Citation Nr: 18121069 Decision Date: 07/25/18 Archive Date: 07/25/18 DOCKET NO. 15-14 256A DATE: July 25, 2018 ORDER New and material evidence having been received, reopening of the claim of entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. Entitlement to service connection for basal cell carcinoma with residual scars is granted. REMANDED Entitlement to service connection for acquired psychiatric disability is remanded. FINDINGS OF FACT 1. In an unappealed August 2007 rating decision, the Veteran was denied entitlement to service connection for PTSD. 2. The evidence received since the August 2007 rating decision is new and raises a reasonable possibility of substantiating the claim of entitlement to service connection for PTSD. 3. Basel cell carcinoma is etiologically related to extreme sun exposure sustain while serving in the Republic of Vietnam. CONCLUSIONS OF LAW 1. New and material evidence has been received to reopen the claim of entitlement to service connection for PTSD. 38 U.S.C. § 5108 (2012); 38 C.F.R. § 3.156 (2017). 2. The criteria for service connection for basal cell carcinoma have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from September 1966 to September 1969 and from March 1976 to December 1976. This case comes before the Board of Veterans’ Appeals (Board) on appeal from October 2012 and November 2013 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. In April 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. Claim to reopen entitlement to service connection for PTSD In an August 2007 rating decision, the Veteran was denied entitlement to service connection for PTSD based on a finding that the Veteran did not have a confirmed diagnosis of PTSD. The Veteran did not appeal that decision. The evidence that has been received since the August 2007 rating decision includes additional VA Medical Center treatment notes showing the Veteran to receive regular treatment at the PTSD clinic, indicating he may have a diagnosis of such. The Board finds that the evidence added to the record is new and material, in that it has not been previously considered by VA and it raises a reasonably possibility of substantiating the claim. Therefore, reopening the claims of entitlement to service connection for PTSD is warranted. Service connection for basal cell carcinoma with residual scars The Veteran has asserted that his diagnosed basal cell carcinoma is the result of sun exposure sustained while serving in the Republic of Vietnam. A review of the record shows that the Veteran did in fact have service in the Republic of Vietnam. As such, his significant sun exposure is conceded by the Board. A review of the post-service treatment notes of record show that the Veteran was diagnosed with basal cell carcinoma as early as 1985. He has had multiple recurrences of such with surgical removal since that time. The Veteran was afforded a VA skin examination in June 2013. The examiner opined that the Veteran’s basal cell carcinoma was related to prolonged sun exposure. During the April 2018 hearing, the Veteran testified that his most significant sun exposure over the course of his life was during his time in Vietnam. The Veteran’s daughter testified that when the Veteran returned from Vietnam, his skin was more tanned than it had been in the past, and he looked unrecognizable. Further, the Veteran provided that upon returning from Vietnam, he mainly worked indoors. The evidence of record indicates that after separation from the military, the Veteran worked in factories undertaking steel and press-setting work. The Board finds the Veteran and his daughter to be credible and competent regarding the level of Veteran’s sun exposure in Vietnam and after discharge. Accordingly, the Board finds that the evidence for and against the claim of entitlement to service connection for basal cell carcinoma and residual scars is at least in equipoise. Therefore, reasonable doubt must be resolved in favor of the Veteran and entitlement to service connection for basal cell carcinoma and residual scars is warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REMANDED ISSUE Entitlement to service connection for acquired psychiatric disorder The Board finds that additional development is required before the remaining claim on appeal is decided. VA examinations conducted in March 2012 and March 2015 concluded that the Veteran did not meet the DSM criteria for a diagnosis of PTSD. However, he was diagnosed with depression and an adequate etiology opinion for that disability was not provided. Additionally, a review of the record shows that the Veteran is in receipt of mental health treatment for PTSD. Those findings do not appear to have been considered by the March 2015 VA examiner. Therefore, the Veteran should be afforded a VA examination to determine the nature and etiology of any currently psychiatric disability. Additionally, current treatment records should be identified and obtained before a decision is made regarding the remaining issue on appeal. The matter is REMANDED for the following action: 1. Identify and obtain any outstanding VA and private treatment records that are not already associated with the claims file. 2. Then, schedule the Veteran for a VA examination by a psychiatrist or psychologist with appropriate expertise, who has not previously examined the Veteran or provided an opinion in this appeal, to determine the nature and etiology of any currently present psychiatric disability. The claims file must be made available to and reviewed by the examiner. Any indicated studies must be performed. Based on the examination results and review of the record, the examiner should first identify all psychiatric disabilities present during the pendency of the appeal, or proximate thereto. For all identified disabilities, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any such disability is etiologically related to the Veteran’s active service, to include his experiences while serving in the Republic of Vietnam. The rationale for all opinions expressed must be provided. 3. Confirm that the VA examination report and all opinions provided comport with this remand and undertake any other development determined to be warranted. 4. Then, readjudicate the remaining claim on appeal. If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Sami, Arooj