Citation Nr: 21061798 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 18-28 597A DATE: October 5, 2021 ORDER The application to reopen the claim of entitlement to service connection for psoriasis/ psoriatic arthritis is granted. The application to reopen the claim of entitlement to service connection for left knee disorder, to include as secondary to psoriasis/ psoriatic arthritis is granted. REMANDED Entitlement to service connection for psoriatic arthritis is remanded. Entitlement to service connection for a left knee disorder, to include as secondary to psoriasis/ psoriatic arthritis is remanded. FINDINGS OF FACT 1. The RO denied service connection for psoriasis/ psoriatic arthritis and a left knee disorder in a January 2011 rating decision. The Veteran did not appeal this rating decision, nor did he submit new and material evidence within one year of the rating decision. 2. The evidence received since the January 2011 rating decision relates to an unestablished fact necessary to substantiate the Veteran's service connection claim for psoriasis/ psoriatic arthritis and a left knee disorder. CONCLUSIONS OF LAW 1. The January 2011 rating decision denying service connection for psoriasis/ psoriatic arthritis and a left knee disorder is final. New and material evidence has been received and the claims are reopened. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1983 to December 1986, and from September 1990 to April 1991. The Board notes that the second period of service is during a wartime period. The Veteran appeared at a Board hearing in June 2021; a transcript is of record. During the Board hearing, the undersigned Veterans Law Judge clarified the issues on appeal, identified potential evidentiary defects, and clarified the type of evidence that would support the Veteran's claim. The actions of the Veterans Law Judge supplement the Veterans Claims Assistance Act (VCAA) and comply with any related duties owed during a hearing. See 38 C.F.R. § 3.103. 1. The application to reopen the claim of entitlement to service connection for psoriasis/ psoriatic arthritis 2. The application to reopen the claim of entitlement to service connection for a left knee disorder Generally, a claim that has been denied in a final unappealed rating decision may not thereafter be reopened and allowed. 38 U.S.C. § 7105(c). An exception to this rule is 38 U.S.C. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, VA shall reopen the claim and review the former disposition of the claim. New and material evidence is defined as evidence not previously submitted to agency decisionmakers which bears directly and substantially upon the specific matter under consideration; such new and material evidence can be neither cumulative nor redundant of the evidence previously of record, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). In deciding whether new and material evidence has been submitted the Board looks to the evidence submitted since the last final denial of the claim on any basis. Evans v. Brown, 9 Vet. App. 273, 285 (1996). The United States Court of Appeals for Veterans Claims (Court) interpreted the language of 38 C.F.R. § 3.156(a) as creating a low threshold. See Shade v. Shinseki, 24 Vet. App. 110 (2010). The Court emphasized that the regulation is designed to be consistent with 38 C.F.R. § 3.159 (c)(4), which "does not require new and material evidence as to each previously unproven element of a claim." See id. The Veteran first filed a compensation claim for psoriasis/ psoriatic arthritis in April 1991, and for a left knee disorder in June 2006. The psoriasis/ psoriatic arthritis claim was denied in September 1994 and September 2002 rating decisions. Both claims were denied in a subsequent rating decision in January 2011. The Veteran was notified of both denials but did not appeal nor submit evidence within the one-year appeal period at any point. The January 2011 decision, the latest decision, was, therefore, final. 38 U.S.C. § 7105 (c); 38 C.F.R. §§ 3.156 (b), 20.1103. The Veteran filed an application to reopen the compensation claim in April 2015, which was ruled on in a September 2015 rating decision. After a review of the evidence of record, the Board finds that new and material evidence has been submitted sufficient to reopen the case. There is evidence that potentially cures a prior evidentiary defect, specifically, if accepted as true, the nexus between the Veteran's psoriasis/ psoriatic arthritis and service. Accordingly, reopening of the claims of service connection for psoriasis/ psoriatic arthritis and a left knee disorder is warranted. REASONS FOR REMAND 1. Entitlement to service connection for psoriasis/ psoriatic arthritis 2. Entitlement to service connection for a left knee disorder The Veteran contends that his psoriasis/ psoriatic arthritis was aggravated by his second period of active duty. He also maintains that his left knee disorder is directly related to his psoriasis/ psoriatic arthritis. The Veteran notes military findings in his medical file stating that with psoriasis, he should not have been put back on active duty. The Veteran also argues that the presumption of soundness should attach to his first period of active service. The Veteran, in his Report of Medical History from his entrance examination, dated December 28, 1983, states that he does not have a skin disease, and no relevant notes are mentioned in an accompanying Report of Medical Examination. Service treatment records indicate that the Veteran received a diagnosis of psoriasis on January 9, 1984. While changed a month later to seborrhea dermatitis, the medical records refer to this condition as psoriasis starting in February 1986. Psoriasis is mentioned again in September 29, 1986 and October 6, 1986 records of medical care. A medical record from November 14, 1986 mentions psoriasis treatment, with only a lesion on scalp and nails. Continuation of treatment is mentioned in a November 20, 1986 medical record. In the Veteran's separation examination, dated October 27, 1986, the Veteran was assessed as "clinically normal" for head, face, neck and scalp, as well as skin, lymphatics. The examination does not list the Veteran as having either psoriasis or dermatitis. In an entrance examination for the Veteran's second period of active service, from September 16, 1990, the Veteran reported that he has psoriasis and is currently taking methotrexate for his condition. In November 1990, an Army doctor took the Veteran off of his methotrexate prescription. January 1991 medical records indicate that the Veteran's psoriasis/ psoriatic arthritis had worsened, and a recommendation for medical evaluation was made. In an April 1991 report of medical examination, psoriasis of the thighs and scalp was observed, as well as nail deformation. Arthritis was also noted. Here, the Board notes that remand is appropriate. As previously discussed, the Veteran's first entrance examination does not list a skin disorder. However, a screening note of acute medical care from January 9, 1984 states that the Veteran had a scalp disorder, which, as previously stated, was found to be psoriasis in a separate record from the same day. A subsequent screening note of acute medical care from February 1984 notes that the Veteran had psoriasis, but a separate February 1984 record from the same day refers to this as seborrhea dermatitis. Both records indicate that the Veteran reported the duration of the scalp issue was around six months. In order to determine whether the Veteran's psoriasis clearly preexisted the Veteran's first period of service, a medical opinion is required. As the Veteran's left knee disorder is intertwined with the Veteran's psoriasis/ psoriatic arthritis, remand for this issue is also appropriate. The matters are REMANDED for the following action: 1. Return the claims file to an examiner of appropriate expertise for an addendum medical opinion. The examiner must answer: (a.) Whether it is at least as likely as not (i.e., a probability of 50 percent or greater) that the Veteran's psoriasis/ psoriatic arthritis was causally or etiologically related to the Veteran's first period of active service (from December 1983 to December 1986). (b.) If the Veteran's psoriasis/ psoriatic arthritis clearly and unmistakably preexisted his first period of active service. (c.) If the Veteran's psoriasis/ psoriatic arthritis clearly and unmistakably preexisted his first period of active service, whether the Veteran's psoriasis/ psoriatic arthritis clearly and unmistakably increased in disability due to the natural progress of the disease. A complete rationale for any opinion expressed should be provided in a report. 2. In regard to the second period of service, was there an increase in disability and if so was the removal of medication related to the change, if any? 3. Readjudicate the Veteran's claim. If the benefits sought on appeal are not granted, the Veteran should be provided a Supplemental Statement of the Case and afforded the requisite opportunity to respond before the case is returned to the Board. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jonah Nelson, 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.