Citation Nr: 21000080 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 15-42 800A DATE: January 4, 2021 ORDER Entitlement to a compensable rating prior to September 4, 2020 and a disability rating in excess of 10 percent thereafter for pseudofolliculitis barbae is denied. FINDINGS OF FACT 1. Prior to September 4, 2020, the Veteran’s pseudofolliculitis barbae on the face and neck affects less than 5 percent of the entire body; no treatment, including use of topical medication, was required during the prior 12-month period. 2. From September 4, 2020, the Veteran’s pseudofolliculitis barbae on the face and neck affects more than 5 percent but less than 20 percent of the entire body; constant or near constant use of topical medication is required, but no more than intermittent use of systematic therapy or immunosuppressive drugs were required during the prior 12-month period. CONCLUSION OF LAW The criteria for entitlement to a compensable rating prior to September 4, 2020, and a disability rating in excess of 10 percent thereafter for pseudofolliculitis barbae have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Codes 7899-7806. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army from September 1966 to July 1974. In August 2019, the Board remanded the above issue to obtain a VA examination. Accordingly, the Veteran underwent a VA examination in September 2020. Therefore, the Board is satisfied there was substantial compliance with its remand orders. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). Following the September 2020 VA examination, in a September 2020 rating decision, the RO granted a 10 percent rating for the Veteran’s pseudofolliculitis barbae, effective September 4, 2020. As this does not represent the full grant of benefits sought on appeal, this issue remains before the Board. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The Board also notes that in the September 2020 rating decision, the RO also granted a separate, 10 percent rating for the painful, tender scars, anterior trunk as secondary to the service-connected disability of pseudofolliculitis barbae and a noncompensable rating for scars, anterior trunk as secondary to the service-connected disability of pseudofolliculitis barbae, both effective September 4, 2020. As the Veteran has not expressed disagreement with these separate ratings granted as secondary to his pseudofolliculitis barbae, they will not be addressed here. Increased Rating The Veteran’s entire history is reviewed when making disability evaluations. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). At the time of an initial rating, consideration of the appropriateness of a staged rating is also required. Fenderson v. West, 12 Vet. App. 119 (1999). Disability evaluations are determined by comparing a Veteran’s symptoms with criteria set forth in VA’s Schedule for Rating Disabilities, which are based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings applies under a particular diagnostic code, the higher of the two evaluations is assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Pyramiding, that is the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when evaluating a Veteran’s service-connected disability. 38 C.F.R. § 4.14 (2017); see Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Staged ratings have been considered for the Veteran’s pseudofolliculitis barbae, and staged ratings are not appropriate for this condition as the evidence demonstrates that the Veteran’s pseudofolliculitis barbae has varied throughout the appeal period. 1. Entitlement to a compensable rating prior to September 4, 2020 and a disability rating in excess of 10 percent thereafter for pseudofolliculitis barbae is denied. The Veteran is in receipt of a noncompensable rating from October 15, 2012 to September 4, 2020 and a 10 percent rating thereafter for his service-connected pseudofolliculitis barbae under Diagnostic Codes 7899-7806. See 38 C.F.R. § 4.20. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. Unlisted disabilities requiring rating by analogy will be coded first with the numbers of the most closely related body part and "99." 38 C.F.R. § 4.27 38 C.F.R. § 4.27. Diagnostic Code 7806 provides a noncompensable disability rating for dermatitis or eczema of less than 5 percent of the entire body or less than 5 percent of exposed areas affected and no more than topical therapy required during the past 12-month period. A 10 percent disability rating is assigned for dermatitis or eczema of at least 5 percent of the entire body, but less than 20 percent of the entire body, or at least 5 percent, but less than 20 percent of the exposed affected areas, or intermittent systemic therapy, such as corticosteroids or other immunosuppressive drugs were required for a total duration of less than six weeks during the prior 12-month period. See 38 C.F.R. § 4.118, Diagnostic Code 7806. For a 30 percent disability rating, there must be dermatitis or eczema on over 20 to 40 percent of the body or 20 to 40 percent of the exposed areas affected, or systemic therapy, such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly during the prior 12-month period. For a 60 percent disability rating, there must be dermatitis or eczema over more than 40 percent of the entire body or more than 40 percent of the exposed areas affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs for the past 12-month period. Id. The Veteran is seeking a higher rating for his service-connected pseudofolliculitis barbae. The Veteran reported that he has breakouts of his skin condition that appear in his chest and abdomen. See March 2019 hearing transcript. Turning to the relevant evidence, in the April 2014 VA examination, the examiner noted the Veteran’s diagnosis of dermatitis or eczema, specifically pseudofolliculitis barbae. The examiner noted that the Veteran had pseudofolliculitis barbae on less than 5 percent of his total body area. The examiner also noted that the Veteran has not been treated with oral or topical medications in the past 12 months for any skin condition. The Veteran also did not have any treatments or procedures other than systemic or topical medications in the past 12 months for his skin condition. In the September 2020 VA examination, the examiner noted the Veteran’s diagnosis of pseudofolliculitis barbae. The examiner noted that the Veteran had pseudofolliculitis barbae on the face and neck on more than 5 percent but less than 20 percent of his total body area and exposed area. The examiner also noted that the Veteran has used cortisone cream for 6 weeks or more in the past 12 months for this skin condition. The Veteran did not have any treatments or procedures other than systemic or topical medications in the past 12 months for any of his skin conditions. The examiner also noted that the Veteran had folliculitis in the chest on more than 5 percent but less than 20 percent of his total body area. Prior to September 4, 2020, as the evidence above does not show that the Veteran had dermatitis or eczema of at least 5 percent of the entire body, the minimum requirement for a compensable rating under DC 7806, entitlement to a compensable rating prior to September 4, 2020 for pseudofolliculitis barbae is not warranted. From September 4, 2020, the evidence does not show that the Veteran had dermatitis or eczema on over 20 to 40 percent of the body or 20 to 40 percent of the exposed areas affected. In the September 2020 VA examination, the Veteran was only noted to have pseudofolliculitis barbae on the face and neck on more than 5 percent but less than 20 percent of his total body area and exposed area. Nor does the evidence show that the Veteran underwent systemic therapy, such as corticosteroids or other immunosuppressive drugs during the prior 12-month period. Accordingly, a disability rating in excess of 10 percent is not warranted for the Veteran’s pseudofolliculitis barbae from September 4, 2020. Given the above, entitlement to a compensable rating prior to September 4, 2020 and a disability rating in excess of 10 percent thereafter for pseudofolliculitis barbae is denied. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. E. Grossman, 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.