Citation Nr: 20042334 Decision Date: 06/22/20 Archive Date: 06/22/20 DOCKET NO. 14-32 089 DATE: June 22, 2020 ORDER Service connection for chloracne is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had chloracne at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for chloracne have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the appellant, served on active duty from August 1965 to August 1968. The issues of service connection for skin cancer and chloracne were previously before the Board in May 2018. At that time, the issues were remanded for further development of the evidence. Following development, service connection was awarded for residual scars, to include in the left and right upper extremities, related to basal cell/squamous cell carcinoma (claimed as skin condition and boils). See July 2019 rating decision. The remaining issue of service connection for chloracne has been returned to the Board for further appellate consideration. Entitlement to service connection for chloracne The Veteran contends that service connection should be established for chloracne. He asserts he was treated for this disorder during service and that it is related to his exposure to herbicide agents while stationed in the Republic of Vietnam (RVN). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 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). 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. The Board concludes that the Veteran does not have a current diagnosis of chloracne and has not had one at any time during the pendency of the claim or recent to the filing 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 they are silent for any complaints, manifestations, or diagnosis of chloracne. However, the Veteran’s postservice VA treatment records reflect notations that he has a history of chloracne. In May 2018, the Board remanded the Veteran’s claim, in pertinent part, to clarify whether the Veteran had a past diagnosis for chloracne and, if so, whether it had resolved. The examiner was asked to consider the VA treatment records indicating a history of chloracne related to Agent Orange exposure as well as the Veteran’s statements that he was treated for chloracne in service. A VA examination was conducted in February 2019. The examiner diagnosed basal cell and squamous cell carcinoma, and the Veteran has since been awarded service connection for the residuals of that disability. See July 2019 rating decision. As for the Veteran’s claim of chloracne, the VA examiner evaluated him and determined that, while he stated that he had experienced symptoms of chloracne in service, he did not have, and had not had, a diagnosis of chloracne. The examiner noted that the Veteran’s STRs showed he had a normal skin examination in August 1968, and there was no evidence of a chronic skin condition in service despite having undergone detailed medical evaluations on several occasions. The examiner explained that chloracne was the term used to describe occupational acne that occurred with exposure to chlorinated hydrocarbons (e.g., dioxins) via percutaneous contact, inhalation, or ingestion. Clinically, chloracne was characterized by large monomorphic comedos with evolution into severely inflammatory and scarring lesions. Therefore, if this had occurred, it would likely have been noted during one of the Veteran’s various physical examinations in service, or during his separation examination. The examiner then stated that although the Veteran might have had an exacerbation of acne in service, it did not rise to the level of requiring medical attention. In an August 2019 addendum medical opinion, the February 2019 VA examiner clarified that the examination performed in February 2019 did not show acne, chloracne, or any other related skin condition. The examiner again noted that although the Veteran’s STRs showed numerous entries documenting a variety of conditions, there was no mention of acne. The skin examination performed during the Veteran’s service separation examination was also within normal limits. The examiner thus stated that the most likely scenario was that the Veteran did not have any clinically significant acne or chloracne during military service. The Board finds the February 2019 VA examiner’s medical opinions be probative as they were based on an examination of the Veteran as well as a thorough review of the claims file, to include his STRs, and with consideration given to the Veteran’s lay statements. They also include an explanation for rationales provided. Notably, the Veteran has not provided any competent evidence to the contrary. Although the Veteran’s VA treatment records report that he has a history of chloracne (see, e.g., February 2008 VA treatment record), no diagnosis of chloracne has ever been rendered. The Veteran’s private treatment records dated from 2009 also do not contain a diagnosis of chloracne. Therefore, any notations of chloracne in the Veteran’s medical history appear to have been based on his self-report without any positive clinical findings. The mere recitation of an uncorroborated history, however, does not constitute competent medical evidence of a connection with service. See Reonal v. Brown, 5 Vet. App. 458 (1993). While the Veteran believes he has a current diagnosis of chloracne, he is not competent as a lay person to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for chloracne, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph P. Gervasio 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.