Citation Nr: 18156459 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 14-38 073A DATE: December 11, 2018 ORDER Entitlement to service connection for a scalp infection, to include scalp fungus, is denied. REMANDED Entitlement to a total disability rating for individual unemployability (TDIU) based upon service-connected disabilities is remanded. FINDING OF FACT The Veteran has not had a scalp infection, to include scalp fungus, during the appeal period. CONCLUSION OF LAW The criteria for a scalp infection, to include scalp fungus, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1968 to April 1970, including service in the Republic of Vietnam from September 1968 to July 1969. This matter is before the Board of Veterans’ Appeals (Board) on appeal from Department of Veterans Affairs (VA) Regional Office (RO) rating decisions dated August 2013 and March 2014. The August 2013 rating decision denied the Veteran’s claim for a TDIU. The March 2014 rating decision denied the Veteran’s claim for service connection for a scalp fungus condition. The Board notes the RO issued ratings decisions dated January 2015 and April 2015 which purported to reopen but continue denial of the Veteran’s service connection claim for a scalp fungus condition. However, in April 2014, the Veteran submitted a request for reconsideration of the March 2014 rating decision, which constituted an informal notice of disagreement that satisfied VA regulations then in effect, such that the March 2014 rating decision did not become final and the claim is thus not subject to being reopened. Nevertheless, the RO’s error in treating the March 2014 rating decision as final was harmless because the RO re-evaluated the claim on its merits before continuing its denial of the claim. The Board has thoroughly reviewed all evidence in the claims file. Consistent with the law, the analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board’s reasons for rejecting evidence favorable to the appellant. See Timberlake v. Gober, 14 Vet. App. 122 (2000). The Veteran must not assume the Board has overlooked evidence that is not explicitly discussed herein. In addition, pertinent regulations for consideration were provided in the October 2014 statement of the case (regarding a TDIU) and February 2017 statement of the case (regarding scalp fungus condition), and are not repeated here in full. The Veteran originally requested a videoconference hearing on his claims, but his representative withdrew the requests in a September 2018 writing submitted after discussion with the Veteran. Neither the Veteran nor his representative has raised any other specific duty to notify or duty to assist issues regarding the claim denied above. 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). Finally, neither the Veteran nor his representative has raised any other issues not addressed herein, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 69-70 (2017) (confirming Board not required to address issues unless specifically raised by claimant or reasonably raised by evidence of record). Service connection for scalp infection, to include scalp fungus The Veteran seeks service connection for a scalp infection condition, to include scalp fungus, which he contends he acquired while in Vietnam. Service connection may only be granted for a current disability; when a claimed condition is not shown, there may be no grant of service connection. See 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (“In the absence of proof of a present disability there can be no valid claim.”). The preponderance of the competent and credible evidence shows the Veteran has not had any infection of the scalp, to include a scalp fungus, during the period on appeal. The Board notes the Veteran has had a diagnosed seborrheic dermatitis of the scalp condition since May 1989, which was included in a prior claim for service connection for a skin disorder of the entire body, claimed as secondary to herbicide agent exposure. The RO denied that claim in an April 2003 rating decision that specifically encompassed the Veteran’s diagnosed seborrheic dermatitis of the scalp, and denied the claims on a direct basis as well as presumptively under the provisions relating to chronic diseases and diseases associated with exposure to herbicide agents. That rating decision became final because the Veteran did not file a notice of disagreement or new and material evidence within one year following notification of that decision. 