Citation Nr: 21061600 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 17-40 660 DATE: October 4, 2021 REMANDED Entitlement to service connection for a skin disability, to include psoriasis, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1997 to August 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas, which, inter alia, denied service connection for psoriasis (claimed as psoriasis of the scalp). This matter was previously before the Board in October 2019. At that time, the Board, inter alia, remanded the claim for further evidentiary development, to include a VA examination. Under the circumstances of this case, the Board has recharacterized the Veteran's claim of service connection for psoriasis more broadly as a claim of service connection for a skin disability, to include psoriasis. In light of the remand below, no prejudice to the Veteran has resulted from the Board's recharacterization of the issue. Bernard v. Brown, 4 Vet. App. 384 (1993) (holding that before the Board may address a matter that has not been addressed by the RO, it must consider whether the claimant has been given adequate notice of the need to submit evidence or argument, an opportunity to submit such evidence or argument, and an opportunity to address the question at a hearing, and whether the claimant has been prejudiced by any denials of those opportunities). Entitlement to service connection for a skin disability, to include psoriasis, is remanded. The Veteran contends that her skin disability is related to active duty. The Veteran's service treatment records (STRs) note that the Veteran was treated in November 1997 for a skin rash. The Veteran was also treated at military treatment facilities in September 2006 for seborrheic dermatitis and in March 2007 for a skin rash and other nonspecific skin eruption. Moreover, she states that she has had continuity of symptoms since service. See March 2016 Notice of Disagreement (NOD). Additionally, VA and private treatment records show a diagnosis of psoriasis and treatment for the condition. See May and July 2012 C.U.F.C. treatment records and May 2016 VA medical records. Pursuant to the Board's October 2019 remand instructions, the Veteran was afforded a VA examination in February 2020. The examiner noted a 2006 diagnosis of seborrheic dermatitis. The Veteran reported developing psoriasis on her forehead which extended into her anterior scalp during active duty, however, she could not recall being seen or treated. She reported using an over-the-counter steroid medication which worked well for her skin. The Veteran reported that she was diagnosed with seborrheic dermatitis in 2006, post-discharge. She reported that she was given shampoo but stopped using it because it dried out her hair and scalp too much. The Veteran reported having psoriasis if she went over a week without washing her hair, and at least one outbreak monthly. The examiner noted that the Veteran's claimed psoriasis was not active at the time of the examination. After examination of the Veteran and review of the claims file, the examiner rendered a negative etiological opinion regarding the Veteran's skin disability. The examiner opined, A thorough review of her str [service treatment records], post discharge records including any lay statements have been review[ed]. According to veteran she does not recall going to be seen for her skin while on active duty. She self[-]diagnosed her claim of psoriasis. She also treated herself with otc [over-the-counter] medications. She was not seen for any skin condition until 2006 and again in 2007. Diagnosed with seborrheic dermatitis and received a prescription for a sulfur based shampoo which she says helped keep the flaking down. She stopped using the shampoo and hasn't been seen in Dermatology or pcp [primary care physician] for a skin issue since 2007. It is less likely that her claimed psoriasis is related to military service. The Board finds that the VA examination is inadequate, as the examiner's opinion is based on an inaccurate factual premise, namely that the Veteran was not seen for any skin condition until 2006, that she had not been seen for issues with her skin since 2007, and that she "self-diagnosed her claim of psoriasis." In that regard, the examiner failed to consider the November 1997 entry in the Veteran's STRs noting that she was treated for a skin rash. Additionally, the examiner failed to consider VA and private treatment records dated in 2012 and 2016 noting a diagnosis of psoriasis and treatment for such. While the Board greatly regrets further delay, remand is required for an addendum medical opinion for full compliance with the Board's previous remand instructions. See Barr v. Nicholson, 21 Vet. App. 303, 311; see also Stegall v. West, 11 Vet. App. 268 (1998). Accordingly, the matter is REMANDED for the following action: 1. Obtain an addendum medical opinion regarding the nature and etiology of the Veteran's skin disability. Access to the Veteran's electronic VA claims file must be made available to the examiner for review in connection with the opinion. After reviewing the record, the examiner should provide an opinion, with supporting rationale, as to the following: Is it at least as likely as not that the Veteran's skin disability was incurred in or otherwise related to her active service? In providing the requested opinion, the examiner should reference any relevant evidence of record, to include the November 1997 entry in the Veteran's STRs noting that she was treated for a skin rash, the September 2006 and March 2007 treatment records noting diagnoses of seborrheic dermatitis and a skin rash and other nonspecific skin eruption, respectively, and VA and private treatment records dated in 2012 and 2016 showing a diagnosis of psoriasis and treatment for such. K. Conner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Ruddy, 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.