Citation Nr: 20034485 Decision Date: 05/18/20 Archive Date: 05/18/20 DOCKET NO. 10-35 613 DATE: May 18, 2020 ORDER Entitlement to service connection for tinea pedis and erythema annulare (claimed as rash) is denied. FINDING OF FACT The evidence does not show that the Veteran has a current diagnosis of tinea pedis and erythema annulare (rash), at any time during the appeal period. CONCLUSION OF LAW The criteria for entitlement to service connection for tinea pedis and erythema annulare (rash) have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served as a member of the Unites States Navy during the Vietnam and Gulf war Era, from March 1965 to April 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2014, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a videoconference hearing. The hearing transcript is associated with the record. This matter was previously remanded by the Board in its December 2013, July 2014, June 2017 and October 2018 decisions. As part of the October 2018 remand directives, the Board instructed the RO to obtain an addendum opinion from an appropriate clinician, regarding etiology of the Veteran’s claimed condition. This appeal has been advanced on the Board’s docket pursuant to 38C.F.R. §21.900(c). 38U.S.C. §7107(a)(2). Entitlement to service connection for tinea pedis and erythema annulare (claimed as rash). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be established on a presumptive basis for a Persian Gulf Veteran who exhibits objective indications of a qualifying chronic disability either during active service in the Southwest Asia Theater of operations during the Persian Gulf War, or to a degree of 10 percent or more not later than December 31, 2021, and which by history, physical examination, and laboratory tests cannot be attributed to any known clinical diagnosis. 38 U.S.C. §§ 1117, 1118; 38 C.F.R. § 3.317 (a)(1). Certain chronic diseases are subject to presumptive service connection if manifest to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). Continuity of symptomatology may also provide a basis for a grant of service connection for those diseases defined as "chronic" by VA. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Veteran asserts that he started experiencing recurrent skin rash on his lower legs, ankles and hips (which has gotten worse over the years) around 1995 when he returned from service in the Gulf. See June 2009 VA 21-4138 Statement in Support of Claim. On his VA Form 9, the Veteran stated that he still has rash on both legs that comes and goes and that he uses creams/medication but that the rash still do not go away. See March 2011 VA Form 9. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. In this regard, the Board concludes that the Veteran does not have a current tinea pedis and erythema annulare diagnosis and has not had one at any time during the pendency of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). A review of the Veteran's Service Treatment Records (STRs) shows evidence of complaints similar to the condition that is being claimed. The evidence shows a record of rash of one week’s duration in the March 1967 examination, and a note of mild “dermatophytosis” on both feet at the May 1967 re-enlistment examination. See STRs. Although the Veteran’s STRs show evidence of rash, and he has asserted that he experiences ongoing problems of rash since then, there is no objective clinical findings or assessments sufficient to establish the existence of a tinea pedis and erythema annulare (rash) diagnosis, which he claims is attributable to service. The Veteran underwent a Gulf war examination in March 2010. During examination, the Veteran reported that his rash disorder started in the 1960’s and that he has been self-treating the condition. The examiner noted that the Veteran’s skin to be dry and clean with no evidence of exfoliation/rash on examination. Tinea pedis and solar keratoses were also not found examination. See March 2010 VA Examination. In an August 2011 follow up note, the Veteran’s dermatology problem list included seborrheic keratoses, actinic keratoses, history of NMSC and erythema annulare centrifugum-noted as likely secondary to underlying tinea pedis. On physical examination however, no abnormalities were noted on the Veteran’s left and right upper/lower extremities. See August 2011 Medical Treatment Record - Government Facility. The Veteran was afforded a Gulf War examination in October 2014. On examination, the Veteran reported having a rash around his ankles, which has not recurred since 2009 after he began using a topical cream. The examiner noted that the Veteran’s condition did not represent a chronic disability. See October 2014 C&P Examination. The Veteran was then afforded a VA Skin examination in October 2014 and his diagnoses were: tumors and neoplasms of the skin, including malignant melanoma (diagnosed in 2004); and basal cell CA (diagnosed in 2013). The examiner noted that the Veteran did not have any of the above listed visible skin conditions at the time of examination. See October 2014 C&P In a medical record from Bend Memorial Clinic, the Veteran’s skin was noted as warm and dry, with no rash or erythema noted. See March 2017 Medical Treatment Record - Non-Government Facility. In April 2018, the VA obtained a medical opinion regarding whether the Veteran’s claimed rash was caused by Gulf War service. The examiner noted that there were no objective findings for tinea pedis on the day of examination. The examiner opined that the condition claimed was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness. The examiner’s rationale was that the Veteran’s disability pattern related to (rash between toes on feet) that meets TL10-01 criteria for a disease with a clear and specific etiology and diagnosis. Therefore, it is less likely than not caused by or related to Gulf War environmental exposure. See April 2018 C&P Examination. The Veteran was afforded another VA examination in August 2019. The examiner stated that tinea pedis was diagnosed in 1967. The examiner noted that the Veteran has other skin conditions (actinic keratoses which was diagnosed in 1991; and non-melanotic skin cancer which was diagnosed in 2003). On examination, the Veteran was reported as stating that he developed rash on his feet while in Guam in 1967. The Veteran narrated that he was seen by medical personnel and treated with topical medication and that he has been clear of rash since 1998. The examiner noted that the Veteran has not been treated for any skin condition with medications in the past 12 months. The examiner concluded that the Veteran’s tinea pedis had resolved and that the only dermatologic care the Veteran receives are for his history of skin cancer and actinic keratoses. See August 2019 C&P Examination. During his Board hearing, the Veteran testified that he “really don't know where the rash (which started developing after he retired from service) came from”. The Veteran further testified that he had not experienced any rash in the previous year and half, preceding Board hearing. See May 2014 Hearing Transcript. The Board observes that a service connection claim must be accompanied by evidence which establishes that the claimant currently has a disability. Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Service connection is not warranted in the absence of proof of current disability. The Board has considered whether the Veteran experienced rash, to include tinea pedis and erythema annulare at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). Although the record evidence shows that the Veteran was treated for tinea pedis and related rash symptoms on two occasions during service, it appears that these in-service complaints resolved with treatment. More importantly, there is no evidence other than the Veteran's unsupported inconsistent lay assertions which demonstrate that he experiences a current rash disability. While symptoms of rash may be lay-observable, see Kahana v. Shinseki, 24 Vet. App. 428 (2011), such symptoms are not necessarily indicative of tinea pedis and erythema annulare conditions. Accordingly, the Board finds that service connection for rash, to include tinea pedis and erythema annulare is not warranted. Congress has specifically limited entitlement to service-connected benefits to cases where there is a current disability. As no underlying rash, to include tinea pedis and erythema annulare disability has been clinically diagnosed during the appeal period or proximate thereto, the preponderance of the evidence is against the claim of service connection for sinusitis and the claim must be denied. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. M. 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. § 20.1303.