Citation Nr: 18155513 Decision Date: 12/04/18 Archive Date: 12/04/18 DOCKET NO. 12-25 383 DATE: December 4, 2018 REMANDED Entitlement to a disability rating in excess of 10 percent for service-connected folliculitis with chloracne is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 1967 to May 1969, and from August 1969 to May 1989, including service in the Republic of Vietnam. For his meritorious service, the Veteran was awarded (among other decorations) the Bronze Star Medal, the Army Achievement Medal, and the Army Commendation Medal. This matter comes before the Board of Veterans’ Appeal (Board) on appeal from a May 2011 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). This case has a long procedural history before the Board. As it must be remanded again, an extended recitation of that history is not needed. In pertinent part, in December 2017, the Board remanded this matter for further development, and the case has been returned for appellate consideration. Entitlement to a disability rating in excess of 10 percent for service-connected folliculitis with chloracne is remanded. This claim was most recently remanded by the Board in December 2017. At that time, the RO was instructed as follows: (1) to retrieve outstanding medical records, (2) schedule the Veteran for a VA examination to determine the current severity of his service-connected folliculitis with chloracne, and (3) issue a Supplemental Statement of the Case (SSOC) if the claims remained denied. The December 2017 Board remand provided that the Veteran has testified that his skin disability manifests in varying degrees, however there was no indication in the previous March 2016 VA examination addressed the extent of the Veteran’s disability during flare-ups. Moreover, the March 2016 VA examination did not indicate whether the Veteran has received any systemic therapy such as corticosteroids, or other immunosuppressive drugs to treat his skin disability. To that end, the Veteran was scheduled for a May 2018 VA examination to determine the current severity of the Veteran’s service-connected skin condition. While the VA examiner noted that the Veteran reported flare-ups and that the Veteran’s skin condition affected less than 5 percent of the Veteran’s body, the examiner did not provide a medical opinion addressing the percentage of the Veteran’s body that could be affected during a period of a flare-up. A remand by the Board confers on a veteran, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). This imposes upon VA a concomitant duty to ensure compliance with the terms of a remand. Accordingly, the Board finds that another remand is required at this time to ensure compliance with the December 2017 Board remand The matter is REMANDED for the following actions: 1. Forward the record and a copy of this remand to the VA clinician who performed the May 2017 VA skin condition examination or, if that clinician is not available, to another similarly qualified VA clinician for preparation of an addendum opinion. Further in-person examination of the Veteran is left to the discretion of the clinician providing the addendum opinion. If the clinician deems such examination necessary to provide the information requested below, then such an examination should be scheduled. The examiner should address the following questions: (a) Measure and record all manifestations of the Veteran's skin disability, including the percentage of the entire body and of the exposed areas of the body affected by the skin disorder. (b) Provide a medical opinion based addressing the percentage of the Veteran’s body area is affected during a period of a flare-up. The Veteran has reported periods of significant flare-ups of his skin condition that have not be observed upon VA examination. (c) Address whether the Veteran’s diagnosed colliculitis and chloracne have separate and distinct physical manifestations, or arise from the same symptomology. (d) Indicate the frequency with which the Veteran has received treatment for the skin disorder with systemic therapy such as corticosteroids or other immunosuppressive drugs. In particular, the examiner should indicate whether the Veteran's use of immunosuppressive drugs had a total duration of more or less than six weeks, or was constant or near-constant, during any 12-month period. The examiner should consider the lay testimony of record. A detailed rationale supporting the examiner’s opinion must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382 (2010). Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. R. Higgins, Associate Counsel