Citation Nr: 18151673 Decision Date: 11/19/18 Archive Date: 11/19/18 DOCKET NO. 16-03 118 DATE: November 19, 2018 ORDER New and material evidence having not been received, the application to reopen the claim of entitlement to service connection for lower back condition is denied. New and material evidence having not been received, the application to reopen the claim of entitlement to service connection for bilateral knee condition is denied. New and material evidence having not been received, the application to reopen the claim of entitlement to service connection for pes planus condition is denied. New and material evidence having been received, the application to reopen the claim of entitlement to service connection for pseudofolliculitis barbae is granted. Entitlement to a 20 percent rating, but no higher, for gunshot wound (GSW) Muscle Group (MG) XI left lower extremity with scar, is granted, subject to controlling regulations governing the payment of monetary awards. Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is denied. REMANDED Entitlement to service connection for pseudofolliculitis barbae is remanded. FINDINGS OF FACT 1. In a December 2009 rating decision, the RO denied service connection for right knee condition and left knee condition, lower back condition, right foot condition and left foot condition, and pseudofolliculitis barbae. Although the Veteran was notified of the RO’s decision and his appellate rights in a December 2009 letter, he did not perfect an appeal within the applicable time period, nor was new and material evidence received prior an appellate decision. 2. The evidence received since the final December 2009 rating decision denying service connection for bilateral knee condition, lower back condition, and bilateral pes planus does not relate to an unestablished fact necessary to substantiate the claims, and does not raise a reasonable possibility of substantiating the claims. 3. The evidence received since the final December 2009 rating decision denying service connection for pseudofolliculitis barbae relates to an unestablished fact necessary to substantiate the claim and, presuming its credibility, raises a reasonable possibility of substantiating the claim of entitlement to service connection for pseudofolliculitis barbae. 4. The Veteran’s gunshot wound of the left lower extremity, more nearly approximates a moderately severe injury to Muscle Group XI. 5. The Veteran failed to report for an examination scheduled in March 2014, and has not provided any explanation for such failure. 6. Entitlement to an increased rating in excess of 30 percent for PTSD cannot be established without a current VA reexamination, and the failure to report without good cause for the reexamination scheduled in connection with this claim, is a claim for increase, rather than an original compensation claim, warrants a denial as a matter of law. CONCLUSIONS OF LAW 1. The December 2009 rating decision denying service connection for right knee condition and left knee condition, lower back condition, right foot condition and left foot condition, and pseudofolliculitis barbae is final. 38 U.S.C. § 7105(c) (2012); 38 C.F.R. §§ 3.104, 20.302, 20.1103 (2017). 2. New and material evidence has not been received to warrant reopening the claims of service connection for bilateral knee condition, lower back condition, and bilateral pes planus. 38 U.S.C. §§ 5107, 5108 (2012); 38 C.F.R. § 3.156 (2017). 3. New and material evidence has been received to warrant reopening the claim of service connection for pseudofolliculitis barbae. 38 U.S.C. §§ 5107, 5108 (2012); 38 C.F.R. § 3.156 (2017). 4. The criteria for a 20 percent rating, but no higher, for GSW MG XI left lower extremity with scar have been met. 38 U.S.C. §§ 1155, 5107(b) (2012); 38 C.F.R. §§ 4.56, 4.73, 4.118, Diagnostic Code 7802-5311 (2017). 5. Entitlement to a rating in excess of 10 percent for PTSD must be denied as a matter of law. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. § 3.655 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1988 to February 1997. This matter came to the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO), denying entitlement to a rating in excess of 30 percent for PTSD, and entitlement to rating in excess of 10 percent for GSW MG XI left lower extremity with scar. In that decision, the RO also denied reopening the claims of service connection for bilateral knee condition, lower back condition, bilateral pes planus, and pseudofolliculitis barbae. The Board has a jurisdictional responsibility to consider whether it was proper for a claim to be reopened, regardless of whether the RO granted or denied an application to reopen. See Jackson v. Principi, 265 F.3d 1366, 1369 (Fed. Cir. 2001). In December 2017, the Veteran’s attorney submitted a notice withdrawing representation on behalf of the Veteran. However, after the agency of original jurisdiction has certified an appeal to the Board, a representative may not withdraw services as a representative in the appeal unless good cause is shown on motion. See 38 C.F.R. § 20.608. As no motion has been submitted showing good cause, the December 2017 notice is not valid and the Veteran is considered to be represented by the attorney listed on the title page. New and Material Evidence The Board notes the Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5103, 5103A; 38 C.F.R. § 3.159. In addition, in Kent v. Nicholson, 20 Vet. App. 1 (2006), the Court held that, in the context of an application to reopen, VCAA notice (1) must notify a claimant of the evidence and information that is necessary to reopen the claim and (2) must notify the claimant of the evidence and information that is necessary to establish entitlement to the underlying benefit sought by the claimant. Id. at 11-12. Further, VA is required, in response to an application to reopen, to look at the bases for the denial in the prior decision and send a notice letter that describes what evidence would be necessary to substantiate that element or elements required to establish service connection that were found insufficient in the previous denial. Id. However, VA is no longer required to provide case-specific “Kent notice” for applications to reopen. VA Office of General Counsel Precedent Opinion 6-2014 (Nov. 21, 2014) concluded that the plain language of 38 U.S.C. § 5103(a)(1) does not require VA, upon receipt of a previously denied claim, to provide notice of the information and evidence necessary to substantiate the element or elements that were found insufficient in the previous denial of a claim. In other words, the opinion holds that Kent v. Nicholson, 20 Vet. App. 1 (2006), is no longer controlling insofar as it construed the former § 5103(a) to require that VA provide case-specific notice to a veteran in an application to reopen. VA must still provide generic notice that explains the requirements for an application to reopen a previously denied claim, and must explain the meaning of the terms “new” and “material” evidence. Compare Kent, 20 Vet. App. at 1, with VAOPGCPREC 6-2014. Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the Veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). In general, decisions of the RO and the Board that are not appealed in the prescribed time period are final. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. § 20.1100, 20.1103. Pursuant to 38 U.S.C. § 5108, a finally disallowed claim may be reopened when new and material evidence is presented or secured with respect to that claim. New evidence means evidence not previously submitted to agency decision-makers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156 (a). To reopen a previously disallowed claim, new and material evidence must be presented or secured since the last final disallowance of the claim on any basis, including on the basis that there was no new and material evidence to reopen the claim since a prior final disallowance. See Evans v. Brown, 9 Vet. App. 273, 285 (1996). For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. See Justus v. Principi, 3 Vet. App. 510, 513 (1992). The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is low. See Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). Furthermore, in determining whether this low threshold is met, VA should not limit its consideration to whether the newly submitted evidence relates specifically to the reason why the claim was last denied, but instead should ask whether the evidence could reasonably substantiate the claim were the claim to be reopened, either by triggering the Secretary’s duty to assist or through consideration of an alternative theory of entitlement. Id. at 118. 1. Bilateral Knee, Lower Back, Bilateral Pes Planus In a December 2009 rating decision, the RO denied entitlement to service connection for bilateral knee condition, lower back condition, and bilateral pes planus. The RO determined that lower back and bilateral knee conditions were not shown in service, nor were related to military service. With regard to the claim for bilateral pes planus, the RO determined that the condition existed prior to service, and there was no evidence that the condition permanently worsened as a result of military service. The Veteran was notified of the decision and his appellate rights in a December 2009 letter. The Veteran filed a timely notice of disagreement and August 2011 SOC was issued, but the Veteran did not perfect an appeal within the applicable time period and no new and material evidence was received prior to an appellate decision. The Veteran does not contend otherwise. Thus, the RO’s December 2009 rating decision is final and not subject to revision on the same factual basis. 38 U.S.C. § 7105(c); 38. C.F.R. §§ 3.104, 20.302, 20.1103. In this appeal, the Veteran seeks to reopen his claims of service connection for bilateral knee condition, lower back condition, and bilateral pes planus. As noted above, despite the finality of a prior adverse decision, a claim will be reopened and the former disposition reviewed if new and material evidence is presented or secured with respect to the claim which has been disallowed. 