Citation Nr: 20007303 Decision Date: 01/28/20 Archive Date: 01/28/20 DOCKET NO. 16-50 105 DATE: January 28, 2020 ORDER Entitlement to service connection of trench foot, also described as jungle rot, is granted. REMANDED Entitlement to service connection for an acquired psychiatric disorder to include alcohol abuse is remanded. FINDING OF FACT It is at least as likely as not that the Veteran has a present diagnosis of trench foot, which had onset during active service and continues to the present. CONCLUSION OF LAW The criteria for entitlement to service connection of trench foot (also described as jungle rot) of the bilateral feet are met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1977 to July 1979 to include service in the Republic of Korea. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran initially requested a hearing before a Veterans Law Judge. In an October 2019 correspondence, the Veteran withdrew his hearing request. To date, he has not reinstated it. The Board has expanded the Veteran’s claim for service connection of alcohol abuse to include consideration of whether service connection is warranted for any acquired psychiatric disability. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Service Connection The law provides that service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, establishing service connection requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) 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. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999). 1. Entitlement to service connection of a skin disability, claimed as trench foot or jungle rot. The Veteran seeks service connection of a skin disability of the bilateral feet. The Board finds the claim should be granted. The Veteran was afforded a VA examination in January 2012. At that time, the examiner diagnosed trench foot, bilateral, which was described as mild. Specifically, the examiner noted fungal infections between the toes and in the nails of both feet, with hyperhidrosis. The examiner stated that this is a mild case of trench foot, otherwise known as jungle rot, which was mold at most. The examiner also stated that the Veteran’s trench foot started while stationed in Korea in 1978, during the monsoon season. Specifically, both feet were exposed to wet, damp, and cold conditions for a very long duration. The Veteran was again evaluated in July 2016. At that time he was diagnosed with tinea pedis of the feet, with an onset in 2013. The examiner described his tinea pedis as erythematous erosions between the toes bilaterally and a diffuse erythematous scaling dermatitis along the soles, medial and lateral surfaces of both feet. The examiner took the Veteran’s own reported history, which indicated that the Veteran experienced what he called “jungle rot” whilst stationed in Korea. He states that at the time he used powder and new boots, but that the boots caused his feet to sweat and remain damp, leading to itching, flaky skin, and reddened toes and feet. He reported symptoms since that time. The examiner then stated that the Veteran’s skin condition of the feet was less likely than not related to service. Specifically, he noted that the Veteran’s available treatment records did not document any type of a skin condition of the feet between separation and the date of the claim. The examiner then concluded that the absence of medical care in the record makes it unlikely that the Veteran has or had residuals of a cold weather injury or dermatological conditions. Ultimately, the Board finds the 2012 examination report more persuasive. First, the Board recognizes that the Veteran, as a lay person, is competent to report observable symptoms such as a skin condition during service and since that time. There is no evidence that this testimony, which was uniform between both examinations was less then credible, and the Veteran’s contentions are at least supported by multiple notations in his service treatment records of a rash on his legs. To the extent that the 2016 examiner found no nexus to service, that opinion is based exclusively on the lack of available treatment records (indeed, it appears as though the examiner may have been searching for such a lack of records, as he consistently cites to records which would unlikely included his foot condition, such as ear, nose, and throat, records. There is no indication in the conclusion that the examiner considered the Veteran’s competent and credible assertions. On the contrary, the 2012 examiner did consider the Veteran’s own reports, as well as his past medical history, and concluded that his present skin disability of the bilateral feet (mild as it may be), had onset during active service, with continuity to the present. Therefore, the Board finds this opinion to be slightly more persuasive in this matter. At the very least, it leaves the evidence in equipoise as to whether or not the claim should be granted. When the evidence is in equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49, 53-54 (1990). As such, the Board finds that the claim should be granted. REASONS FOR REMAND 1. Entitlement to service connection for an acquired psychiatric disorder, to include alcohol abuse, is remanded. While the Board regrets a further delay, a remand is necessary to fully satisfy the duty to assist. As noted above, the Board has expanded the definition of this claim, to include any acquired psychiatric disability which might account for the Veteran’s psychiatric symptoms. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). As of this time, the claim has been exclusively adjudicated as a claim for alcohol dependence alone. However, the Veteran’s own statements refer to other symptoms beyond mere alcohol use. In support of his claim, the Veteran has submitted May 2008 neuropsychological evaluation in which the Veteran stated he was struggling with events that occurred while in service. Furthermore, May 1991 psychiatric evaluation shows that the Veteran suffers from major depression, alcohol dependence, intermittent explosive disorder, and passive/aggressive personality disorder with antisocial traits. To date, a VA examination has not been conducted which assesses his complete psychiatric profile, and discussed the etiology and nature of his acquired psychiatric disorder or disorders. As such, on remand, an examination should be scheduled. The matters are REMANDED for the following action: 1. Invite the Veteran to submit any additional evidence in support of his claim. 2. Schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current acquired psychiatric disability onset during service or is otherwise related to an in-service injury, event, or disease, to include active service. The examiner should not limit the examination and requested opinion to alcohol abuse disorder, but should consider the complete medical record and provide a comprehensive diagnosis and etiology opinion for any and all psychiatric disabilities diagnosed. (Continued on the next page)   The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. In offering the opinion, the examiner is asked to consider the May 1991 discharge summary and May 2008 neuropsychological evaluation. M. Pryce Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. J. Kim, 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.