Citation Nr: 20006482
Decision Date: 01/27/20	Archive Date: 01/27/20

DOCKET NO. 18-31 675
DATE: January 27, 2020

REMANDED

Entitlement to service connection for a skin condition is remanded.

REASONS FOR REMAND

The Veteran served honorably in the Army from July 1977 to July 1980 and from November 1990 to June 1991, including in Southwest Asia (SWA) in support of Operation Desert Storm/Desert Shield. 

Entitlement to service connection for a skin condition is remanded.

The Veteran has reported, and his service treatment records (STRs) confirm, he was diagnosed with a recurring rash during his deployment to SWA. Moreover, VA treatment records indicate he currently experiences periodic flare-ups of tinea and dermatitis. VA treatment records also indicate he has been prescribed Triamcinolone Acetonide Cream on multiple occasions to treat his current skin condition.   

While the Board realizes the Veteran was afforded a VA examination in May 2015 in response to this claim, an additional examination is warranted to provide an adequate rationale and additional clarity. Specifically, the examiner is asked to provide a list of the Veteran’s current skin condition diagnoses. Notably a skin condition is not required to be active at the time of the examination for it to be considered a “current disability,” provided the Veteran has experienced periodic flare-ups during the period under review. Indeed, caselaw recognizes that skin disorders often wax and wane so are sometimes more apparent than others. Moreover, primarily for this reason, it is recommended an examination of a skin disorder occur during an active stage of the disease, i.e., when it is symptomatic. 

In addition, the examiner is also asked to provide an opinion with adequate rationale as to whether any of the Veteran’s current skin conditions are related to the rash noted in his STRs. 

Accordingly, the matter is REMANDED for the following action:

Schedule an examination with an appropriate clinician for further medical comment concerning the nature and etiology of the Veteran’s current skin condition(s). The Veteran’s record must be reviewed by the examiner to assist in making the necessary determinations, including a complete copy of this remand. After review of the record and examination of the Veteran, the examiner is asked to:

(a.) Identify (by diagnosis) every skin condition found/shown by the record to exist since the filing of this claim or contemporaneous thereto.

(b.) Identify the etiology of each skin condition found to exist or have existed at some point since the filing of this claim or contemporaneous thereto. Specifically, is it at least as likely as not (a 50% or greater probability) the disorder was incurred in, or aggravated by, the Veteran's military service? The examiner’s attention is drawn to the Veteran’s documented rash from his service in Southwest Asia (noted in his STRs in April 1991). 

 

(c.) Alternatively, was a skin disorder caused OR aggravated by a service-connected disability?

The examiner must discuss the rationale for all opinions, preferably citing to evidence in the file supporting conclusions and/or accepted medical authority. 

If a skin condition is found to be unrelated to the Veteran’s service, the examiner is asked to identify and explain the etiology considered more likely.

 

 

KEITH W. ALLEN

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	C.B. Kucera

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.