Citation Nr: 21064187 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 16-31 184 DATE: October 19, 2021 REMANDED Entitlement to service connection for a skin disorder, to include as due to herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1964 to August 1966 to include approximately a year of service in Vietnam. The matter come before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision of the St. Petersburg, Florida, Regional Office (RO) of the Department of Veterans Affairs (VA). In a November 2018 decision, the Board denied, inter alia, the claim of entitlement to service connection for skin disorder. The Veteran appealed this determination to the Court of Appeals for Veterans Claims (CAVC) which granted a partial Joint Motion for Partial Remand (JMPR) in October 2019. In April 2020, the Board remanded the claim for compliance with the terms of the JMPR. In an October 2020 decision, the Board denied, inter alia, the claim of entitlement to service connection for skin disorder to include as due to herbicide agent exposure. The Veteran appealed this determination to the CAVC which granted a JMPR in June 2021 and remanded the claim to the Board. The matter is again before the Board. Entitlement to service connection for a skin disorder, to include as due to herbicide agent exposure is remanded. A new VA examination with opinion must be obtained to comply with the June 2021 JMPR, as the parties to the JMPR deemed the examination record inadequate. It was noted that a March/April 1997 VA examination reflected the Veteran's report of a history of skin rash since service in Vietnam that never resolved. While the July 2020 VA examination listed the 1997 VA examination as part of the medical records reviewed, and noted the Veteran's statement that symptoms had existed since 1966 in the Medical History portion of the examination, the July 2020 VA examiner did not make any findings that addressed Veteran's lay statements pertaining to symptomatology since 1966. An examination that specifically addresses the Veteran's lay contentions that he had a history of skin rash since service in Vietnam that has never resolved was deemed warranted by the parties to the 2021 JMPR. Also, the JMPR characterizes the July 2020 examination as unclear inasmuch as the examiner (1) stated that fungal skin infections are known to cause hyperpigmentation of the skin, which may be irreversible; (2) found that the Veteran's current dermatitis causes hyperpigmented patches and slight pinkish areas; (3) opined that there is no indication that that diagnosed heat rash or jock rash in service would contribute to the development of psoriasis or atopic dermatitis, and (4) noted that the Veteran has stated he has had hyperpigmentation since service. Accordingly, on remand, a VA examiner must address the Veteran's statements that he had hyperpigmentation in service, opine as to whether the Veteran has hyperpigmentation currently, and opine as to whether there is any relationship between his in-service symptomatology and current diagnoses. We note that the Veteran has been diagnosed with psoriasis during the appeal period and there is evidence of skin rash in service inasmuch as service treatment records (STRs) show a May 26, 1966 visit to sick call for heat rash all over body and between the legs, a May 30, 1966 visit for heat rash between legs and on arms, and June 1966 visits for jock rash. There had been a report of a boil in September 1964. However, the August 1966 separation Report of Medical Examination was silent for complaints or diagnosis of rash or other skin condition. Finally, the Board notes that the Veteran does not allege, and the evidence does not reflect, that the disability for which he claims entitlement to service connection is the result of participation in combat with the enemy. His DD form 214 reflects he was a heavy vehicle driver, and that his awards and decorations include Marksman (Rifle M-14), National Defense Service Medal and Viet-Nam Service Medal. Therefore, the combat provisions of 38 U.S.C. § 1154 are not applicable. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any skin disorder, to include psoriasis. The examiner must review the claims file. The examiner must opine whether any currently diagnosed skin disorder, to include psoriasis is at least as likely as not, (a 50 percent probability or greater) related to an in-service injury, event, or disease, including in-service exposure to herbicide agents. (a) The examiner must specifically address the Veteran's lay contentions that he had a history of skin rash since service in Vietnam that has never resolved. (b) Also, referencing the July 2020 VA examiner's observations (as required in the JMPR) with regard to fungal infections and hyperpigmentation, the examiner should address the Veteran's statements that he had hyperpigmentation in service, determine whether the Veteran has hyperpigmentation currently, and opine as to whether it is at least as likely as not that there is any relationship between his in-service symptomatology and current diagnoses. The examination report must include a complete rationale for the opinion provided. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Rippel, 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.