Citation Nr: 21062964 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 18-23 150 DATE: October 12, 2021 ORDER Entitlement to service connection for a skin condition to include blepharitis of both eyes, seborrheic dermatitis, acne vulgaris, and post-inflammatory hyperpigmentation is denied. FINDING OF FACT The preponderance of the evidence is against finding that skin condition to include blepharitis of both eyes, seborrheic dermatitis, acne vulgaris, and post-inflammatory hyperpigmentation began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a skin condition to include blepharitis of both eyes, seborrheic dermatitis, acne vulgaris, and post-inflammatory hyperpigmentation have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the Air Force from July 2002 to July 2006, from May 2010 to September 2010, and from November 2010 to September 2011. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a video conference hearing in January 2020. A transcript of the proceeding has been associated with the claims file. The Board remanded the Veteran's claim in a May 2020 decision for a VA examination and additional medical records. The Veteran was sent a Subsequent Development Letter in May 2020 and July 2020 affording him the opportunity to submit a completed VA Form 21-4142 for the RO to obtain additional medical records. However, the Veteran never responded to the letters. A VA examination was completed in November 2020. Thus, the Board finds that the RO has substantially complied with the May 2020 Board remand directive. See Stegall v. West, 11 Vet. App. 268 (1998). Additionally, the Veteran's claims of service connection for sinusitis and a back condition were also remanded by the Board in May 2020. However, in a February 2021 rating decision, the RO granted service connection for both sinusitis and degenerative arthritis of the spine. This is considered a full grant of benefits sought and are not included in the current appeal before the Board. Entitlement to service connection for a skin condition to include blepharitis of both eyes, seborrheic dermatitis, acne vulgaris, and post-inflammatory hyperpigmentation The Veteran contends that he currently experiences dryness, flakiness, and swelling of the eyelids and skin which began in service. Generally, service connection may be established if the evidence demonstrates that a current disability resulted from a disease or injury incurred in or aggravated by active duty service. 38 C.F.R. § 3.303. To that end, service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to the period of service, establishes the disease was incurred during active duty service. 38 C.F.R. § 3.303 (d). In order to prove service connection, there must be competent and credible evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus or link between the current disability and the in service disease or injury. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Veteran's service treatment records include a May 2011 diagnosis of blepharitis of both eyes. He was advised to treat the condition with a hot compress. The Veteran's service treatment records do not include any other diagnoses of or treatment for any other skin conditions. The Veteran's VA treatment records contain a November 2013 primary care note where the Veteran complained of spots on his face and hyperpigmentation on his arms. He stated that he visited with an outside dermatologist who diagnosed him with tinea versicolor and gave him a steroid shot and prescribed him a topical steroid with minimal relief. The VA doctor referred the Veteran to dermatology. During his February 2014 dermatology consultation, the Veteran complained of dark areas to his face and a scaly, itchy area on his arms. He stated that over the summer, he developed dark areas around his eyes that later scaled and itched. The Veteran denied a history of allergies or asthma but noted having skin problems as a child. The Veteran was diagnosed with "likely atopic dermatitis" and prescribed desonide for the Veteran's face during flare-ups. The Veteran's VA treatment records do not contain any further complaints of or treatment for a skin condition. The Veteran provided private dermatology records in March 2020. The records contained an October 2013 consultation for examination and treatment of scaly brown or white macules on the Veteran's body. The Veteran noted that the condition had been present for months and is worse in the summer. The dermatologist noted that the Veteran's past medical history is negative for skin disease. The Veteran was assessed with tinea versicolor, facial dermatitis, post-inflammatory hyperpigmentation, and pruritus. In April 2015, the Veteran was also assessed with acne vulgaris. In October 2017, he was assessed with seborrheic dermatitis on his face. The Veteran has received ongoing treatment for his conditions through December 2019. The Veteran was afforded a VA examination in November 2020. The Veteran was diagnosed with seborrheic dermatitis located on his thighs. The examiner opined that the Veteran's claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided was that the Veteran's April 2011 military physical noted that the Veteran's skin was within normal limits and there is no evidence to support a finding that the Veteran's current diagnosis is due to his May 2011 diagnosis of blepharitis of the eyes. During the January 2020 Board hearing testimony, the Veteran testified that he experiences dryness, flakiness, and swelling of the eyelids beginning in 2002 and 2003. He stated that he used over the counter medications. He further testified that he saw a doctor in 2011 while on active duty who diagnosed the Veteran with blepharitis. The Veteran stated he was given ointments and creams and currently sees a dermatologist. After careful consideration of the evidence of record, the Board finds that the preponderance of the evidence is against finding that the Veteran's currently diagnosed skin condition is at least as likely as not related to his service, including the May 2011 diagnoses of blepharitis of the eyes. The Board finds that the Veteran's service treatment records note a diagnosis of blepharitis in May 2011 with hot compresses recommended for treatment. However, his records are negative for any further treatment until after his separation from service in October 2013. In October 2013, the Veteran's dermatologist diagnosed the Veteran with tinea versicolor, facial dermatitis, post-inflammatory hyperpigmentation, and pruritus on his face. The dermatologist did not note that the condition was on the Veteran's eyes as diagnosed in service. Further, the treatment records note that the Veteran's symptoms had been present for months rather than since the Veteran was in service. The Veteran's VA treatment records include additional diagnoses of skin conditions, but at no time do the physicians attribute the conditions to the Veteran's service and at no time does the Veteran indicate that his conditions are related to his service. Additionally, the November 2020 VA examiner diagnosed the Veteran with seborrheic dermatitis and found that it was less likely than not related to his service or his in-service diagnosis of blepharitis. The Board has considered the Veteran's contentions that his skin condition is related to his service. As a lay person, however, the Veteran has not shown that he has specialized training sufficient to render such an opinion or diagnosis. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). Consequently, the Board affords more probative value to the negative medical opinion of record. Moreover, the Board has considered the Veteran's January 2020 Board testimony that symptoms of his skin condition started in service. Although the Veteran is competent to report his symptoms, the Board finds that the evidence does not corroborate the Veteran's testimony. Specifically, the Veteran did not state that his symptoms started during his military service when first seeking treatment with his dermatologist in October 2013 or with the VA primary care physician in November 2013. He contended that the symptoms started months prior rather than years prior. Thus, the Board affords more probative value to the Veteran's statements made for the purpose of treatment. See Rucker v. Brown, 10 Vet. App. 67, 73 (1997) (statements made to physicians for purposes of diagnosis and treatment are exceptionally trustworthy because the declarant has a strong motive to tell the truth in order to receive proper care); Curry v. Brown, 7 Vet. App. 59, 68 (1994) (contemporaneous evidence has greater probative value than history as reported by the Veteran). Accordingly, the Board finds that entitlement to service connection for a skin condition is not warranted. In reaching the above decision, the Board considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the Veteran's claim, the doctrine does not apply. Gilbert, 1 Vet. App. at 54; 38 U.S.C. § 5107; 38 C.F.R. § 3.102. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hartford, 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.