Citation Nr: 18159126 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 17-66 347 DATE: December 19, 2018 ORDER New and material evidence having been submitted, reopening of the claim of entitlement to service connection for a skin disability is granted. REMANDED Entitlement to service connection for a skin disability is remanded. Entitlement to service connection for a reproductive organ disability, to include prostate cancer, is remanded. FINDINGS OF FACT 1. In an unappealed January 1997 rating decision, the Veteran was denied entitlement to service connection for a skin disability. 2. The evidence received since the January 1997 rating decision is not cumulative or redundant of the evidence of record at the time of the prior denial and relates to an unestablished fact necessary to establish the claim of entitlement to service connection for a skin disability. CONCLUSION OF LAW New and material evidence has been received and the claim of entitlement to service connection for a skin disability is reopened. 38 U.S.C. § 5108 (2012); 38 C.F.R. § 3.156 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active military service from September 1950 to May 1952. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a May 2016 rating decision issued by the VA Regional Office (RO). In a December 2017 substantive appeal, the Veteran requested an in-person hearing before a member of the Board. In April 2018, the Veteran stated that he wished to withdraw his request for a hearing. As such, his hearing request is deemed withdrawn. 38 C.F.R. § 20.704(e) (2018). Claim to Reopen In a January 1997 rating decision, the RO denied entitlement to service connection for a skin disability. The RO determined that the evidence did not establish that the Veteran had a chronic skin disability or that his skin disability was related to service. The Veteran did not appeal that decision. The evidence that has been received since the January 1997 rating decision include post-service treatment records noting additional skin disabilities, a lay statement from a fellow servicemember who recalled that the Veteran had skin problems during service, and the Veteran’s lay statement that he was exposed to trichloroethylene (TCE) while stationed in Germany. The Board finds that the additional evidence is new and material as it has not been previously considered by VA and raises a reasonable possibility of substantiating the claim of entitlement to service connection for a skin disability. Therefore, reopening of the claim is warranted. REASONS FOR REMAND The Board finds that additional development is required before the remaining claims on appeal are decided. The Veteran has contended that his skin disability is related to his active service. Specifically, the Veteran reported that he was a truck mechanic and was assigned to the 38th Truck Battalion headquarters in Freiburg, Germany. He stated that his hands, feet, and legs were exposed to the TCE that he used to clean parts. A fellow service member recalled that the Veteran received treatment for breakouts on his hands and fingers during service. Further, the Veteran alleged that exposure to TCE caused skin cancer/growths and rashes on his head, face, and body. Additionally, the Veteran claims that he has a reproductive organ disability, to include prostate cancer, due to his exposure to TCE. A review of the Veteran’s DD-214 confirms that the Veteran was assigned to the 38th Transportation Trucking Battalion in Germany. The Board notes that not all of the Veteran’s service treatment records (STRs) were available as set forth in a December 2003 letter to the Veteran. In a case in which a Veteran’s service records are unavailable through no fault of his or her own, there is a heightened obligation for VA to assist the Veteran in the development of their claim and provide reasons or bases for any adverse decision rendered without these records. See Cromer v. Nicholson, 19 Vet. App. 215, 217 (2005) (quoting O’Hare v. Derwinski, 1 Vet. App. 365, 367 (1991)). To the extent that STRs were available, there was no evidence of a reproductive organ disability, to include prostate cancer. However, the Veteran’s May 1952 separation examination indicated that the Veteran had a skin disability, to include a pilonidal cyst with multiple sinus formation and a small subcutaneous tumor mass in the mid-abdomen, existing prior to service. With regard to the Veteran’s skin disability, a review of post-service treatment records shows that the Veteran was treated for skin lesions as early as 1996. Additionally, a private dermatologist stated that the Veteran had been evaluated and treated for sun damage and pre-cancerous actinic keratoses “many times.” She stated that the Veteran developed a superficial squamous cell carcinoma on his right temple in 2012. Further, there is evidence of record that the Veteran received treatment for a number of additional skin conditions, to include petechiae, erythema, advanced dermal elastosis, basal cell carcinoma, and sebaceous cysts. In December 1996, the Veteran was afforded a VA examination. The Veteran reported that during service he experienced skin itching, shredding, and cracking on his hands, feet, legs, elbows, and scrotum. He described his skin as tight, painful, cracked and bleeding. He added that he would break out, his nails had disintegrated, and that he had received private treatment for fungal infections on his feet, hands, and in his inguinal area. The examiner diagnosed dermatophytosis of the hands, feet, and inguinal areas with onychomycosis of the nails, left hand, and bilateral feet. As the precise nature of the Veteran’s skin disability remains unclear, particularly in the context of exposure to TCE, the Board finds that a new VA examination should be provided to determine the nature and etiology of any currently present skin disability. With regard to the Veteran’s reproductive organ disability, a review of post-service treatment records reveals that the Veteran was diagnosed with prostate cancer in 2017. Given the Veteran’s possible exposure to TCE as a truck mechanic, the Board finds that a VA examination is warranted to determine the nature and etiology of any currently present reproductive organ disability, to include prostate cancer. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Finally, current treatment records should be identified and obtained before a decision is made with regard to the remaining issues on appeal. The matters are REMANDED for the following action: 1. Obtain all VA treatment records for the Veteran dated from October 2017 to the present and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any currently present skin disability. The claims file must be made available to, and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and the review of the record, the examiner should first identify all skin disabilities present during the pendency of the claim, or proximate thereto. 3. Then, for each skin disability identified, the examiner should state whether the disability clearly and unmistakably existed prior to the Veteran’s active service. In responding to this question, the examiner is advised that “clear and unmistakable” means that the conclusion is undebatable, unconditional, and unqualified, and cannot be misinterpreted or misunderstood. (a.) For any skin disability found to clearly and unmistakably exist prior to service, the examiner should provide an opinion as to whether such disability was clearly and unmistakably NOT aggravated by service, to include as due to exposure to trichloroethylene. The examiner should specifically comment on the Veteran’s skin disability, to include a pilonidal cyst with multiple sinus formation and a small subcutaneous tumor mass in the mid-abdomen, existing prior to service, noted on the May 1952 separation examination report. (b.) For any skin disability that did NOT clearly and unmistakably exist prior to service, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that such disability is etiologically related to the Veteran’s active service, to include as due to exposure to trichloroethylene. The examiner should specifically comment on the Veteran’s skin disability, to include a pilonidal cyst with multiple sinus formation and a small subcutaneous tumor mass in the mid-abdomen, existing prior to service, noted on the May 1952 separation examination report. Additionally, in forming the requested opinions, the examiner should consider that the Veteran’s lay assertions alone are not a sufficient basis to determine that he clearly and unmistakably had a skin disability that pre-existed entrance to service. Further, the lack of medical treatment or diagnosis of a skin disability during service alone is not a sufficient basis to determine that a skin disability was clearly and unmistakably not aggravated during active service. The rationale for all opinions expressed must be provided. 4. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any currently present reproductive organ disability, to include prostate cancer. The claims file must be made available to, and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and the review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any currently present reproductive organ disability, to include prostate cancer, is etiologically related to the Veteran’s active service, to include as due to exposure to trichloroethylene. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Ware, Associate Counsel