Citation Nr: 21069312 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 14-20 092A DATE: November 18, 2021 REMANDED Entitlement to service connection for a skin condition, to include as secondary to herbicide exposure and/or various chemical exposures is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1969 to January 1972. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) in December 2017. A transcript of the hearing is associated with the electronic claims file. The Board issued two prior remands on this claim in March 2018 and February 2021. 1. Entitlement to service connection for a skin condition, to include as secondary to herbicide exposure and/or various chemical exposures is remanded. The Veteran first made an informal request for service connection for a skin condition in January 2012. In a May 2012 statement in support of this claim, the Veteran wrote "Immediately after service I reported these conditions and it is located in my claims file." A review of the Veteran's service treatment records shows that in March 1971 he complained of an unexplained rash on both hands and lower extremities for three months. At the time the examiner noted the Veteran's time in Thailand. VA treatment records show that in September 2011 the Veteran had an initial visit and complained of pruritic rash on his whole body for several weeks. At the time he was diagnosed with scabies and prescribed Elimite cream. At a follow up in October 2011, the Veteran reported no improvement of his rash after using the prescribed cream and indicated that he had the rash for the past six months. This time he was diagnosed with allergic dermatitis and prescribed additional medication and cream. By December 2011 the Veteran was still only reporting mild relief from the prescribed medication and had a dermatology consult. Treatment notes show that the Veteran had been homeless but was able to wash all of his clothing and shower several times per week. He reported no dermatology history and had no systemic complaints or other skin complaints. This time the Veteran was diagnosed with an unspecified rash including allergic contact dermatitis (likely gold), Id reaction, nummular dermatitis, and seborrheic dermatitis. The dermatologist noted that the Veteran's history and physical was not congruent for scabies, body lice, drug reaction, or infections etiology. In the February 2021 remand, the Board instructed the RO to update the electronic file, undertake appropriate efforts to determine whether the Veteran was exposed to herbicides during his military service, and provide the Veteran with a VA examination for his skin condition, wherein an opinion regarding its etiology was rendered. The Board notes that the record does not show that the RO made any efforts to determine whether the Veteran was exposed to herbicides during his military service, including through his military occupational specialty as a mechanic. As such, remand is warranted. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding remand by the Board confers on the claimant the right to compliance with the remand requests). Moreover, the September 2021 VA examiner opined that the Veteran's current skin condition was less likely than not related to his service providing in part as rationale "There were no medical records to support claim that this condition is related to service." However, as noted above, the Veteran did complain of an unspecified rash during his active service and his service in Thailand was noted by the examiner. The Board regrets further delay in deciding this claim however the September 2021 VA examiner's opinion was inadequate. Accordingly, the claim must be remanded to obtain another opinion. Id. The matters are REMANDED for the following action: 1. Update the electronic file with any new VA treatment records and private treatment records. 2. Undertake appropriate efforts to determine whether the Veteran was exposed to herbicides during his military service. 3. Obtain an addendum opinion regarding the Veteran's skin condition and its etiology. The entire record should be reviewed by the examiner and note that such review was completed should be provided in the examiner's report. The examiner should answer the following question: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's current skin condition(s) is/are casually or etiologically related to his active service, to include possible herbicide exposure and/or other various chemical exposures from working as a mechanic? In formulating an opinion, the examiner should specifically consider and address: (1) the Veteran's March 1971 service treatment records wherein he complained of a rash; and (2) VA treatment records regarding the Veteran's complaint of a rash. A detailed rationale for the opinion must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Ruiz, 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.