Citation Nr: 19190892 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 14-35 092 DATE: December 3, 2019 REMANDED Entitlement to service connection for residuals of a shrapnel wound is remanded. Entitlement to service connection for a skin disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1967 to June 1970. He served honorably in the U.S. Army, including service in the Republic of Vietnam during the Vietnam era, and is a Parachute Badge recipient. The Board thanks the Veteran for his service to our country. The Veteran was scheduled for a January 2019 travel board hearing; however, this hearing was noted in the Veterans Appeals Control and Locator System to have been cancelled by the Veteran. Entitlement to service connection for residuals of a shrapnel wound and for a skin disorder is remanded. The Veteran contends that service connection is warranted as he was injured by shrapnel and his presumed exposed to herbicide agents in Vietnam led to his skin disorder. A remand is warranted to afford the Veteran an examination. There is evidence of current left leg and skin problems. In an August 2011 posttraumatic stress disorder VA examination, the Veteran reported a shrapnel wound in his leg which causes pain when walking and prevents him from exercising. Additionally, there are multiple notations of a cyst above his left knee, keratosis, and a nodule on his neck. There is also an indication of a nexus between in-service events and the Veteran’s current disorders. At a DRO hearing the Veteran testified that he sustained a left leg shrapnel injury when his firebase was attacked and that a medic removed the shrapnel from his leg. He testified that he has had a scar and sores in that area since then. He also testified that he has had a skin condition on his buttocks that has flared and caused discomfort since he was in Vietnam. Accordingly, the matters are REMANDED for the following action: 1. Please secure for the record copies of complete updated clinical records (any not already of record) of all VA and non-VA treatment the Veteran has received for the disorders on appeal. Please ask the Veteran to provide the releases necessary for VA to secure any adequately identified private treatment records. 2. After the record is determined to be complete, please schedule the Veteran for an examination to determine the nature and etiology of his disorders. The Veteran’s claims-file must be reviewed by the examiner in conjunction with the examination. Any indicated tests or studies should be conducted. Based on review of the record, the examiner should identify all left leg disorders, skin disorders, and relevant functional impairments current during the period on appeal including cysts, keratosis, and nodules on the Veteran’s face, back, buttocks, and left leg. For each identified left leg disability (including diagnosed disorders and functional manifestations resulting in impairment of earning capacity), the examiner is requested to provide the following opinions: (a.) Is it at least as likely as not (a 50 percent or greater probability) related to a reported shrapnel injury incurred during service? (b.) Is it at least as likely as not (a 50 percent or greater probability) otherwise related to service? For each identified skin disorder, the examiner is requested to provide the following opinions: (c.) Is it at least as likely as not (a 50 percent or greater probability) related to exposure to an herbicide agent? (d.) Is it at least as likely as not (a 50 percent or greater probability) otherwise related to service? The examiner is specifically requested to consider the Veteran’s testimony in a July 2013 DRO Hearing, labeled “Hearing Transcript,” as to the nature of his shrapnel injury, decisions regarding treatment for his leg, and in service manifestations of a skin disorder. If the basis of a negative opinion is the absence of evidence of treatment in the Veteran’s in-service medical records, the examiner must explain whether (1) treatment for residuals of a shrapnel wound, a skin disorder, or their respective symptoms would have been noted in the Veteran’s treatment records at the time; and (2) the Veteran would have sought treatment for residuals of a shrapnel wound, a skin disorder, or their respective symptoms at the time. Exposure to an herbicide agent is presumed. The examiner is advised that the sole basis of a negative opinion cannot be that an identified disorder is not on the list of diseases subject to presumptive service connection based on exposure to herbicide agents. The examiner must explain the rationale for all opinions and conclusions in detail, citing to supporting clinical data and/or medical literature, as appropriate. The examiner should take into consideration that the Veteran is competent to report post-service symptom experiences; other witnesses are competent to report observable symptoms. If the examiner cannot provide an opinion without resorting to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Vashaw, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.