Citation Nr: 21067015 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 20-04 290 DATE: November 3, 2021 REMANDED Entitlement to service connection for a skin disability, claimed as chloracne, to include as due to herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1966 to June 1968. He testified at a videoconference hearing before the undersigned in July 2021. A transcript is of record. Entitlement to service connection for a skin disability, claimed as chloracne, to include as due to herbicide agent exposure, is remanded. The Veteran asserts that he has a skin disability that is due to his exposure to herbicide agents while serving in the Republic of Vietnam. In the alternative, the Veteran contends that his skin disability is due to sun exposure during service. The Veteran has been variously diagnosed with acne and cystic lesions of the skin, actinic keratosis, verruca vulgaris, cherry angiomas, and seborrheic keratoses. See June 2017 VA Dermatology Consult; June 2017 Dr. K.V. Dermatology Consult Notes. Additionally, during his July 2021 Board hearing, the Veteran indicated that he had been diagnosed with chloracne by a VA physician in 2017. While the Veteran is competent to report a diagnosis made by a health professional, the Board notes that the Veteran's VA treatment records are silent for a diagnosis of chloracne. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (a layperson is competent to report a contemporaneous medical diagnosis). Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in disability compensation (service connection) claims, VA must provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for VA to make a decision on the claim. In this case, service treatment records indicate that the Veteran was treated for a possible heat rash in July 1967 and prescribed bacitracin ointment. During his July 2021 Board hearing, the Veteran testified that he has had ongoing skin issues following service that continued to the present; and June 2017 VA and private treatment records indicate variously diagnosed skin disabilities. Prior to denying the claim, the agency of original jurisdiction should have afforded the Veteran a VA examination and obtained a medical opinion addressing the nature and etiology of the Veteran's claimed skin disability. Remand is warranted. The matters are REMANDED for the following action: 1. Schedule the Veteran for a skin examination to assess the nature and etiology of his skin disability (claimed as chloracne). The claims folder must be made available to and reviewed by the examiner. The examiner should take a history from the Veteran as to the progression of the claimed disability. Upon review of the file, the examiner is asked to respond to the following: (a.) Identify all currently diagnosed skin disabilities. The examiner should specifically indicate whether the Veteran currently has chloracne, or whether he had chloracne during the appeal period (i.e., since February 2018) but such resolved. (b.) For each identified disability, is it at least as likely as not (i.e., 50 percent or greater probability) that the disability had onset in, or is otherwise related to the Veteran's period of active-duty service, to specifically include exposure to herbicide agents and/or sun exposure while serving in the Republic of Vietnam? The examiner is advised that a negative opinion cannot be based solely on the fact that a specific disease is not on the list of diseases that are presumptively associated with exposure to herbicide agents. In answering the above questions, the examiner should consider and comment on the Veteran's in-service treatment for suspected heat rash in July 1967, his competent lay statements that he has experienced the same skin issues since service, and his testimony that a VA physician diagnosed him with chloracne in 2017. All opinions should be supported by a medical explanation or rationale. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Bristow Williams, 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.