Citation Nr: 20021930 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 14-16 522 DATE: March 27, 2020 REMANDED Entitlement to service connection for a skin condition is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1968 to January 1970. He appeals a November 2009 rating decision by the Agency of Original Jurisdiction (AOJ) denying service connection for undefined dermographia. A Board hearing was held in March 2019. A transcript is of record. On July 1, 2019, the Secretary of Veterans Affairs directed the Board to stay adjudication of all cases which may be affected by the Blue Water Navy Vietnam Veterans Act of 2019 (the Act), until the effective date of the Act, January 1, 2020. The stay of adjudication has been lifted. As such, the Board will proceed with the appeal. In an October 2019 decision, the Board remanded the issues of entitlement to service connection for obstructive sleep apnea (OSA), a respiratory condition, and a back condition. The Board’s review of the claims file reveals that the AOJ is still acting on those issues. As such, the Board will not accept jurisdiction over them now, but they will be the subject of a subsequent Board decision, if otherwise in order. At his Board hearing, the Veteran described having rashes since service. See March 2019 Board hearing transcript at 15-17. In service, the Veteran has documented complaints of rashes and was diagnosed with urticaria, undefined dermatographia, and dermal hypersensitivity. See, e.g., January 1970, September 1969, and August 1969 service treatment records. The Veteran claims his rashes began after touching liquids in unmarked barrels he believes to contain Agent Orange. See March 2019 Board hearing transcript at 15. Consistent with VA’s duty to assist, VA must provide a medical examination when there is evidence of (1) a current disability; (2) an in-service injury; (3) some indication that the claimed disability may be associated with the established injury; and (4) insufficient competent evidence of record for VA to decide. See McClendon v. Nicholson, 20 Vet. App. 79, 84 (2006). The third prong, which requires evidence that the claimed disability or symptoms “may be” associated with the established event, has a low evidentiary threshold. See 20 Vet. App. at 83. Here, the Veteran’s service treatment records reflect numerous rash complaints and he currently complains of a skin condition with continuous manifestations since service. Therefore, the low evidentiary standard is met, and a VA examination is necessary to determine if the Veteran’s current skin condition is related or attributable to his time on active duty. The record also shows the Veteran may have been exposed to herbicide agents in service. He contends he was exposed to herbicide agents while serving on the U.S.S. Constellation from January 1969 to January 1970. Specifically, he said the ship was located around the Gulf of Tonkin. See March 2019 Board hearing transcript at 15; see also August 2011 Veteran statement. Therefore, the Veteran’s skin condition claim is premised at least in part on his alleged exposure to herbicide agents. As a result, a determination should be made as to whether the U.S.S. Constellation was within 12 nautical miles of Vietnam from January 1969 to January 1970. See 38 U.S.C. § 1116A. The matter is REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his skin condition that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. Attempt to verify whether the U.S.S Constellation sailed within 12 nautical miles of the Republic of Vietnam or sailed within the waters outlined in 38 U.S.C. § 1116A at any time from January 1969 to January 1970. This should include obtaining relevant deck logs or any other relevant records that might serve to verify the U.S.S. Constellation’s position during the relevant period. If the search for corroborating information leads to negative results, the AOJ should notify the Veteran, explain the efforts taken to obtain this information, and describe any further action to be taken. 3. After completing directive #1-2 above, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of any skin condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination must include a notation that this record review took place. The examiner should identify all skin disabilities present. He or she is asked to respond to the following inquiry: Is it at least as likely as not that the Veteran’s skin condition was incurred in, or is otherwise related, to his time on active service, to include documented rash complaints and potential herbicide agent exposure in service? In rendering this opinion, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that question. (Continued on the next page)   4. After completing directives #1-3 above to the extent possible, readjudicate the claim. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Salazar, 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.