Citation Nr: 21064897 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-40 448 DATE: October 21, 2021 REMANDED Service connection for a skin disorder, to include basal cell carcinoma, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1976 to December 1981. In December 2019, the Board of Veterans Appeals (Board) remanded this appeal for further evidentiary development. Regrettably, for the reasons discussed below, the Board finds that there has not been substantial compliance with all of the December 2019 remand directives. Thus, an additional remand is necessary. In accordance with the December 2019 remand, an addendum VA opinion was obtained in March 2020 regarding the etiology of the Veteran's skin disorder. The December 2019 remand directives included specific instructions that the examiner discuss the significance of the Veteran's assertion that she was severely sunburned on her face and arms, in addition to her legs, at the time of her July 1979 hospitalization. The remand also specified that the examiner discuss any significance of a small papilloma on the external surface of the Veteran's right ear which was discovered by a VA examiner in October 1984. Unfortunately, the examiner only addressed the Veteran's 1979 lower extremity sunburn in his opinion and failed to address both the Veteran's assertion regarding her face and arm sunburn in 1979 as well as the papilloma of her right ear discovered in 1984. A remand by the Board confers on the claimant a legal right to compliance with the remand order. Stegall v. West, 11 Vet. App. 268, 271 (1998). Compliance with a remand is neither optional nor discretionary, and failure to comply with the terms of a remand necessitates remand for corrective action. Id. Substantial compliance with the remand order, not strict compliance, is required. Donnellan v. Shinseki, 24 Vet. App. 167, 176 (2010); Dyment v. West, 13 Vet. App. 141, 147 (1990). The Board's failure to ensure compliance with remand instructions constitutes error and warrants the vacating of a subsequent Board decision. Stegall, 11 Vet. App. at 271. The Board sincerely regrets the delay associated with another remand but finds that this remand is necessary to ensure substantial compliance with the Board's prior remand order. Accordingly, this matter is REMANDED for the following action: Schedule the Veteran for an appropriate VA examination to determine the nature, extent, and etiology of her skin disorder, to include basal cell carcinoma of the face and arms. Her electronic claims file must be accessible for review by the examiner in conjunction with this examination, and the examiner should acknowledge such review in the examination report. A complete history from the Veteran should be obtained and recorded. All testing deemed necessary by the examiner should be performed, and the results should be reported in detail. Following the review of the claims file and examination of the Veteran, the examiner is then asked to opine whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's skin disorder, to include basal cell carcinoma of the face and arms, onset during or is otherwise etiologically related to, her active service? Why or why not? The Veteran is competent to report her symptoms and history; such reports must be acknowledged and considered in formulating any opinion. The examiner should provide a reason for discounting of the Veteran's description of her dermatological symptoms and history. Specifically, the examiner must discuss the Veteran's assertion that she was severely sunburned on her face and arms, in addition to her legs, at the time of her July 1979 hospitalization. The examiner must also discuss any significance of a small papilloma on the external surface of the Veteran's right ear that was discovered by a VA examiner in October 1984. A clear rationale for all requested opinions shall be provided. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why. No action is required of the Veteran until she is notified by VA. However, she is advised of her obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). Her failure to report for any VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran is also advised that she has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Benson, 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.