Citation Nr: 21001449 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 16-44 704 DATE: January 8, 2021 REMANDED Entitlement to service connection for pseudofolliculitis barbae, claimed as razor bumps, is remanded. Entitlement to service connection for a right eye condition is remanded. Entitlement to service connection for a left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1984 to January 2004. This matter comes before the Board of Veteran’s Appeals (Board) from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). These matters were previously before the Board in August 2019, when the Board denied the claims addressed herein. The Veteran disagreed with that decision and appealed to the United States Court of Appeals for Veterans Claims (Court). In August 2020, the Court granted a Joint Motion for Remand (JMR) where the parties requested vacatur of the August 2019 Board decision and that the claims were remanded for re-adjudication. The claims are now before the Board. 1. Entitlement to service connection for pseudofolliculitis barbae is remanded. The Veteran seeks service connection for pseudofolliculitis barbae, also claimed as “razor bumps.” In favor of his claim the Veteran asserts that he has razor bumps on his face that are constantly burning and bleeding after shaving. He stated that the bumps are very irritating and have been ever since he joined the service and was required to shave. He further asserted that while in service he was given a no shave chit for a short period of time which was a temporary fix and his problem still exists. He explains that after the chit expired, he had to shave again which made his issue recur. He stated he was in constant pain from the razors bumps which still exist. See statement of December 2013. In January 2015, the Veteran submitted another statement where he explained that his razor bumps did not occur until he joined the military and was forced to shave every day. He explained that the situation got so bad that in August 1985 he would constantly go to sick bay to get a no shave chit which would expire in a few days and the cycle would repeat. He again stated that the bumps are still very irritating and painful. See statement of January 2015. The Veteran’s service treatment records (STRs) and post-service medical records have been associated with the claims file. In July 1984, the Veteran was diagnosed with folliculitis on the back of the neck that had been present for 2-3 years prior to the visit. The Veteran complained that they were painful and irritating. He was referred to a dermatology clinic. See STRs for July 1984. In August 1985, the Veteran was diagnosed with pseudofolliculitis barbae and given a no shave chit for 2 weeks. See STRs for August 1985. In September 1985, the Veteran’s STRs show he complained of razor bumps that had been present for approximately 6 months. The physician noted the Veteran had pseudofolliculitis barbae prominent to neck and jaw. The Veteran was given a new shave chit and recommended a clipper shave only. See STRs for September 1985. In October 2003, the Veteran was examined for his skin condition. The Veteran reported having found a special shaving cream that seemed to have cured his problem. He stated he shaved regularly without any pustules or ingrown hairs. The examiner did not note any skin abnormalities. See examination of October 2003. In March 2018, the Veteran visited a VA clinic and his skin was noted to have no wounds, pressure ulcers or any other skin problems. See medical records for March 2018. The Board notes that although the Veteran is not competent to self-diagnose with pseudofolliculitis barbae, he is competent to give evidence about observable symptoms such as a skin rash or razor bumps. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994). The available post-service medical records do not contain complaints of a skin disorder or treatment for pseudofolliculitis barbae. However, the Veteran has submitted statements where he noted he still suffers from razor bumps and that these are painful. The Board finds the Veteran’s competent statements credible. The Veteran has not been provided with a VA examination and nexus opinion with regard to the claim of service connection for his pseudofolliculitis barbae condition. VA will provide a medical examination or opinion if the information and evidence of record does not contain medical evidence sufficient for VA to decide the claim but: (1) contains competent lay or medical evidence that the claimant has a current diagnosed disability or persistent or recurring symptoms of disability; (2) establishes that the Veteran suffered an event, injury, or disease in service; and (3) indicates that the claimed disability or symptoms may be associated with the established event, injury, or disease in service. See 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4). Resolving doubt in the Veteran’s favor, the Board finds the claim must be remanded so that the Veteran is afforded a VA examination for his claimed skin condition, as the Veteran was treated for pseudofolliculitis barbae during service, he has submitted lay evidence that suggest he suffers from recurring symptoms of a disability and the Veteran’s symptomatology may be related to his in-service condition. 2. Entitlement to service connection for a right eye condition is remanded. The Veteran seeks service connection for a right eye condition. In favor of his claim, the Veteran stated that his right eye is often blurry and burns constantly following incidents in the military. He explained that at times, his eye burns so bad he has to close it and use his left eye. He also stated that his eye pains him when he is in bright sunlight. See statement of December 2013. In January 2015, the Veteran submitted another statement where he explained that he has been having problems with his right eye since it was injured while in the military back in 2000. He also noted that the injury resulted in him wearing glasses due to his right eye vision. He explains his situation has worsened since his incident. See statement of January 2015. In September 1986, the Veteran complained of a foreign body flying into his right eye while working in the galley. The Veteran’s eye was flushed, and his visual acuity was noted. See STRs for September 1986. In October 2000, the Veteran was struck in the right eye while playing basketball. He complained of watery eye, photophobia and redness. He was diagnosed with traumatic iritis. See STRs for October 2000. In the examination dated October 2003, the Veteran’s right eye was examined. The Veteran reported feeling like his eye hurt and watered about once a week for a few minutes. No evidence of trauma to the eye nor cause for the intermittent pain and watering were found. See examination of October 2003. The Veteran’s post-service treatment records do not show any complaints, treatment or diagnosis related to the Veteran’s right eye. However, the Board finds the Veteran is competent to describe the symptomatology he has experienced related to his right eye. The Veteran has not been provided with a VA examination and nexus opinion with regard to the claim of service connection for a right eye condition. VA will provide a medical examination or opinion if the information and evidence of record does not contain medical evidence sufficient for VA to decide the claim but: (1) contains competent lay or medical evidence that the claimant has a current diagnosed disability or persistent or recurring symptoms of disability; (2) establishes that the Veteran suffered an event, injury, or disease in service; and (3) indicates that the claimed disability or symptoms may be associated with the established event, injury, or disease in service. See 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4). As the Veteran has asserted that he has been having issues with his right eye since his in-service injury, the Board finds that resolving doubt in his favor, the claim must be remanded for a VA examination to determine whether the Veteran currently has a right eye condition and if so, whether such condition is etiologically related to service. 