38 U.S.C. § 5108 38 C.F.R. § 3.156. Thus, the Board has reviewed the entire record, with particular attention to the additional evidence received since the last final rating decision in December 2009. The evidence includes VA treatment records that are negative of complaints, treatment, or findings of bilateral knee, lower back, and bilateral pes planus conditions. The record also includes an August 2012 statement from the Veteran, indicating that the VA will not see him for his bilateral knee condition, so he received treatment from his private doctor. He noted that he advised his doctor that the medication he gets from VA helps with the pain in his knees and feet. The Veteran further stated that his doctor has seen him for his bilateral pes planus condition, and that he was prescribed medication for his toenails. The Board finds that although this additional evidence was not of record at the time of the December 2009 rating decision, the new evidence does not relate to the bases for the prior denial. This evidence contains no indication that the Veteran has lower back and bilateral knee conditions related to military service or that the Veteran’s bilateral pes planus was permanently worsened as a result of military service. For these reasons, the Board finds that the additional evidence received since the December 2009 rating decision is not new and material within the meaning of 38 C.F.R. § 3.156(a). Consequently, the Board finds that new and material evidence has not been received and the claims of service connection for bilateral knee condition, lower back condition, and bilateral pes planus are not reopened. 2. Pseudofolliculitis Barbae As set forth above, in a December 2009 rating decision, the RO denied entitlement to service connection for pseudofolliculitis barbae. The RO determined that a pseudofolliculitis barbae condition was not shown in service, nor related to military service. The Veteran was notified of the decision and his appellate rights in a December 2009 letter. He did not he did not perfect an appeal within the applicable time period and no new and material evidence was received prior to issuance of an appellate decision. The Veteran does not contend otherwise. Thus, the RO’s December 2009 rating decision is final and not subject to revision on the same factual basis. 38 U.S.C. § 7105(c); 38. C.F.R. §§ 3.104, 20.302, 20.1103. In this appeal, the Veteran seeks to reopen his claim of service connection for pseudofolliculitis barbae. As noted above, despite the finality of a prior adverse decision, a claim will be reopened and the former disposition reviewed if new and material evidence is presented or secured with respect to the claim which has been disallowed. 38 U.S.C. § 5108 38 C.F.R. § 3.156. Thus, the Board has reviewed the entire record, with particular attention to the additional evidence received since the last final rating decision in December 2009. The evidence includes post-service VA treatment records that are negative for complaints, treatment, or findings of pseudofolliculitis barbae. The record also includes an August 2012 lay statement from the Veteran, asserting that he was given a permanent “no shave” directive from Portsmouth Navy hospital where he went through all the treatment they offered. He stated that his face got “messed up” when he was aboard the USS New Port. The Veteran noted that the hard water made from the boiler rooms were used in salt and he could not shave. He further noted that until this day he cannot shave. Given the evidence previously of record, the Board finds that the Veteran’s lay statements are new and material evidence. Although the newly received evidence is adequate for the limited purposes of reopening the claim, for the reasons set forth below in the Remand portion of this decision, it is not sufficient to allow the grant of the benefits sought. See Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998) (material evidence is evidence that would contribute to a more complete picture of the circumstances surrounding the origin of a claimant’s injury or disability, even where it would not be enough to convince the Board to grant the claim); See also Shade v. Shinseki, 24 Vet. App. 110, 124 (2010) (noting that [n]ew and material evidence is evidence that-if found credible-would either entitle the claimant to benefits or to some further assistance from the Secretary in gathering evidence that could lead to the granting of the claim. Of course, once a claim is reopened, the adjudicator may determine that the new evidence is not credible or is outweighed by other evidence.). Thus, additional development is necessary before the Board may proceed to a decision on the merits. Increased Rating Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. Evaluations are based upon lack of usefulness of the part or system affected, especially in self-support. 38 C.F.R. § 4.10. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the veteran. 38 C.F.R. § 4.3. In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where a claimant appeals the denial of a claim for an increased disability rating for a disability for which service connection was in effect before he filed the claim for increase, the present level of disability is the primary concern, and past medical reports should not be given precedence over current medical findings. Francisco v. Brown, 7 Vet. App. 55, 57-58 (1994). Where VA’s adjudication of the claim for increase is lengthy and factual findings show distinct time periods where the service-connected disability exhibits symptoms which would warrant different ratings, different or “staged” ratings may be assigned for such different periods of time. Hart v. Mansfield, 21 Vet. App. 505, 509-510 (2007). The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107 (b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b). 3. GSW MG XI Left Lower Extremity with Scar The Veteran seeks a higher rating for his service-connected GSW MG XI left lower extremity with scar. He contends that the rating currently assigned does not reflect the severity of his disability. The Veterans GSW MG XI left lower extremity with scar is currently rated as 10 percent disabling under Diagnostic Codes 7802-5311. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the assigned rating; the additional code is shown after the hyphen. Diagnostic Code 7802 applies to burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. Diagnostic Code 5311 applies to functions of Group XI muscles of the foot and leg. Under DC 5311, the following ratings apply: a noncompensable rating is warranted for slight injury, a 10 percent rating is warranted for moderate injury, a 20 percent rating is warranted for moderately severe injury, and a 30 percent rating is warranted for severe injury. Id. Muscle injuries are evaluated in accordance with 38 C.F.R. § 4.56. The pertinent provisions of 38 C.F.R. § 4.56 are as follows: (a) An open comminuted fracture with muscle or tendon damage will be rated as a severe injury of the muscle group involved unless, for locations such as in the wrist or over the tibia, evidence establishes that the muscle damage is minimal. (b) A through-and-through injury with muscle damage shall be rated as no less than a moderate injury for each group of muscles damaged. (c) For VA rating purposes, the cardinal signs and symptoms of muscle disability are loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination and uncertainty of movement. (d) Under Diagnostic Codes 5301 through 5323, disabilities resulting from muscle injuries shall be classified as slight, moderate, moderately severe or severe as follows: (1) Slight disability of muscles-(i) Type of injury. Simple wound of muscle without debridement or infection. (ii) History and complaint. Service department record of superficial wound with brief treatment and return to duty. Healing with good functional results. No cardinal signs or symptoms of muscle disability as defined in paragraph (c) of this section. (iii) Objective findings. Minimal scar. No evidence of fascial defect, atrophy, or impaired tonus. No impairment of function or metallic fragments retained in muscle tissue. (2) Moderate disability of muscles--(i) Type of injury. Through and through or deep penetrating wound of short track from a single bullet, small shell or shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or prolonged infection. (ii) History and complaint. Service department record or other evidence of in-service treatment for the wound. Record of consistent complaint of one or more of the cardinal signs and symptoms of muscle disability as defined in paragraph (c) of this section, particularly lowered threshold of fatigue after average use, affecting the particular functions controlled by the injured muscles. (iii) Objective findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through muscle tissue. Some loss of deep fascia or muscle substance or impairment of muscle tonus and loss of power or lowered threshold of fatigue when compared to the sound side. (3) Moderately severe disability of muscles--(i) Type of injury. Through and through or deep penetrating wound by small high velocity missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts, and intermuscular scarring. (ii) History and complaint. Service department record or other evidence showing hospitalization for a prolonged period for treatment of wound. Record of consistent complaint of cardinal signs and symptoms of muscle disability as defined in paragraph (c) of this section and, if present, evidence of inability to keep up with work requirements. (iii) Objective findings. Entrance and (if present) exit scars indicating track of missile through one or more muscle groups. Indications on palpation of loss of deep fascia, muscle substance, or normal firm resistance of muscles compared with sound side. Tests of strength and endurance compared with sound side demonstrate positive evidence of impairment. (4) Severe disability of muscles--(i) Type of injury. Through and through or deep penetrating wound due to high-velocity missile, or large or multiple low velocity missiles, or with shattering bone fracture or open comminuted fracture with extensive debridement, prolonged infection, or sloughing of soft parts, intermuscular binding and scarring. (ii) History and complaint. Service department record or other evidence showing hospitalization for a prolonged period for treatment of wound. Record of consistent complaint of cardinal signs and symptoms of muscle disability as defined in paragraph (c) of this section, worse than those shown for moderately severe muscle injuries, and, if present, evidence of inability to keep up with work requirements. (iii) Objective findings. Ragged, depressed and adherent scars indicating wide damage to muscle groups in missile track. Palpation shows loss of deep fascia or muscle substance, or soft flabby muscles in wound area. Muscles swell and harden abnormally in contraction. Tests of strength, endurance, or coordinated movements compared with the corresponding muscles of the uninjured side indicate severe impairment of function. If present, the following are also signs of severe muscle disability: (A) X-ray evidence of minute multiple scattered foreign bodies indicating intermuscular trauma and explosive effect of the missile. (B) Adhesion of scar to one of the long bones, scapula, pelvic bones, sacrum or vertebrae, with epithelial sealing over the bone rather than true skin covering in an area where bone is normally protected by muscle. (C) Diminished muscle excitability to pulsed electrical current in electrodiagnostic tests. (D) Visible or measurable atrophy. (E) Adaptive contraction of an opposing group of muscles. (F) Atrophy of muscle groups not in the track of the missile, particularly of the trapezius and serratus in wounds of the shoulder girdle. (G) Induration or atrophy of an entire muscle following simple piercing by a projectile. 