Citation Nr: 21003553 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 14-24 869A DATE: January 21, 2021 ORDER Entitlement to service connection for a skin disability other than discord lupus, to include eczema, acne, dermatitis, and skin tags is denied. FINDING OF FACT The Veteran’s skin disability was not incurred in or caused by her time in service. CONCLUSION OF LAW The criteria for entitlement to service connection for a skin disability other than discord lupus, to include eczema, acne, dermatitis, and skin tags 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 had active service from May 1982 to May 1992. This matter was previously before the Board of Veterans’ Appeals (Board) in March 2018 and November 2019, at which time it was remanded for further evidentiary development. The Board finds there has been substantial compliance with its November 2019 remand directives. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that only substantial and not strict compliance with the terms of a Board remand is required pursuant to Stegall v. West, 11 Vet. App. 268 (1998)); see also Dyment v. West, 13 Vet. App. 141, 14647 (1999) (holding that there was no Stegall violation when the examiner made the ultimate determination required by the Board’s remand). By way of history, the Board previously denied entitlement to service connection for discord lupus in a September 2011 decision. In June 2012, the Veteran filed a new claim for benefits for entitlement to service connection for eczema, acne, contact dermatitis, and skin tags. Therefore, entitlement to service connection for a skin disability, to include eczema, acne, contact dermatitis, and skin tags is the only issue on appeal. The Veteran contends her skin disabilities are related to active military service. 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, 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 Veteran’s claims file shows she was diagnosed with eczema, acne, contact dermatitis, and skin tags in service. See January 2019 VA Examinations. However, the evidence does not support a chronicity of care, as the condition was acute only during service. Id. Furthermore, the January 2019 VA examiner opined that the Veteran’s eczema, acne, contact dermatitis, and skin tags was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner stated the Veteran’s eczema, acne, contact dermatitis, and skin tags have resolved since service. To fully address this issue, another examination was undertaken. A recent VA examination yielded similar results. The January 2020 VA examiner opined that the Veteran’s eczema, acne, contact dermatitis, and skin tags was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted no evidence of chronicity of care, no objective evidence of any chronic skin conditions, and no visible eczema, acne, dermatitis, or skin tags upon examination. See January 2020 VA Examination. Furthermore, the diagnoses are acute skin conditions while in the military. A nexus has not been established. An addendum was provided to the January 2020 VA Examination in October 2020. The Veteran underwent excision of a skin tag from her left chin by the Columbia VAMC in February 2012 and the exam report of December 2018 found a small scar from this procedure. The Veteran also had a skin tag removed in December 2015. Therefore, an addendum opinion was required to address the etiology of these skin tags. The examiner opined that the Veteran’s skin tags are likely caused by diabetes mellitus. See October 2020 Addendum. In support of their rationale, the examiner cited medical literature to support their nexus opinion. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board concludes that the Veteran does not have a current diagnosis of eczema, acne, or dermatitis 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). While the Veteran has a current diagnosis of skin tags and evidence shows the Veteran was seen in service for skin tags, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of skin tags at this time began during service or is otherwise related to an in-service injury, event, or disease. The issue is medically complex, as it requires knowledge of anatomical relationships and pathology. Therefore, it is outside the competence of the Veteran in this case because the record does not show that she has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the January 2020 VA Examination and October 2020 Addendum. Therefore, the Board finds service connection for a skin disability, to include eczema, acne, contact dermatitis, and skin tags must be denied. Regarding all the above, the Board has considered the applicability of the benefit of the doubt doctrine. Because the preponderance of the evidence is against the Veteran’s claim, the benefit of the doubt doctrine does not apply. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Laura Cochran, 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.