Citation Nr: 20005870 Decision Date: 01/23/20 Archive Date: 01/23/20 DOCKET NO. 17-64 460 DATE: January 23, 2020 ORDER Entitlement to service connection for a skin disability, to include hyperkeratotic lesions and lentigo is granted. FINDING OF FACT The Veteran’s hyperkeratotic lesions and lentigo were incurred during his active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for a skin disability, to include hyperkeratotic lesions and lentigo, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Army from May 2007 to September 2007 and again from July 2008 to July 2009. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in May 2016 by a Department of Veteran’s Affairs (VA) Regional Office. Entitlement to Service Connection for a Skin Disorder, to Include Hyperkeratotic Lesions and Lentigo Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent medical or lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The Veteran claims entitlement to service connection for a skin disability which he characterizes as severe sunburns from blistering heat while serving in Iraq. See December 2017 Substantive Appeal. The Veteran’s military personnel records reflect that he served in Iraq from August 2008 to June 2009. See DD-214. The Veteran has current diagnoses of hyperkeratotic lesions and lentigo. See December 2015 Skin Diseases Disability Benefits Questionnaire (DBQ). Accordingly, he has a current disability. Shedden element (1) is thereby met. As for Shedden element two, a June 2016 statement from L.D., corroborates observable sunburns on the Veteran’s scalp during service. L.D. recalled witnessing the Veteran being unable to wear any head gear for several days due to the severity of the sunburns to the Veteran’s scalp. He also recalled that during the healing process, thick layers of the Veteran’s skin would peel off leaving raw skin exposed to more burning. Though a layperson, L.D. is competent to report such observable symptomatology as skin changes. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Veteran further asserts that his skin disability symptoms have been present and continuous since they first developed. See December 2017 Substantive Appeal. As for Shedden element three, the Board notes that a negative etiological opinion exists in the form of a December 2017 skin condition medical opinion. The Board finds this opinion inadequate, as it merely relied on the absence of evidence in the Veteran’s records, and did not address his, or L.D.’s, competent and credible statements regarding the onset of the Veteran’s skin symptomatology. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); Dalton v. Nicholson, 21 Vet. App. 23 (2007) (an examination was inadequate when the examiner did not comment on the Veteran’s report of in-service injury and instead relied on the absence of evidence in the Veteran’s service medical records to provide a negative opinion). However, in her December 2017 Gulf War VA medical opinion, the examiner opined the Veteran’s skin condition is at least as likely as not related to sun exposure with severe burns and that previous sun exposure contributed to the Veteran’s hyperkeratotic lesions. (Continued on the next page)   Although the December 2017 examiner’s positive medical opinion does not specifically state when the Veteran sustained sun exposure with severe burns, a remand is not necessary as the benefit of the doubt will be conferred on the Veteran whose competent and credible statements, corroborated by L.D., provide probative evidence in favor of the Veteran’s condition having occurred in service. When the evidence for and against a claim is in relative equipoise, by law, the Board must resolve all reasonable doubt in favor of the Veteran. 38 U.S.C. § 1154(b); 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Therefore, the benefit of the doubt must be resolved in favor of the Veteran and entitlement to service connection for a skin disorder to include hyperkeratotic lesions and lentigo is warranted. MARISSA CAYLOR Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith, 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.