38 C.F.R. § 4.56. For the following reasons, the Veteran’s GSW MG XI left lower extremity with scar, more nearly approximates the criteria for moderately severe injury to Muscle Group XI. In this case, the Veteran’s service treatment records indicate that he suffered a gunshot wound to the left lateral calf. He was admitted to a private hospital and the bullet was left in his leg, with no exit wound. Service treatment records further reflect consistent complaints and treatment for pain associated with left leg gunshot wound. A November 2012 VA examination report indicates that the Veteran reported issues of pain and was on daily pain pills of hydrocodone, gabapentin, and meloxicam. The examiner noted that while in service, the fragment in the left leg was left in. The wound was irrigated/debrided, but there was no further surgery. The examiner further noted that since that time, the Veteran has had residuals of scar and also pain in the leg, and residuals of the muscle. The Veteran’s muscle injury involved Muscle Group XI on the left leg. The Veteran had a penetrating muscle injury, such as a gunshot wound or shelf fragment would. The Veteran had a minimal scar associated with a muscle injury. There was no known fascial defects or evidence of fascial defects. His muscle injury did not affect muscle substance or function. The Veteran exhibited cardinal signs and symptoms of fatigue-pain. The Veteran’s muscle strength was normal, and there was no evidence of atrophy. The Veteran did not use assistive devices. The examiner concluded that the Veteran’s muscle injury impacted his ability to work, such as resulting in inability to keep up with work requirements due to muscle injury. The examiner noted some increased pain with duties of a physical nature. In March 2014, the Veteran underwent another VA medical examination. The Veteran complained of chronic pain from original wound. Upon examination, the examiner indicated that Veteran’s muscle injury involved Muscle Group XI on the left leg. The Veteran had a penetrating muscle injury, such as a gunshot wound or shelf fragment would. The Veteran had a minimal scar associated with a muscle injury. There was no known fascial defects or evidence of fascial defects. His muscle injury did not affect muscle substance or function. The Veteran exhibited cardinal signs and symptoms of fatigue-pain. The Veteran’s muscle strength was normal, and there was no evidence of atrophy. The Veteran did not use assistive devices. The examiner concluded that the Veteran’s GSW MG XI left lower extremity with scar did not impact his ability to work, such as resulting in inability to keep up with work requirements due to muscle injury. Post-service VA clinical records indicate that the Veteran continues to experience chronic leg pain for associated with the gunshot wound. See e.g. February 2014 CAPRI. The evidence of record also includes the Veteran’s lay statements, reporting in-service treatment for a left leg gunshot wound, and his current treatment of medication for pain associated with the wound. See August 2012 VA 21-438 Statement in Support of Claim. As set forth above, the evidence of record demonstrates that the Veteran suffered a GSW to his left calf in service, with debridement. Service treatment records reflect consistent complaints and treatments for leg pain associated with a gunshot wound. The evidence of record includes the Veteran’s competent and credible statements of leg pain and treatment with prescribed medication. Both the November 2012 and March 2014 VA examiners determined that the Veteran experienced cardinal signs and symptoms of fatigue-pain. Additionally, the March 2012 VA examiner concluded that the Veteran’s muscle injury impacted his ability to work, such as resulting in inability to keep up with work requirements due to muscle injury. The examiner noted some increased pain with duties of a physical nature. Based on this evidence, the Veteran’s GSW MG XI left lower extremity with scar, more nearly approximates the criteria for a 20 percent rating. However, the evidence of record does not indicate that a rating in excess of 20 percent is warranted. Specifically, the Veteran does not have a through-and-through GSW, with evidence it resulted in shattering bone fracture or open comminuted fracture. He does not have ragged, depressed, and adherent scars. He does not have loss of deep fascia or muscle substance, or soft flabby muscles in the wounded area. He does not have muscle atrophy. There is no indication he has impaired muscle strength, endurance, or coordinated movements. He has fatigue-pain of a level consistent with a moderately severe disability. In reaching this decision, the Board has considered whether higher ratings could be assigned under an alternative diagnostic code. The record on appeal shows that the Veteran’s service-connected GSW of the left leg includes scarring. The evidence, however, indicates that the Veteran is currently in receipt of a separate10 percent evaluation for one painful scar on left lower extremity. The evidence of record further shows that the Veteran does not have five or more scars that are unstable or painful. Thus, a 30 percent rating under Diagnostic Code 7802 is not warranted. Based on the foregoing, the Board finds that a 20 percent rating, but no higher, is warranted for the Veteran’s GSW MG XI left lower extremity with scar symptoms. As the preponderance of the evidence is against any higher rating, the benefit of the doubt doctrine is not otherwise for application. 