Citation Nr: 18161145
Decision Date: 12/28/18	Archive Date: 12/28/18

DOCKET NO. 17-09 770
DATE:	December 28, 2018

REMANDED

Entitlement to an initial compensable evaluation for acne is remanded.

Entitlement to an initial evaluation in excess of 10 percent for migraines is remanded.

Entitlement to total disability based on individual unemployability (TDIU) is remanded.

REASONS FOR REMAND

1.  Acne

The March 2015 compensation and pension (C&P) examination which only found superficial acne that did not impact the Veteran’s functional ability or disfigure his face or neck; then, between December 2016 and February 2017, the Veteran underwent a few surgical procedures to remove a cyst from his jawline.  He was prescribed oral and topical medication after the procedure.  However, the Veteran’s current disability is not clear, as the doctor’s performing those procedures did not offer adequate opinions regarding the Veteran’s condition, whether there were residual scars, or whether this issue would reoccur or resulted in a more severe disability than the one for which he is rated.  An examination is necessary for the Board to better understand the Veteran’s condition in late 2016 and early 2017 until the present.  Since the Board cannot substitute its own opinion for that of a medical expert, a new examination and opinion is required.  Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991).

2.  Migraines

In March 2015 the Veteran reported having just one characteristic prostrating attack per month.  In April 2018 he submitted an affidavit, through his attorney, stating that he has 2 to 3 characteristic prostrating attacks per month that cause him to “shut-down” completely.  An examination must be conducted to determine the current severity of the Veteran’s migraine headaches in light of the competent evidence of worsening.

3.  TDIU

Additionally, the Veteran has reasonably raised the issue of TDIU and it is an issue that must be decided by the Board.  Rice v. Shinseki, 22 Vet. App. 447 (2009).  Because a decision on TDIU may be impacted by the outcome of the current appeal for ance and migraines, the issue of TDIU is considered inextricably intertwined and must be deferred.

The matters are REMANDED for the following action:

1.  Associate with the claims file updated VA treatment records.

2.  Schedule the Veteran for a VA skin disease examination to determine the current severity of his service-connected acne.  The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.  To the extent possible, the examiner should identify any symptoms and functional impairments and discuss the effect of the Veteran’s acne on any occupational functioning and activities of daily living.

3.  Schedule the Veteran for a VA headaches examination to determine the current severity of his service-connected headaches.  The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.  To the extent possible, the examiner should identify any symptoms and functional impairments and discuss the effect of the Veteran’s headaches on any occupational functioning and activities of daily living.

4.  The RO is to readjudicate the issues on appeal, to include TDIU. If the benefits sought are not granted, the Veteran and his representative should be furnished with a supplemental statement of the case (SSOC) and afforded an opportunity to respond before the record is returned to the Board for further review.

 

 

Veterans Law Judge

Board of Veterans’ Appeals

ATTORNEY FOR THE BOARD	C. Harner, Associate Counsel