Citation Nr: 18155358 Decision Date: 12/04/18 Archive Date: 12/04/18 DOCKET NO. 16-00 001A DATE: December 4, 2018 REMANDED Entitlement to an annual clothing allowance for the calendar year 2015 is remanded. REASONS FOR REMAND The Veteran had active service in the Marine Corp from December 1983 to November 2008. The Veteran contends that his bilateral knee braces, back brace, wrist brace, and rubbing creams result in damage to his clothing. He has explained that the cream used to treat back pain causes a permanent odor that requires him to replace his clothing. He also asserts that his back brace, wrist brace, and bilateral knee braces damage his outer garments. A veteran is entitled to one clothing allowance if either (i) a VA examination or a hospital or examination report from a facility specified in 38 C.F.R. §3.326(b) establishes that the veteran, because of a service-connected disability, wears or uses a qualifying prosthetic or orthopedic appliance that tends to wear or tear clothing; or (ii) the Under Secretary for Health or a designee certifies that the veteran, because of a service-connected disability or disabilities, wears or uses a qualifying prosthetic or orthopedic appliance that tends to wear or tear clothing, or the veteran uses medication prescribed by a physician for a skin condition, which is due to a service-connected disability, that causes irreparable damage to the veteran’s outer garments. 38 C.F.R. § 3.810(a)(1). A veteran is entitled to two annual clothing allowances if a veteran uses more than one prosthetic or orthopedic appliance, (including, but not limited to, a wheelchair), medication for more than one skin condition, or an appliance and a medication, and the appliance(s) or medication(s): (i) Each satisfy the requirements of 38 C.F.R. § 3.810(a)(1); and (ii) Together tend to wear or tear a single type of article of clothing or irreparably damage a type of outer garment at an increased rate of damage to the clothing or outer garment due to a second appliance or medication. 38 C.F.R. § 3.810(a)(3). The Under Secretary for Health designee is the Prosthetic Representative. See VHA Handbook 1173.15 paragraph 5.c. If a clinical determination is required pursuant to VHA Handbook 1173.15 paragraph 6, then the Under Secretary for Health designee will be the appropriate clinician (e.g., VHA clinician, Prosthetist, or Orthotist, or Pharmacist). Id. To determine that a Veteran is entitled to the allowance, the Under Secretary for Health designee must find and document that: (1) The use of the prosthetic, orthopedic appliance, or skin medication is medically necessitated for a service-connected disability or disabilities; (2) The prosthetic, orthopedic appliance, or skin medication meets the definition in this Handbook; and (3) The prosthetic or orthopedic appliance tends to wear out or tear the clothing of the Veteran or the skin medication causes irreparable damage (e.g., permanent irreversible staining, bleeding or damage not removable with laundering or dry cleaning) to the Veteran’s outer garments. VHA Handbook 1173.15 paragraph 5.c (1)-(3). If insufficient medical evidence of record exists to award the claim, then a clinical review or physical evaluation of the prosthetic, orthopedic appliance, or skin medication is warranted. VHA Handbook 1173.15 paragraph 6.a. The Board finds that there is insufficient medical evidence to determine whether the Veteran’s back, knee, and wrist braces and topical medications cause the damage as claimed. In this regard, the Board observes that the Veteran’s treatment records have not been associated with the claims file. Further, the October 2015 statement of the case is internally inconsistent, noting that the Veteran was prescribed back and bilateral knee braces for low back pain by his primary care physician in December 2015, but then lists as a justification for denial that the claimed bilateral knee braces were not prescribed for a service-connected condition. The Board notes that the Veteran is service-connected for lumbar spine and bilateral knee disabilities. After the Veteran’s treatment records have been associated with the claims file, in light of the Veteran’s statements regarding the damage caused by these appliances to his clothing, the Board finds that he should be examined to address the issues on appeal. He may bring evidence of damage to clothing done reportedly caused by the appliances to the examination. The matter is REMANDED for the following action: 1. Obtain and associate with the claims file all VA treatment records. Specifically, records of orthopedic treatment should be obtained, including any information as to the specific type(s) of prosthetic and/or orthopedic appliances and external medications prescribed to the Veteran for treatment of his service-connected disabilities. All attempts to obtain records should be documented in the claims folder. 2. Following completion of the above, schedule the Veteran for an appropriate examination by a designated clinician to address whether the Veteran’s back, bilateral knee, and wrist braces, and/or any other prosthetic or orthopedic appliance or topical medication prescribed to treat a service-connected disability result in wear and tear or other irreparable damage to the Veteran’s clothing. If there is wear and tear or staining due to prescribed prosthetic/orthopedic appliance or topical medications for service-connected disabilities, the examiner should certify any such wear and tear, and staining to the Veteran’s clothing was caused by his prescribed prosthetic/orthopedic appliance or topical medications for service-connected disabilities. The Veteran may, and is encouraged to bring, evidence of worn or torn or otherwise damaged clothing reportedly caused by the appliances or medications. A complete rationale must be provided for all opinions expressed. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Christopher Murray, Counsel