38 U.S.C. § 5107 (b); 38 C.F.R. § 4.3 4. PTSD The Veteran seeks a higher rating for his service-connected PTSD. He contends that the rating currently assigned does not reflect the level of severity. VA regulations provide that individuals for whom an examination has been scheduled are required to report for the examination. See 38 C.F.R. § 3.326(a). Where entitlement to a VA benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination scheduled in conjunction with a claim for an increase, the claim shall be denied. 38 C.F.R. § 3.655. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant. 38 C.F.R. § 3.655(a). 38 C.F.R. § 3.655 (b) provides that when a claimant fails to report for an examination scheduled in conjunction with, among other things, a claim for increase, “the claim shall be denied.” A claim for a higher initial rating is an “original compensation claim” and not a “claim for increase” for purposes of 38 C.F.R. § 3.655 (b). Turk v. Peake, 21 Vet. App. 565, 570 (2008). In this case, the Veteran’s claim of service connection for PTSD was evaluated at a September 2012 VA examination. In a November 2012 rating decision, the RO granted entitlement to service connection for PTSD, and assigned a 30 percent rating, effective January 26, 2012. In February 2013, the RO received notice to reopen claims for multiple disabilities, including the Veteran’s service-connected PTSD. In a February 2014 telephone conversation with the RO, the Veteran stated that he was seeking an increase of service-connected PTSD and left leg gunshot wound. This claim is therefore a claim for increase under 38 C.F.R. § 3.655 (b). In a February 2014 letter, the RO advised the Veteran that he would be scheduled for a VA medical examination in connection with his claim. He was advised that when a claimant, without good cause, fails to report for an examination or reexamination, the claim shall be rated based on the evidence of record, or even denied. He was advised that examples of good cause included, but are not limited to, illness or hospitalization, death of a family member, etc. However, in March 2014 the Veteran failed to report to his PTSD examination; no reason was given. There is no indication that he did not receive notification or other correspondence sent to him, including the March 2014 rating decision and December 2015 statement of the case, notifying him that he had failed to report for the examination. As indicated above, the Veteran had not been afforded a contemporaneous examination to assess the current severity of his PTSD. The RO attempted to schedule the Veteran for a VA examination, and the Veteran failed to report without providing good cause. As the Veteran has provided no explanation for his failure to report for examination, the Board is satisfied that he received notice and failed to report to the scheduled VA examination without good cause. See 38 C.F.R. § 3.655. The next question to be addressed under 38 C.F.R. § 3.655 (a) is whether entitlement to the benefits sought can be established without the scheduled reexamination. The available medical records do not include findings responsive to the applicable rating criteria. The Veteran has not provided lay statements that would otherwise substantiate his claim for increase. For the foregoing reasons, the claim for an increased rating for PTSD on appeal must be denied as a matter of law. 38 C.F.R. § 3.655 (b). REASONS FOR REMAND 1. Pseudofolliculitis Barbae The Veteran seeks service connection for pseudofolliculitis barbae. In support of his claim, the Veteran submitted an August 2012 statement in which he reported in-service treatment at Portsmouth Navy hospital and was given a permanent “no shave” directive. He indicated that his face got “messed up” while serving aboard the USS New Port. The Veteran noted that the hard water made from the boiler rooms were used in salt and he could not shave. The Veteran further noted that he continued to suffer from the condition to the present day. Service treatment records indicate that the Veteran complained of facial bumps, and findings of pseudofolliculitis barbae were noted. Evidence that the Veteran needed to wear a beard and not shave during active service is also of record. The Board observes that the Veteran has not been afforded a VA examination in conjunction with his pseudofolliculitis barbae claim. On remand, the Veteran should be scheduled for a VA examination and an etiological opinion should be obtained. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his pseudofolliculitis barbae disability. The claims file, including a copy of this remand should be reviewed by the examiner to become familiar with the Veteran’s relevant medical history. The examiner is to provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that pseudofolliculitis barbae had its onset during service or is otherwise related to military service. The examiner must provide a comprehensive rationale for all opinions provided. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Walker, Associate Counsel