Citation Nr: 20021291 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 13-34 883 DATE: March 25, 2020 REMANDED Entitlement to service connection for a scar on the head, to include as secondary to service-connected acne of the scalp, is remanded. REASONS FOR REMAND The Veteran had active service from January 1983 to January 1986, February 1986 to May 1989, and from January 2000 to January 2003. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a July 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in July 2015 when it was remanded for additional development. The matter now returns to the Board for appellate consideration. 1. Entitlement to service connection for a scar on the head, to include as secondary to service-connected acne of the scalp, is remanded. The July 2015 Remand instructed the RO to obtain a VA examination to determine whether the Veteran’s head scar is related to his service-connected acne. The Remand specifically instructed the examiner to indicate if any head scar noted on examination is consistent with treatment for skin disorders in service or was caused or aggravated by service-connected acne. Further, the examiner was to provide an opinion as to whether it is as at least as likely as not (a 50 percent or greater probability) that any currently diagnosed head scars are related to and/or had their onset during the Veteran’s period of service or are caused or aggravated by service-connected acne. A resulting VA examination in August 2015 found that the Veteran’s scalp scar was less likely than not due to active duty service. The examiner supported his conclusion by stating that he could not rule out intercurrent causes as it had been many years since service. The examiner also noted that the Veteran had a tinea versicolor condition, but it was not the same condition as claimed as infected bump for which the Veteran attributes a scar status post treatment in service. The examiner provided no supporting rationale for that conclusion. The examiner then noted that a link to military service had not been proven and chronicity had not been proven for the claimed condition. The examiner did not provide a medical opinion as to whether the Veteran’s scar was proximately due to or aggravated by his service-connected acne. Insofar as the examiner distinguished the Veteran’s condition in service from his current condition, he provided no supporting rationale. For the above-stated reasons, the Board finds the August 2015 examiner’s opinion to be inadequate for decision-making purposes. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); see also Stegall v. West, 11 Vet. App. 268, 271 (1998). As such, an addendum opinion is necessary on remand. The matters are REMANDED for the following action: 1. Forward the record and a copy of this remand to the examiner who conducted the August 2015 VA examination, or if the examiner is unavailable, another suitably qualified examiner, for completion of an addendum opinion. If the examiner determines that another in-person examination of the Veteran is required to provide the below-requested information, then such an examination should be scheduled. Following review of the record, the examiner should express an opinion as to: a) Whether it is as at least as likely as not (a 50 percent or greater probability) that any currently diagnosed head scars are related to and/or had their onset during the Veteran’s period of service. Rationale must be provided for the opinion proffered. b) Whether it is as at least as likely as not (a 50 percent or greater probability) that any currently diagnosed head scars are proximately due to the Veteran’s service-connected acne. Rationale must be provided for the opinion proffered. c) Whether it is as at least as likely as not (a 50 percent or greater probability) that any currently diagnosed head scars are aggravated beyond natural progression by the Veteran’s service-connected acne. Rationale must be provided for the opinion proffered. In rendering the requested rationale, the examiner must address the October 2002 examination report finding multiple lesions and findings of record showing the Veteran’s skin condition affects multiple areas of the posterior scalp. The examiner must address the Veteran’s lay statements as to onset. The examiner must cite to medical principles where possible, for any conclusion reached. 2. After completion of the above, review the expanded record, including any evidence entered since the most recent statement of the case, and determine whether the benefit sought may be granted. If the benefit sought   remains denied, furnish the Veteran and his representative with a supplemental statement of the case. U. R. POWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Baker, 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.