Citation Nr: 20007569 Decision Date: 01/30/20 Archive Date: 01/29/20 DOCKET NO. 16-30 729 DATE: January 30, 2020 ORDER Entitlement to service connection for a skin disorder, diagnosed as dermatophytosis, is granted. FINDING OF FACT The Veteran’s dermatophytosis had its onset during active service. CONCLUSION OF LAW The criteria for service connection for a skin disorder, diagnosed as dermatophytosis, are met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from May 1958 to October 1962, including service in Thailand on Udorn Royal Thai Air Force Base (RFTAB). This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board denied entitlement to service connection for skin cancer in a September 2012 decision. The Veteran timely appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In November 2013, the Court vacated and remanded the September 2012 Board decision. In April 2014, the Board again denied entitlement to service connection for skin cancer. The Veteran timely appealed this decision to the Court, and in May 2015, the Court vacated and remanded the April 2014 decision. The appeal was remanded for further development in December 2015 and August 2018. Entitlement to service connection for a skin disorder, diagnosed as dermatophytosis, is granted. Service connection may be established for a disability resulting from injury or disease incurred during active service. 38 U.S.C. § 1131. Service connection may also 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, to establish service connection the evidence must show: (1) the existence of a present disability; (2) in- service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The Board has conceded the Veteran’s herbicide agent exposure at Udorn RTAFB. See December 2015 Board decision at 4. Diseases presumptively associated with herbicide agent exposure are listed in 38 C.F.R. § 3.309(e). Notably, dermatophytosis is not among the presumptive diseases associated with herbicide agent exposure. However, even if a veteran is found not to be entitled to a regulatory presumption of service connection, the claim must still be reviewed to determine if service connection can be established on a direct basis. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Veteran asserts that his skin disorders manifested themselves immediately following service and have been continuous since that time. Alternatively, he maintains that his skin disorders are due to conceded exposure to herbicide agents during his service at Udorn RTAFB as combat engineer. See June 2009 VA Form 9, August 2012 Appellant Brief, March 2014 Affidavit, and December 2016 VA examination report. The Veteran has a current diagnosis of dermatophytosis. See December 2016 VA examination report. Thus, element one is met. Regarding element two, in-service incurrence of a disease or injury, the Veteran’s service treatment records (STRs) document the onset of skin symptoms including fungus on his leg and lesions on his legs, thigh, and lower abdomen, and corresponding treatment, and his exposure to herbicide agents is conceded as noted above. See March 1959 STR. Thus, for reasons outlined below element two is also met. As to the final element, nexus, the only competent opinion of record substantiates the claim. Specifically, the September 2018 VA examiner opined that it is at least likely as not that the Veteran’s dermatophytosis is casually or etiologically related to service. In support of his opinion, the examiner stated that the Veteran’s STRs showed that the Veteran was diagnosed with and treated for dermatophytosis during service with no evidence that he had preexisting dermatophytosis prior to entering military service. Thus, he concluded that his dermatophytosis was due to service. Albeit quite brief, the Board finds this opinion tends to demonstrate that the Veteran’s dermatophytosis had its onset during active service. There is no adequate competent evidence to the contrary. The Board acknowledges the December 2016 and May 2017 VA examiners rendered opinions unfavorable to the Veteran’s dermatophytosis. However, neither examiner addressed the Veteran’s relevant STRs. Thus, both opinions are inadequate and of no probative value. Accordingly, element three of service connection is met, and service connection for dermatophytosis, is warranted. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. The Board notes that all VA examiners have rendered negative nexus opinions in relation to the Veteran’s other diagnosed skin disorders, including basal cell carcinoma, rosacea and actinic keratosis. The most recent of these unfavorable opinions, rendered in September 2018, is adequate for rating purposes as it contains sufficient rationale, with the VA examiner fully considering the Veteran’s lay statements, the relevant evidence of record and conceded exposure to herbicide agents in service. To the extent the Veteran attributes his other skin conditions to herbicide agent exposure in service, he is not competent to do so, and therefore his opinion is of no probative value. Thus, for reasons outlined above, service connection is warranted for dermatophytosis, and dermatophytosis only. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Asante 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.