Citation Nr: 21062711 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 10-27 084 DATE: October 12, 2021 ORDER Entitlement to service connection for seborrheic dermatitis is denied. FINDING OF FACT The Veteran's seborrheic dermatitis did not begin in service and is not related to service, to include chemical exposure. CONCLUSION OF LAW The criteria for service connection for seborrheic dermatitis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1991 to August 1993. This case has a long procedural history and has been before the Board previously. The Veteran testified before the undersigned Veterans Law Judge during a February 2018 hearing. In an October 2018 decision, the Board denied the claim for service connection for seborrheic dermatitis. The Veteran appealed the denial to the U.S. Court of Appeals for Veterans Claims (Court). In August 2020, the Court issued a Memorandum Decision that vacated the denial and remanded the matter to the Board for readjudication consistent with the decision. In May 2021, the Board remanded to obtain any outstanding VA treatment records prior to September 1999. The RO completed the requested development and further remand is unnecessary. The Veteran seeks service connection for his seborrheic dermatitis. Specifically, he contends that his dermatitis is related to in-service exposure to the chemical hydrazine during his verified military occupational specialty (MOS) duties as an aircraft maintenance specialist in service. Alternatively, he contends that his current seborrheic dermatitis is related to an in-service incident when airplane soap splashed into his face. The Board finds that the Veteran was exposed to chemicals such as hydrazine sulfate and aircraft soap during active service based on his service personnel and treatment records, lay statements, and December 2016 VA medical opinion. Thus, the remaining issue is whether the Veteran's current disability is related to service, to include said chemical exposure. The Veteran's service treatment records are associated with the claims file. The Veteran contends that records, like his separation examination, are missing. As an official separation examination is not associated with the claims file, the Board will not presume the complete service records are available. In June 1992, he splashed aircraft soap into and irritated his right eye. The treatment record shows a diagnosis of irritative conjunctivitis and is negative for any skin complaints or treatment at that time. In September 1992, he sought treatment for three transient, non-painful, and tiny bumps on his lower lip lasting one day each. He was diagnosed with transient allergic reaction versus viral syndrome. He did not relate his condition to the June 1992 incident, nor report experiencing dermatitis-like symptoms previously. Notably, the Veteran underwent a physical examination in May 1993, which was normal and did not document dermatitis symptoms or complaints. The Veteran also denied taking medications and all medical conditions on a May 1993 dental patient medical history form. While the Board does not consider the service records complete, it is reasonable to expect that the Veteran would have reported dermatitis symptoms if he was experiencing them when he sought treatment for skin issues in September 1992. See Horn v. Shinseki, 25 Vet. App. 231, 248 (holding that that the Board may consider a lack of notation of medical condition or symptoms as substantive negative evidence where such notation would normally be expected) (citing Kahana v. Shinseki, 24 Vet. App 428 (2011)). It is also reasonable to presume that if the Veteran was experiencing skin problems in May 1993, they would have been documented on the annual physical or he would have reported a history of symptoms, as he contends that he did during his separation examination. See id. Instead, the examination was normal and negative for complaints. Finally, the Board notes that the Veteran explicitly denied medical conditions and medications on his May 1993 dental patient medical history form. Thus, the Board finds that the lack of complaints, diagnoses, or treatment, as well as the Veteran's explicit denial of such, in the specific records discussed weighs against his claim. Importantly, the Board finds that the Veteran's contentions that he received treatment in service are not credible. In a June 2008 statement, he wrote that he received a separation examination at which time he reported random redness and flaking. An official separation examination is not associated with the claims file. In his July 2009 notice of disagreement, he wrote that he was hospitalized in April 1993 for dermatitis and submitted a service record to support this assertion. In August 2011, he submitted another statement reiterating that it was "clear that [he] was at MacDill AFB hospital on 4/30/1993 for a medical problem" and that he "went to the hospital to complain about redness on my face." The record he submitted demonstrates that he was in the hospital on April 30, 1993, but it does not specify for which condition. His service treatment records show, however, that he was hospitalized for nausea, vomiting, and diarrhea on April 30, 1993, not dermatitis. Thus, the Board does not find that this contention is credible as it is contradicted by the contemporaneous medical records. Further, the Board finds that this incorrect assertion demonstrates he is an unreliable history and, together with the Veteran's explicit denial of medical conditions and medications in treatment and other lack of evidence of a skin condition, weighs against his credibility generally. The Board therefore finds that his June 2008 contention is not credible either. The Board also reviewed his VA treatment records. Although VA treatment records show that he was prescribed skin medications in December 1998, the first available VA treatment record is dated September 1999. The RO conducted a search for earlier records, including in the paper archives, and