Citation Nr: 21063620 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 18-27 646 DATE: October 14, 2021 REMAND Entitlement to service connection for a skin disability is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1969 to May 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from the May 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). A Board video-conference hearing was held in May 2021 before the undersigned Veterans Law Judge; a transcript of the hearing has been associated with the record. The Veteran contends that his current skin disability is related to a rash on his lower extremities he experienced in service and the rash has continued since service. See May 2018 VA Form 9; May 2021 Hearing Transcript, pages 2-3, 6, 7. As an initial matter, the Veteran has been diagnosed with a current skin disability; specifically, dermatitis and eczematous dermatitis. The Board finds that an addendum medical opinion is required before adjudication on the merits. The Veteran was provided a VA examination in May 2015. In the accompanying opinion, the examiner noted the Veteran's report of onset of symptoms to his lower legs and arms since 1969 or 1970 during service in Vietnam and his current symptoms and treatment. Nonetheless, the examiner opined the skin disability was less likely than not incurred in or caused by the in-service illness as the Veteran's separation examination did not indicate a skin disability was present; the locations of the rash in service were inconsistent with the location of the current condition; and there was no evidence available of continued care from post-service to indicate continuity of care. The Board finds the May 2015 medical opinion to be inadequate. First, the examiner found the Veteran's skin disability impacted only his trunk and upper legs as indicated by the June 1969 service treatment record (STR) but failed to address the Veteran's lay statement that the in-service rash also appeared on his lower legs and arms. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). In the same vein, the examiner found there was no evidence of continuity of care but did not address the Veteran's lay statements that he continued to suffer from a skin disability after service and sought treatment, resulting in prescriptions for creams and other medications. Id. In addition, the Veteran noted that in the early 1970s he recalled meeting with a private dermatologist who told him that some skin disabilities could be related to exposure to Agent Orange. See Hearing Transcript, page 4-5. The Veteran voiced the same concern to a VA primary care physician. See September 2014 VA Initial Primary Care Nursing Note. However, the Board is unable to ascertain whether the Veteran had Vietnam service within the Vietnam era. His DD-214 reflects that he had foreign and/or sea service but does not specify to where. However, a Request for Information notes that veteran "completed Vietnam tour more than ninety days prior to EAOS." On remand, development should be undertaken to determine whether the Veteran had Vietnam service, to include while stationed aboard the U.S.S. Sanctuary. See Procopio v. Wilkie, 913 F.3d 1371 (Fed. Cir. 2019). The matter is REMANDED for the following action: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Undertake the necessary development to determine whether the Veteran had service in the Republic of Vietnam during the Vietnam era, to include whether the ship he was stationed aboard, the U.S.S. Sanctuary, was within the 12 nautical mile territorial sea of the Republic of Vietnam. 3. Regardless of whether Vietnam service is confirmed, forward the Veteran's claim file to a dermatologist, if available, for the purpose of obtaining an addendum medical opinion as to the nature and etiology of the Veteran's dermatitis and eczematous dermatitis. The claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. After a review of the claims file, the examiner is asked to respond to the following: (a) Provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's dermatitis and eczematous dermatitis had their onset during or is otherwise related to it. *In doing so, specifically consider the Veteran's lay statements regarding having had a rash on his lower legs in service in addition to the rash on the trunk and upper legs, and having had continuing skin rashes since service for which he received treatment. See May 2018 VA Form 9 and May 2021 Hearing Transcript. (b) If, and only if, the Veteran's service within 12 nautical miles of the Republic of Vietnam, or if his exposure to Agent Orange is verified, the examiner should also address whether his current skin disability, to include dermatitis and eczematous dermatitis, is related to exposure to Agent Orange. ** In doing so, the Board informs the examiner that it is not sufficient to provide a negative opinion based on the fact that a claimed condition is not listed among the presumptive conditions set forth in 38 C.F.R. § 3.309(e). A complete rationale for all proffered opinions must be provided. 4. Thereafter, readjudicate the remanded claim. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Moldawer, 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.