Citation Nr: 21064394 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 12-06 294 DATE: October 20, 2021 REMANDED Entitlement to a rating in excess of 30 percent for pseudofolliculitis barbae (PFB) and tinea versicolor is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1976 to December 1978. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in April 2019. A transcript of the hearing is of record. This matter was previously before the Board in September 2019 and January 2021 when it was remanded for further development. A May 2021 rating decision granted service connection for urticaria (claimed as hives). As the decision constitutes a full grant of the claim previously before the Board, the matter is no longer before the Board and will not be discussed further. Entitlement to a rating in excess of 30 percent for PFB and tinea versicolor is remanded. Although the additional delay is regrettable, the Board finds an additional remand is required before a decision can be made on the Veteran's claim. In the January 2021 Board remand, the Board directed the Agency of Original Jurisdiction (AOJ) to schedule the Veteran for a VA examination to assess the current severity of his PFB and tinea versicolor. To the extent possible, the AOJ was asked to schedule the Veteran during an active stage of his skin conditions. The VA examiner was asked to specify all symptoms and functional impairment associated with the Veteran's conditions and to report the nature and severity of symptomatology in detail. Specifically, the examiner was asked to provide clinical findings as to the percentage of the total body area and exposed areas affected by the Veteran's conditions. (If the examination was conducted during an inactive stage, the examiner was asked to provide separate percentages based on a review of the record and the Veteran's description of his symptoms.) Additionally, the examiner was asked to indicate whether the Veteran's conditions required treatment with systemic therapy, such as corticosteroids or other immunosuppressive drugs, and identify the total duration of such treatment. In May 2021, the Veteran underwent the requested VA examination. On the examination report, the examiner noted, "the current symptoms are none until it starts, first starts with itching." The examiner also noted that the Veteran currently treated his condition with Benadryl and that itching caused by his condition affected his sleep. However, it is unclear from the examination whether the Benadryl was used to treat PFB and tinea versicolor or his urticaria, which was also a subject of the examination. The examiner indicated that less than five percent of the Veteran's total body area and none of the Veteran's exposed area were affected by his tinea versicolor and less than five percent of his total and exposed body area were affected by his PFB. The examiner noted that the Veteran's PFB was located over his beard area with hyperpigmentation and papules along the base of the neck. As for the tinea versicolor, the examiner noted that it was located over the mid back with macular hyperpigmented circular lesions scattered in nature. In May 2021, the AOJ requested clarification from the May 2021 VA examiner as it was unclear whether the examination was completed during an inactive stage, so as to require the requested separate percentages of total and exposed body area affected. In a May 2021 response, the examiner indicated that the Veteran's PFB and tinea versicolor were active during the examination and that the percentages provided were during an active stage. While the examiner reported that the examination was conducted during an active stage, the Board finds the response inconsistent with findings reported on the May 2021 examination report. Specifically, the examiner's notation that, "the current symptoms are none until it starts, first starts with itching," seems to indicate the Veteran's conditions were in an inactive stage during the examination. In light of this and since the examiner did not provide separate percentages of total and exposed body areas affected during active stages, the Board finds remand for a new VA examination is required. The matter is REMANDED for the following action: 1. Obtain any updated VA treatment records for the period from May 2021 to the present. After obtaining any additional records, schedule the Veteran with a VA examiner other than the May 2021 examiner for evaluation of his service-connected pseudofolliculitis barbae and tinea versicolor. To the extent possible, attempt to schedule the examination during an active stage of the Veteran's disability since skin conditions by their very nature tend to have active versus inactive periods. The electronic claims file, including this remand, must be made available to the examiner for review in connection with the examination. All indicated tests should be conducted, and the reports of any such studies incorporated into the examination reports to be associated with the claims file. The examiner should specify all symptoms and functional impairment associated with the Veteran's service-connected pseudofolliculitis barbae and tinea versicolor only. The nature and severity of such symptomatology should be described in detail. The examiner should also render specific clinical findings as to the percentage of the total area of the body affected by the service-connected disability, as well as the percentage of the exposed areas affected. If the examination must take place during an inactive period, separate percentages based on a review of the record and the Veteran's description of his symptoms during a period of exacerbation or flare-ups should be provided. Additionally, the examiner should indicate whether the Veteran's service-connected skin disability requires treatment with systemic therapy, such as corticosteroids or other immunosuppressive drugs, and should identify the total duration of such required treatment during the relevant period. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.