issued a negative response in June 2021. Thus, the Board finds that all available VA treatment records are of record. In September 1999, he was assessed with recurrent seborrheic dermatitis. In January 2001, his record was updated to reflect that his dermatitis onset in August 1993, but the record does not reflect whether this update was made based on the Veteran's reports. In a February 2007 consultation, the Veteran reported that his dermatitis onset in 1992 or 1993. As discussed previously, the Board finds that the Veteran is not a reliable historian and does not find these self-made reports probative of onset. Thus, the Board finds that the Veteran's statements, service records, and post-service treatment records do not support his claim that his condition began in service. The Board further considered the 2013 and 2016 VA examiners' negative nexus opinions and afforded them great probative value because their respective findings included thorough medical rationales based on accurate reviews of the Veteran's pertinent medical history and relevant medical literature. Specifically, the 2013 VA examiner competently and persuasively found that the Veteran's current seborrheic dermatitis was less likely than not incurred in or caused by the claimed in-service injury or event, i.e., exposure to airplane soap. The 2013 VA examiner considered pertinent medical records, including a January 2001 VA emergency room note (indicating Veteran's report that his seborrheic dermatitis began in August 1993) and the September 1992 service treatment record summarized above (diagnosing transient bumps of the low lip and diagnosing allergic versus viral etiology). The examiner explained that the lesions noted during active duty did not appear to be seborrheic dermatitis based on cited medical literature describing the clinical manifestations of this specific skin condition. In addition, the cited medical literature explained that the exact pathogenesis of seborrheic dermatitis is unclear. Moreover, the 2016 VA examiner competently and persuasively concluded that the Veteran's current seborrheic dermatitis was less likely than not incurred in or caused by the claimed in-service injury or event, including specifically exposure to the chemical hydrazine sulfate. The examiner cited articles discussing the possible health effects of exposure to hydrazine sulfate and noted that this chemical can cause skin irritation; however, the examiner stressed that these are acute and transitory reactions, and the medical literature does not report that this chemical causes seborrheic dermatitis. Moreover, like the 2013 VA examiner, the 2016 VA examiner also reasoned that the skin condition described during active duty did not have the clinical picture of seborrheic dermatitis. In addition, the 2016 VA examiner noted that the Veteran's seborrheic dermatitis was diagnosed years after active duty. While the examiner incorrectly noted the date of diagnosis as 2001, the Board finds that this error is harmless as the earliest documentation of dermatitis is December 1998 (based on when skin medications were potentially prescribed), which is still years after discharge. While the examiners did not explicitly document review of the Veteran's lay statements submitted in June 2008, July 2009, and August 2011, it is clear from the examination reports that they considered the Veteran's statements regarding onset. Both examiners documented that they considered the entire claims file. The 2013 examiner noted, in the VA headaches examination conducted at the same time as the skin examination, that the Veteran reported his headaches began when he had redness and inflammation on his face in 1992. The 2013 examiner also considered the January 2001 VA record that noted the dermatitis onset in August 1993. Additionally, the 2016 examiner reviewed both the skin and headaches examination reports before issuing an opinion. Finally, the Board does not find that the examiners failure to explicitly document consideration of the 2008, 2009, and 2011 statements render their opinions inadequate because the Board has found that the contentions are not credible. The Board also considered the web articles that the Veteran submitted regarding dermatitis generally and the health effects of hydrazine sulfate, including a January 2000 article stating that hydrazine exposure "may produce" dermatitis from skin contact in humans. However, these general articles do not address his specific medical situation. Thus, they do not support a finding that his seborrheic dermatitis was incurred in service or otherwise related to any in-service event or injury. See Sacks v. West, 11 Vet. App. 314, 316-17 (1998) (holding that information contained within treatises is generally too abstract to prove the nexus element of a service-connection claim, although it is possible that a treatise might "discuss generic relationships with a degree of certainty" that would allow a finding of "plausible causality based upon objective facts."). Therefore, the Board affords more probative value to the 2013 and 2016 negative VA medical opinions summarized above, which competently and persuasively applied pertinent medical literature to the Veteran's specific medical history. Finally, the Court, in its August 2020 Memorandum Decision, stated that the Veteran "seemingly challenges the competency of the VA examiner" but as there was "no evidence or argument that [the Veteran] raised the issue of examiner competency before VA" the Court did not address the argument. The Veteran has not since challenged the VA examiners' competency to the Board; accordingly, there is no such argument to address. Accordingly, the Board finds that the competent and credible evidence show the Veteran's dermatitis did not begin in service and is otherwise unrelated to service, and the claim for service connection is denied. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Lavan 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.