Citation Nr: 21065223
Decision Date: 10/25/21	Archive Date: 10/25/21

DOCKET NO. 17-03 324
DATE: October 25, 2021

REMANDED

Service connection for a skin disorder of the bilateral hands.

REASONS FOR REMAND

In February 2020, the Board denied the Veteran's claim of service connection for a skin disorder.  The Veteran appealed to the Veterans Claims Court and in December 2020, the Court Clerk granted a Joint Motion for Remand (JMR) which vacated the Board's decision.  Subsequently in May 2021, the Board remanded the claim for further development in accordance with the JMR, to include obtaining a new VA examination to assess the nexus between each of his diagnosed skin disorders, including both dyshidrotic eczema and tinea manuum, and service. 

In June and July 2021, VA examiners opined that it was less likely than not that dyshidrotic eczema was incurred in or caused by an in-service incident, to include exposure to yellowcake uranium, explaining that medical literature did not establish a causal relationship between the disorder and either service in Southwest Asia or exposure to yellowcake uranium.  In so doing, the July 2021 examiner notably dismissed the Veteran's lay testimony as not constituting credible diagnosable medical evidence supporting a nexus to service.  

However, for purposes of eligibility for service connection, lay witnesses are competent to credibly report symptoms capable of lay observation such as cracking and peeling hands and in-service events such as exposure to yellowcake uranium incurred when inspecting shipping containers.  Moreover, the examiners failed to address the relationship between his tinea manuum and service.

As there was not compliance with the Board's prior instructions, further development is required.  

The matter is REMANDED for the following actions:

1. Identify and obtain any pertinent, outstanding private or VA treatment records not already of record and associate them with the claims file.

2. Direct the claims file to a clinician to determine the nature and etiology of the Veteran's skin disorder, to include dyshidrotic eczema and tinea manuum. 

Based on a review of the record, the clinician is asked to opine as to whether it is at least as likely as not (a 50 percent probability or greater) that:

(a.) dyshidrotic eczema is etiologically related to claimed in-service exposure to yellowcake uranium;

(b.) dyshidrotic eczema is otherwise etiologically related to service;

(c.) tinea manuum is etiologically related to claimed in-service exposure to yellowcake uranium; 

(d.) tinea manuum is otherwise etiologically related to service; and

(e.) any other skin disorder is etiologically related to service, to specifically include in-service exposure to yellowcake uranium. 

In forming the opinions, the clinician is asked to consider May 2010 and January 2013 treatment notes offering that the Veteran's skin disorder developed following in-service exposure to a mustard compound or uranium.  

The clinician is also asked to address the January 2017 and December 2019 lay statements and May 2019 testimony reporting that he experienced cracking and peeling hands while in service. 

The clinician is reminded that for purposes of eligibility for service connection, the Veteran is competent to report his service history and symptoms capable of lay observation and that, as such, his credible reports establish both in-service exposure to yellowcake uranium and in-service cracking and peeling hands.

The rationale for all opinions must be provided.

3. If the clinician determines that an examination is necessary in order to provide the requested opinions, then one should be scheduled.

 

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Spigelman, 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.