3. Entitlement to service connection for a left knee condition is remanded. The Veteran seeks service connection for a left knee condition. In favor of his claim, the Veteran submitted a statement in December 2013, where he noted his left knee had been bothering him since he injured it in service. He further asserted that serving 8 years on board of ships damaged his left knee. He explained that at times he can barely stand the pain, that the knee swells up and that he can barely bend it. He also noted that at times, his knee gives out. See statement of December 2013. In January 2015, the Veteran further noted that while in service he constantly went to sick bay and received pain medication. See statement of January 2015. The Veteran’s post service treatment records have been associated with the claims file and these do not show any complaints, treatment or diagnosis related to the Veteran’s left knee. The Veteran’s service treatment records do show that he was treated for a left knee condition during service. In April 2001, the Veteran complained of left leg pain, which was assessed as tendinitis. See STRs for April 2001.In May 2001, the Veteran was given physical therapy for left knee pain that sometimes travelled to lower leg. See STRs for May 2001. In June 2001, the Veteran again complained of left knee pain. See STRs for June 2001. The Veteran reported in his report of medical history for separation, dated October 2003, that he had been having issues with his left leg for years and some days he could barely move it. In the report of medical examination for separation, dated October 2003; the Veteran’s lower extremities were noted as normal. See report of medical history and report of medical examination for separation both dated October 2003. In the October 2003 examination, the Veteran reported originally injuring his left knee in high school and that the knee had started to bother him in 2001. In this examination, the knee was noted to not swell or lock and the Veteran reported not feeling any instability. See October 2003 examination. The Board notes the Veteran’s report of medical examination for enlistment does not note any issues with the Veteran’s left knee. See report of medical examination for enlistment dated May 1983. Accordingly, the Veteran is presumed to have been sound upon entrance into the service. 38 U.S.C. § 1111. As previously noted, VA will provide a medical examination or opinion if the information and evidence of record does not contain medical evidence sufficient for VA to decide the claim but: (1) contains competent lay or medical evidence that the claimant has a current diagnosed disability or persistent or recurring symptoms of disability; (2) establishes that the Veteran suffered an event, injury, or disease in service; and (3) indicates that the claimed disability or symptoms may be associated with the established event, injury, or disease in service. See 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4). In the present case, the Veteran has submitted competent lay statements describing recurrent symptomatology that the Veteran believes is related to his service. Although the Veteran is not competent to provide an etiology opinion regarding his left knee, as that is a medical determination requiring medical expertise; the Veteran is competent to describe his symptoms such as knee pain, swelling and locking. Accordingly, the Board finds that, resolving doubt in his favor, the claim must be remanded so that the Veteran is afforded a VA examination for his claimed left knee condition. The matters are REMANDED for the following action: 1. Update medical records. If necessary, contact the Veteran and request that he provide information as to any outstanding medical records not already associated with the claims file. Perform any required development to obtain such records and to update medical records. All responses must be associated with the claims file. 2. Schedule the Veteran for an examination regarding his claimed pseudofolliculitis barbae. The examiner is asked to opine: a. whether the Veteran currently has a diagnosis of pseudofolliculitis barbae b. whether the Veteran’s claimed condition is at least as likely as not (i.e., 50 percent or greater probability) related to his service. 3. Schedule the Veteran for an examination regarding his right eye. The examiner is asked to opine: a. whether the Veteran currently has a diagnosis of a right eye condition b. whether the Veteran’s claimed condition is at least as likely as not (i.e., 50 percent or greater probability) related to his service. 4. Schedule the Veteran for an examination regarding his left knee. The examiner is asked to opine: a. whether the Veteran currently has a diagnosis of a left knee condition b. whether there is clear and unmistakable evidence that the Veteran’s left knee condition pre-existed service. If yes, the examiner must identify the medical records that demonstrate the condition existed prior to service. The Board notes the Veteran’s subjective reported history does not rise to the level necessary to establish the condition by clear and unmistakable evidence. whether there is clear and unmistakable evidence that the Veteran’s left knee condition was not aggravated by the Veteran’s service beyond its natural progression. c. If the Veteran’s left knee condition is not found to have clearly and unmistakably pre-existed service, the examiner must opine whether the Veteran’s claimed condition is at least as likely as not related to his service. (Continued on the next page)   Any tests deemed necessary to render the requested opinion should be conducted. All opinions must be supported by a clear rationale, and a discussion of the facts and medical principles involved is required. 5. Finally, readjudicate the appeal. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and given the opportunity to respond thereto before the case is returned to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Gonzalez-Maldonado 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.