Citation Nr: 21067461 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 15-08 614 DATE: November 4, 2021 REMANDED Entitlement to an initial disability rating in excess of 30 percent for tinea versicolor of the face, back, head and both flanks with tinea cruris of the groin prior to April 9, 2021, and in excess of 60 percent thereafter is remanded. REASONS FOR REMAND The Veteran had active duty service from February 1984 to February 2008. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) in March 2013. The RO, in relevant part, continued a noncompensable disability rating for the Veteran's service-connected tinea versicolor. By way of history, the RO granted service connection for tinea versicolor of the face, back, head, and both flanks in a November 2008 rating decision and assigned an initial noncompensable disability rating, effective March 1, 2008. The Veteran filed an increased rating claim in February 2009, and his claim was denied in a December 2009 rating decision. He again filed another increased rating claim in June 2010, which was denied in December 2010. These matters were before the Board in November 2018 and April 2021, at which time they were remanded for further evidentiary development. In its April 2021 decision, the Board found that the November 2008, December 2009, and December 2010 rating decisions did not become final because the Veteran had submitted new and material evidence in the year following each rating decision. Therefore, the entire rating period remains on appeal. In an April 2021 rating decision, the RO increased the disability rating for the Veteran's service-connected tinea versicolor from 30 percent to 60 percent, effective April 9, 2021. In an August 2021 rating decision, the RO granted an initial disability rating of 30 percent for the Veteran's tinea versicolor. Thus, his disability is currently rated at 30 percent disabling for the period prior to April 9, 2021 and at 60 percent disabling from April 9, 2021. Entitlement to an initial disability rating in excess of 30 percent for tinea versicolor of the face, back, head and both flanks with tinea cruris of the groin, for the period prior to April 9, 2021, is remanded. When VA undertakes the effort to provide an examination, the examination must be adequate. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board finds that the VA examinations of record are insufficient to determine whether the Veteran is entitled to an initial disability rating in excess of 30 percent for his service-connected tinea versicolor. The Veteran has submitted photographs dated in 2008, 2009, 2013, 2014, January 2020, and October 2020, which show the areas of his body affected by tinea versicolor. In this regard, none of the examiners discussed the Veteran's photographs in detail. The Veteran underwent an initial VA examination in September 2011. The examiner noted that less than five percent of the Veteran's total body area was affected by tinea versicolor. In correspondence dated in May 2013, the Veteran stated that his tinea versicolor had partially cleared up, due to the use of medication, at the time of his examination. The Veteran underwent subsequent VA examinations in November 2014, April 2016, November 2020, and April 2021, with an additional phone examination in June 2020. The April 2016 examination report indicates that the Veteran brought photos of his skin during a breakout, which the examiner stated looked like tinea corporis. The June 2020 phone examination report states that the examiner reviewed photographs in VBMS, but that the photos were taken years before the examination. The September 2011, November 2014, November 2020, and April 2021 VA examinations do not indicate that any of the Veteran's submitted photographs were reviewed. Specifically, no examiner has opined as to the percentage of the Veteran's body area affected by tinea versicolor, as shown in each set of photographs. Given the Veteran's assertion that his skin disability has periods of breaking out and clearing up, these photographs may provide a more accurate estimation of his disability throughout the rating period on appeal. Therefore, a remand is warranted to obtain an opinion as to the percentage of the Veteran's total and exposed body area affected by tinea versicolor, as shown in the 2008, 2009, 2013, 2014, January 2020, and October 2020 photographs. The matter is REMANDED for the following action: Schedule the Veteran for an examination by the examiner who conducted the April 2021 VA skin examination or, if unavailable, then another similarly qualified examiner may respond instead. The entire claims folder, including a copy of this remand, must be made available for review by the examiner, and such review should be noted in the examination report. The examiner is asked to review the photographs submitted by the Veteran, dated in 2008, 2009, 2013, 2014, January 2020, and October 2020, as well as the Veteran's lay statements regarding the areas of his body impacted during flare-ups. For each set of photographs, the examiner should opine as to what percentage of the Veteran's total body area and exposed body area was affected by his service-connected tinea versicolor. The examiner is asked to provide a separate opinion for each set of photographs. The examiner must provide a comprehensive rationale for each proffered opinion. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. If any opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner does not have the knowledge or training. As appropriate, the AOJ should conduct additional development or supplement the record. Marissa Caylor Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Pratt 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.