Citation Nr: 21061700 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 16-15 284 DATE: October 5, 2021 REMANDED Entitlement to service connection for spots on arms is remanded. Entitlement to service connection for rash on legs is remanded. Entitlement to service connection for numbness in fingertips of the right hand is remanded Entitlement to service connection for numbness in fingertips of the left hand is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1964 to July 1972. The Veteran's service included a tour of duty in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from March 2014 and December 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Louisville, Kentucky. The Veteran attended a Board hearing in May 2019. The transcript of that hearing has been associated with the Veteran's claims file. In September 2019, the case came before the Board. The Board denied entitlement to service connection for a respiratory disorder and a kidney disorder. In addition, the Board remanded the Veteran's claims for entitlement to service connection for a rib disorder, upper extremity skin disorder, lower extremity skin disorder, left-hand fingertip numbness, and right-hand fingertip numbness for additional VA examinations. In April 2021, the RO issued a rating decision that granted entitlement to service connection for a rib disorder. Thus, this issue is no longer before the Board. 1. Entitlement to service connection for spots on arms is remanded. 2. Entitlement to service connection for rash on legs is remanded. In April 2021, the Veteran attended a VA skin examination. Following the examination, the examiner found that the Veteran's skin disorders were less likely as not due to his military service. The examiner reached that conclusion because he found "no medical records showing diagnosis, treatment for the rash condition during active duty, or that his exposures to herbicides and chemicals would cause rashes 40 years later." The Board finds this opinion inadequate because the examiner did not address the Veteran's lay statements or the fact that the Veteran reported that he experienced mumps on his 1969 separation examination. Thus, the Board a remand is required to obtain a more complete medical opinion as to the nature and etiology of the Veteran's skin disorders. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.310; Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate); Bloom v. West, 13 Vet. App. 185, 187 (1999) (a medical opinion without supporting clinical data or other rationale does not provide the required degree of medical certainty). 3. Entitlement to service connection for numbness in fingertips of the right hand is remanded. 4. Entitlement to service connection for numbness in fingertips of the left hand is remanded. In April 2021, the Veteran attended a VA peripheral nerve examination. Following the examination, the examiner found that the numbness in the Veteran's fingertips was less likely as not due to his military service. The examiner reached that conclusion because he found "no medical records showing diagnosis, treatment for the nerve condition during active duty, or that his exposures to herbicides and chemicals would cause nerve pain 40 years later." The Board finds this opinion inadequate because the examiner did not address the Veteran's lay statements regarding the onset of his pain or the fact that the Veteran reported that he experienced swollen or painful joints on his 1972 separation examination. Thus, the Board a remand is required to obtain a more complete medical opinion as to the nature and etiology of the Veteran's nerve disorders. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records from August 4, 2021, to the present. 2. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of the Veteran's skin disorders that are affecting the Veteran's arms and legs. The electronic claims file must be reviewed by the examiner. All indicated studies and testing must be conducted, and all pertinent symptomatology must be reported in detail. After a review of the claims file, the examiner should provide answers to the following questions: (A). Please state the diagnoses for all of the Veteran's skin disorders. (B). Is it at least as likely as not (50 percent probability or greater) that the Veteran's skin disorders, are caused by or related to his active service? The examiner's opinion should address the Veteran's concerns that his skin disorders are related to his exposure to herbicides and chemicals used in fighting fires. The examiner's opinion should address the Veteran's reports of mumps on his 1969 separation examination. 3. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of the Veteran's numbness in his upper extremities. The electronic claims file must be reviewed by the examiner. All indicated studies and testing must be conducted, and all pertinent symptomatology must be reported in detail. After a review of the claims file, the examiner should provide answers to the following questions: (A). Please state the diagnosis for the condition affecting the Veteran's left and right upper extremities. (B). Is it at least as likely as not (50 percent probability or greater) that the Veteran's numbness in his upper extremities, is caused by or related to his active service? The examiner's opinion should address the Veteran's concerns that the numbness in his upper extremities is related to his exposure to herbicides, chemicals used in fighting fires, and his duties as a fireman. The examiner should address the Veteran's contentions that he experienced these symptoms while on active duty. The examiner should address the Veteran's reports of swollen and painful joints on his 1972 separation examination. In providing all of the requested opinions, the examiners should consider the Veteran's competent lay claims regarding the observable symptoms he has experienced. The VA examination reports must include a complete rationale for all opinions expressed. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Rescan, 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.