Citation Nr: 21002232 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 19-21 391 DATE: January 13, 2021 ORDER Entitlement to an earlier effective date prior to February 17, 2015 for the grant of service connection for non-Hodgkin’s lymphoma is dismissed. REMANDED Entitlement to a compensable rating for non-Hodgkin’s lymphoma is remanded. FINDING OF FACT On June 19, 2020, at his hearing before the Board, the Veteran indicated his wish to withdraw his claim for entitlement to an earlier effective date prior to February 17, 2015 for the award of service connection for non-Hodgkin’s lymphoma. CONCLUSION OF LAW The criteria for withdrawal of the issue of entitlement to an earlier effective date prior to February 17, 2015 for service connection non-Hodgkin’s lymphoma have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from November 1965 to August 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an October 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). A hearing was conducted on June 19, 2020 before the undersigned Veterans Law Judge, with the Veteran, his spouse, and his representative all present. A transcript of the hearing has been associated with the file. The record was held open for 90 days following the hearing to allow for the submission of additional evidence. In September 2020, the Veteran’s representative requested an additional 30 days to submit evidence. This request was granted in October 2020. The Board notes that the Veteran submitted additional evidence in support of the appeal following the June 2020 hearing, to include private dermatology treatment records and a Skin Disorders Disability Benefit Questionnaire (DBQ) report submitted in November 2020. This Skin Disorders DBQ report submitted in November 2020 is potentially incomplete as only four pages have been uploaded into the record. This appeal has been advanced on the Board’s docket on account of advanced age. 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). 1. Entitlement to an earlier effective date prior to February 17, 2015 for service connection for non-Hodgkin’s lymphoma is dismissed. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 19.55; see Anderson v. Brown, 9 Vet. App. 542, 547 (1996). Here, at his June 19, 2020 hearing, the Veteran testified that he wished to withdraw his appeal for any entitlement to an earlier effective date prior to February 17, 2015 for the grant of service connected non-Hodgkin’s lymphoma, as was previously a claim before the Board. See Hearing Tr. (June 19, 2020), at Page 2. The Board finds the Veteran’s testimony to be clear, unambiguous and done with a full understanding of the consequences of such action. See DeLisio v. Shinseki, 25 Vet. App. 45, 57 (2011). As such, the Veteran has withdrawn his appeal concerning this issue listed above, and there remains no allegation of error or fact or law for appellate consideration. REASONS FOR REMAND 1. Entitlement to a compensable rating for non-Hodgkin’s lymphoma is remanded. By way of background, the Veteran’s non-Hodgkin’s lymphoma has been rated as noncompensable since February 17, 2015. The rating decision on appeal is the rating decision by which the Veteran was afforded an initial noncompensable rating. The Veteran’s Parkinson’s disease is not on appeal at this time, because jurisdiction as to that issue is proper under the Appeals Modernization Act (AMA); meanwhile, this Board decision is being adjudicated pursuant to the Legacy system. Prior to the Veteran’s hearing, the Veteran was previously afforded two VA examinations for his service connected non-Hodgkin’s lymphoma: once in October 2015 and then again in May 2019. See Hearing Tr. (June 2020), at Pages 7-10. The Veteran testified that the VA examiners did not give him an opportunity to offer any statements by which the Veteran would have otherwise recounted a history of the progression of his disorder, and that they failed to properly examine him contemporaneously. Notwithstanding any previous inadequate examinations, the Veteran also offered credible testimony that his skin disorder has manifested in up to approximately 60 percent coverage of his body, see id. at Page 4, an increased susceptibility to cuts that require stitches, see id. at Page 5, and surgical freezing and excision of wounds approximately four times per year, see id. at Page 6. Finally, whereas the most recent VA examination of record indicated that the Veteran has no current skin disorder aside from his non-Hodgkin’s lymphoma that was in remission, the Board is now in receipt of evidence suggesting additional diagnoses of basal cell carcinoma, squamous cell carcinoma, cutaneous T-cell lymphoma, and/or actinic keratosis. See Skin Diseases DBQ (rec’d Nov. 9, 2020 ). On account of all of the above evidence before and after the last VA examination of record, and in the event of the other skin disorders may constitute evidence of increasingly severe non-Hodgkin’s lymphoma, see, e.g.: Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board concludes that an updated VA examination is required to fully assess and adjudicate the Veteran’s claim. See Weggerman v. Brown, 5 Vet. App. 281 (1993); Allday v. Brown, 7 Vet. App. 517 (1995); Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997). The matter is REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records, to include any VA treatment records, should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative, and afford them an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. After the receipt of any outstanding records, schedule the Veteran for appropriate VA examinations to determine the current nature and severity of his service-connected non-Hodgkin’s lymphoma. The Veteran’s claims file should be forwarded to a VA examiner with requisite credentials to administer a dermatological examination. The examiner should also elicit testimony as to the progression of the Veteran’s skin disorder. Whether the Veteran may be required to submit to in-person physical examinations for any of the above is left to the discretion of the examiner. The record, including a complete copy of this remand, must be made available for review in connection with the examination, and all indicated tests should be performed. The examiner must discuss the functional effects of the Veteran’s service connection non-Hodgkin’s lymphoma from February 17, 2015 to the present, including but not limited to percentage of body area affected, color and texture of affected skin, the Veteran’s purported propensity to suffer from cuts, the Veteran’s purportedly required treatment regimen of freezing and excising wounds, and any topical ointments ever prescribed or used to treat the Veteran’s skin disorder. A complete rationale for the examiner's opinions should be provided, citing to specific evidence of record, as necessary. A rationale should be provided for all opinions offered. If it is not possible to provide a specific opinion regarding the above questions, 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). (Continued on the next page)   The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael B. Engle, 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.