38 U.S.C. § 7105; 38 C.F.R. §§ 20.302, 20.1103. The Board finds no indication the Veteran is seeking to reopen his previously denied claim for seborrheic dermatitis of the scalp, but rather that the Veteran is making a new service connection claim specifically for an infection of the scalp, to include scalp fungus. For the reasons set forth below, service connection is not warranted. The Veteran’s service medical records are silent for any complaint of a scalp condition. The Veteran’s March 1970 Report of Medical History and Report of Medical Examination, prepared approximately one month before his discharge from service, do not show any complaint or diagnosis of any fungal or other infection of the scalp (or any other scalp condition). The Veteran’s post-service treatment records show he first complained in May 1989 regarding seborrheic dermatitis of the scalp, for which the Veteran continues to receive treatment, but are silent as to any diagnosis of any type of scalp infection. The Board considered the Veteran’s lay statements regarding the onset of his condition. The Veteran is competent to provide evidence regarding any symptoms capable of lay observation, such as dry, scaling scalp skin. However, he is not competent to diagnose the medical cause of those symptoms, which has been diagnosed and confirmed as seborrheic dermatitis (for which service connection was previously denied). The Board acknowledges the Veteran’s contention that he was unable to report his scalp symptoms to a dermatologist because he was “in the field”. See May 2015 notice of disagreement. However, his service medical records show he complained of ringworm of the groin area (diagnosed as tinea cruris for which he was given Tinactin) in October 1968, while he was in Vietnam. Thus, the evidence shows the Veteran was able to and did report and receive treatment for another fungal skin condition while in Vietnam, such that the Board may reasonably infer that the absence of any similar complaint for a scalp condition indicates none existed. To be clear, this is not an instance where the Board is negating the probative value of the Veteran’s lay statements simply because they are unaccompanied by supporting contemporaneous medical evidence, which would be in contravention of Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). To the contrary, the medical evidence of record, namely the evidence referenced above which the Board finds more credible as contemporaneous evidence of the Veteran’s condition given in the course of receiving medical care, is inconsistent with and affirmatively contradicts the Veteran’s present claim of having had a fungal infection of the scalp since service. The Board finds the preponderance of the evidence weighs against finding the Veteran has had any scalp infection condition, to include scalp fungus, during the period on appeal. Service connection is denied. The benefit-of-the-doubt doctrine is not applicable because the preponderance of the evidence is against the claim. REASONS FOR REMAND The Veteran seeks a TDIU. The Board finds additional development is needed. First, the record indicates the Veteran has continued to receive individual and group therapy for his service-connected posttraumatic stress disorder (PTSD) at a Vet Center facility following his 2012 in-patient treatment. He contends his PTSD prevents him from working, making those records relevant to his claim, and VA has a duty to assist in obtaining those records. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). Second, although the Veteran contends his inability to secure and maintain employment is due to his PTSD (rated at 50 percent), he is also service-connected for diabetes mellitus (rated at 20 percent), residuals of shrapnel and shell fragment wounds to his left shoulder and arm (rated at 10 percent), residuals of prostate cancer (rated at 10 percent), tinnitus (rated at 10 percent), as well as the following conditions rated at 0 percent: right arm shell fragment wound, erectile dysfunction associated with diabetes mellitus, and bilateral hearing loss. In November 2014, the Veteran underwent a VA examination for his left shoulder and arm shrapnel wound residuals. The examiner noted reduced range of motion and painful motion, and opined the Veteran’s condition will impact any job requiring lifting or reaching with his left arm. Thus, at least one of the Veteran’s other service-connected disabilities is shown to negatively impact his ability to work. Moreover, the Veteran’s last psychiatric VA examination was in 2013. Considering the passage of time and the nature of PTSD, the Veteran should be afforded new VA examinations to determine the current severity of his service-connected disabilities and for opinions on any functional impairment caused thereby, including on his ability to obtain and maintain substantially gainful employment. Accordingly, the matters are REMANDED for the following action: 1. Ask the Veteran to identify the Vet Center where he attends therapy, and then take all actions necessary to obtain all his VA Vet Center records. Document all efforts and any negative responses in the claims file. 2. Obtain the Veteran’s VA medical records from Miami VA Health Care System for treatment from January 2017 to the present. 3. ONLY AFTER the above-listed records have been obtained to the extent possible, the Veteran should be afforded VA examinations with appropriate medical providers to address the current severity of ALL his service-connected disabilities. Each examiner should provide an opinion on any functional impairments caused by the Veteran’s service-connected disabilities, including on his ability to obtain and maintain substantially gainful employment. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Leamon, Associate Counsel