Citation Nr: 18151695
Decision Date: 11/20/18	Archive Date: 11/19/18

DOCKET NO. 16-53 645A
DATE:	November 20, 2018
REMANDED
Entitlement to service connection for actinic keratosis is remanded.
Entitlement to service connection for a groin rash (claimed as fungal infection) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from May 1964 to October 1967, to include service in the Republic of Vietnam.
This matter comes on appeal before the Board of Veterans’ Appeals (Board) from a May 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
The Veteran maintains that his skin disorders first manifested in service and have persisted since service separation.  In his May 2016 Notice of Disagreement, the Veteran stated that he sought treatment at the Sepulveda VA clinic in the 1990s for his actinic keratosis.  He also noted that he had difficulty seeking continuous treatment at VA following service separation due to his PTSD symptoms.  Nonetheless, the Veteran contends that his skin disorders are a result of exposure to environmental conditions in Vietnam, to include sun exposure.
VA treatment records confirm a diagnosis of actinic keratosis.  In a January 2017 VA treatment note, the Veteran requested referral to the dermatology department because he had a white lesion on his scalp that had been present “since he was in Vietnam.”  Further, VA treatment records show that the Veteran has been prescribed medication for a “groin rash.”  
On remand, the Board finds that attempts should be made to obtain treatment records from the Sepulveda VA clinic from the 1990s.  The Board observes that the Veteran underwent a March 1995 examination at the VA Medical Center at Sepulveda.  Although it appears that the Veteran was seen for a psychiatric disability at that time, the Board observes that the Veteran reported “a rash in the groin area and others.”
The Veteran has not been afforded a VA examination regarding his skin disorders despite evidence of current diagnoses and some indication that they may be related to service.  See McClendon v. Nicholson, 20 Vet App. 79, 81 (2006).  Accordingly, a remand is warranted. 
The matters are REMANDED for the following actions:
1. Obtain all of the Veteran’s VA treatment records from the Sepulveda VA medical center and associate with the claims file.  (NOTE: The Veteran has indicated that he received treatment at this facility in the 1990s).
2. Then, schedule the Veteran for a VA skin examination to assist in determining the nature and etiology of his skin disorder(s).  Any indicated tests should be accomplished.  The examiner should review the claims file prior to examination, to include any newly associated records obtained as a result of this remand.  Then, the examiner is asked to provide an opinion as to the following: 
(a.) List all current skin disorders.  (NOTE: VA treatment records show current diagnoses of actinic keratosis and prescription medication for a groin rash).  
(b.) For each diagnosis, state whether it is at least as likely as not (50 percent or more probability) that the Veteran’s skin disorder(s) was incurred in service or is otherwise related to service.
**In making this determination, the examiner is asked to consider the Veteran’s lay statements that his disorders first manifested in service as a result of the environmental conditions in Vietnam and any reports of continuing symptoms since service.  Also attention is called to the March 1995 VA examination report showing dermatological complaints. 
(c.) All opinions are to be accompanied by a rationale consistent with the evidence of record.
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3. Then, readjudicate the claims on appeal.
 
S. B. MAYS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Casadei, Counsel