Citation Nr: 21061451 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 17-21 275 DATE: October 4, 2021 ORDER Entitlement to service connection for psoriasis is denied. FINDING OF FACT The preponderance of the evidence is against a finding that the Veteran has a current diagnosis of psoriasis and the Veteran is being compensated for service-connected dermatitis. CONCLUSION OF LAW The criteria for entitlement to service connection for psoriasis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.317. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 2005 to June 2014. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for psoriasis and left leg pain with strain. In July 2015, the Veteran filed his Notice of Disagreement and the RO issued a Statement of the Case in March 2017. In April 2017, the Veteran perfected a timely appeal to the Board via a VA Form 9, requesting a hearing on his claim before a Veterans Law Judge. In his substantive appeal, the Veteran specifically declined to perfect the appeal as to his claim for left leg pain with strain. This issue is therefore not before the Board. A Supplemental Statement of the Case was issued in October 2017, continuing the denial of service connection for psoriasis. In a November 2020 written statement, the Veteran withdrew his hearing request, and requested his claim be adjudicated based on the evidence of record. SERVICE CONNECTION Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F. 3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Entitlement to service connection for psoriasis. December 2013 and March 2014 service treatment records (STRs) reflect that the Veteran was diagnosed with psoriasis, with symptoms presenting behind his right ear. In the Veteran's March 2014 separation Report of Medical Examination, the examiner indicated that the Veteran had a skin abnormality, which he noted as dermatitis. In a July 2014 VA skin examination report, the examiner diagnosed the Veteran with dermatitis with pruritis and parakeratosis. He noted that the Veteran had been experiencing symptoms of dermatitis behind his right ear since 2010, and the condition was currently being treated regularly with a topical corticosteroid. In January 2015, the RO requested clarification of the July 2014 skin examination report, requesting that the examiner provide a clear statement as to whether the Veteran had a current diagnosis of psoriasis. An addendum opinion was issued in January 2015, in which a VA examiner found the Veteran had no current diagnosis of psoriasis. The Veteran submitted written statements in July 2015 and April 2017, indicating that he had been diagnosed with psoriasis during service and that he has subsequently experienced flare-ups of psoriasis on his elbows, arms, back and neck since his discharge from service. To the extent the Veteran asserts that he currently has psoriasis, his reports standing alone are not competent. Jandreau v. Nicholson, 492 F. 3d 1372, 1377, n. 4 (Fed. Cir. 2007). The medical evidence received following the Veteran's April 2014 claim identifies dermatitis and parakeratosis as the current diagnoses and does not suggest the presence of an additional skin disorder. While the Veteran is competent to opine as to his observations and to relay a diagnosis, he has not submitted evidence of a diagnosis of psoriasis which occurred during the appeal period or approximate thereto, and the question of the precise diagnosis based on his skin symptoms is a complex medical question requiring medical expertise, as to which he is not competent to opine. Id. Therefore, the Veteran's lay contentions as to his diagnosis are not competent. To the extent that they are competent, they are of significantly lower probative value than, and are outweighed by, the July 2014 and January 2015 VA examination reports and the medical evidence of record. Thus, the weight of the evidence reflects there is no current diagnosis of a psoriasis disability. The Board notes the current disability element is broad. It encompasses intermittent manifestations and evidence or diagnosis prior to the claim must be considered as well. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013). The record includes STRs reflecting that the Veteran was diagnosed with psoriasis in March 2014. However, based on the medical evidence and diagnosis received following the claim, the Board finds that the current disability is limited to dermatitis, as there is no competent and credible medical evidence showing any current diagnoses of psoriasis at any time during the appeal period or approximate thereto. Additionally, the Board acknowledges that a diagnosis is not required to show disability and a claim is not limited to the disorder as characterized by the Veteran. See Saunders v. Wilkie, 886 F. 3d at 1364-65 (1993). A claim must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim. Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009). In this case, based on the above evidence, the Board finds that the Veteran's psoriasis and the symptoms it causes, including rashes, redness, and swelling, were contemplated by the grant of service connection for dermatitis, which is rated similarly to psoriasis. See 38 C.F.R. § 4.118, Diagnostic Codes 7806 and 7816, each rated under the General Rating Formula for the Skin. For the foregoing reasons, the weight of the evidence reflects that the Veteran has not been diagnosed with psoriasis at any time during the claim period or approximate thereto and his skin symptoms since service are contemplated by the grant of service connection for dermatitis. Entitlement to service connection for psoriasis is therefore not warranted. As the preponderance of the evidence being against the claim, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.K. Donaldson, 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.