Veteran was last afforded a VA skin examination in September 2016.  VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive.  McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991).  When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  Given the Veteran’s statements as to the worsen of the service connected tinea versicolor since the September 2016 VA skin examination, the Board of Veterans' Appeals (Board) finds that further VA skin evaluation is necessary to adequately address the issues raised by the instant appeal.  
Clinical documentation dated after September 2016 is not of record.  VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran’s claim.  Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992).  
The matter is REMANDED for the following action:
1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated the service connected tinea versicolor.  Make two requests for any authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile.  
2. Obtain the Veteran’s VA treatment records associated with treatment after September 2016.  
3. Schedule the Veteran for a VA skin examination to ascertain the current severity of the service connected tinea versicolor.  The examiner must review the record and should note that review in the report.  A rationale for all opinions should be provided.  The examiner should: 
(a)  Identify the percentage of both the entire body and exposed areas of the body affected by the service connected skin disability. 
(b)  Indicate whether the service-connected skin disability is productive of ulceration, extensive exfoliation or crusting, or systemic or nervous manifestations; is exceptionally repugnant; or requires constant or near constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period.  
(c)  Discuss the medication treatment used and whether that medication constitutes systemic therapy such as corticosteroids or other immunosuppressive drugs.  
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(d)  Discuss the impact of the service-connected skin disability on the Veteran’s vocational pursuits and should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran is unable to secure or follow a substantially gainful occupation due to the service-connected disabilities.  If the Veteran is felt capable of work despite the service-connected disabilities, the examiner should describe what type of work and what accommodations would be necessary due to the service-connected disabilities.
 
J. T. HUTCHESON
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	N. Sangster, Counsel