Citation Nr: 20026057 Decision Date: 04/15/20 Archive Date: 04/15/20 DOCKET NO. 17-63 311 DATE: April 15, 2020 REMAND Entitlement to an initial rating in excess of zero percent, for tinea cruris, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from April 1980 to November 1985. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to an initial rating in excess of zero percent, for tinea cruris. The Veteran contends that he is entitled to a compensable rating for his tinea cruris. The record reflects that he has consistently complained about his skin disability throughout his lower body, including his groin, legs, toes, and feet. As such, the Board finds that both a current assessment and a retrospective medical assessment are warranted to evaluate the nature and severity of his service-connected tinea cruris disability throughout the period on appeal. See Chotta v. Peake, 22 Vet. App. 80 (2008) (noting that a duty to assist may include development of medical evidence through a retrospective medical evaluation where there is a lack of medical evidence for the time period being rated); see also Vigil v. Peake, 22 Vet. App. 63 (2008) (holding that the duty to assist may include development of medical evidence through a retrospective medical evaluation where there is a lack of medical evidence for the time period being rated). The Veteran was afforded a VA examination in June 2017. During that examination, the examiner noted that the Veteran had a history of skin disorders to include the groin, nails, and lower extremities. Critically, the examination only reflects that the Veteran’s toes were examined. Furthermore, the Veteran asserts in his December 2017 VA Form 9, that the examiner only checked his toes, and did not check his groin or legs. Notably, although there is a positive opinion via a private examination dated October 2017, this also does not address the Veteran’s contentions that this disability is beyond just his feet. The Veteran, through his representative, in an April 2019 informal hearing presentation, contends that his skin disability covers at least 10 percent of his total body. As such, an opinion is needed on remand. Additionally, while the record contains a June 2017 VA examination regarding the Veteran's skin disability, the examination does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). Specifically, the record indicates that his skin symptoms are intermittent. However, the examiner did not attempt to elicit relevant information regarding the description of the Veteran's skin symptoms when present and any additional functional loss suffered at these times. Of note, if the examiner cannot provide an opinion as to additional loss of motion during a flare-up without resorting to mere speculation, the examiner must make clear that s/he has considered all procurable data (i.e., the information regarding frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups elicited from the Veteran), but that any member of the medical community at large could not provide such an opinion without resorting to speculation. Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017). Upon a review of the Veteran's June 2017 VA examination, it does not appear that such conformed to the Court's holdings in Sharp. Therefore, the Board finds that a remand is necessary to afford the Veteran another VA examination which assesses the current severity of his skin disability and includes the requisite testing. Furthermore, such examination should include a retrospective medical opinion addressing the Veteran’s flare-ups. Updated VA treatment records should be obtained and associated with the electronic claims file. See 38 C.F.R. § 3.159 (c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). This appeal is REMANDED for the following action: 1. Obtain all outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain all outstanding relevant private treatment records. 3. Thereafter, schedule the Veteran for a VA examination with an appropriate medical examiner to determine the nature and severity of his tinea cruris throughout the period on appeal. The claims file should be made available for the examiner to review and the examination report should reflect that such review was accomplished. All pertinent findings should be reported. The VA medical examiner is directed to provide an assessment of the nature and severity of the Veteran’s skin disability for the entire period on appeal (from December 19, 2011, to present). A retrospective assessment should be provided, as necessary. The examiner is directed to provide an assessment and evaluation of the Veteran’s skin disability as it affects the Veteran’s groin, legs, feet, toes, and arms (to include elbows). The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups for the entire period on appeal (from December 19, 2011, to present). Specifically, the examiner should elicit information about the nature and severity of his tinea cruris, including the estimated size of the affected areas, even if not present at the time of the examination. To the extent possible, the examiner should identify any symptoms and functional impairments due to the Veteran's tinea cruris alone and discuss the effect of such disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). J. TUNIS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. J. Rogers, 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. § 20.130