Citation Nr: 21070240 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 18-27 391 DATE: November 23, 2021 REMANDED Entitlement to service connection for a skin disability, to include as due to herbicide exposure. REASONS FOR REMAND The Veteran had active naval service from April 1964 to August 1967, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2021, the Veteran testified before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. This case was previously before the Board in April 2021, at which time the issue on appeal was remanded for additional development. The matter has since been returned to the Board for further appellate action. The Veteran has contended that his skin disability is secondary to his in-service exposure to herbicides. Specifically, he reported that he received treatment for an itchy skin rash while serving in Guam in 1965. He described a reoccurring skin rash primarily on his chest, which usually appeared in early spring and/or conditions with heat/moisture and lasted for a few weeks. In the April 2021 remand, the Board directed that the Veteran be afforded a VA examination to determine the nature and etiology of any currently present skin disability. A review of the record shows that in June 2021, the Veteran was afforded a VA examination. The examiner diagnosed the Veteran with eczema. In an August 2021 addendum medical opinion, a VA examiner pointed out that the Veteran's eczema diagnosis had not been confirmed by a dermatologist. Based on the Veteran's described symptoms, the August 2021 VA examiner found that the Veteran's skin condition was not chronic, to specifically include eczema. The August 2021 VA examiner proposed a new diagnosis of polymorphic light eruption. However, the medical literature did not support a causal nexus between polymorphic light eruption and herbicide exposure. The Board finds that the development conducted does not adequately comply with the April 2021 Board remand directives. Specifically, the Veteran's skin disability was not diagnosed by a VA examiner with the appropriate expertise. The Board notes that compliance with a remand is not discretionary, and failure to comply with the terms of a remand necessitates remand for corrective action. Stegall v. West, 11 Vet. App. 268 (1998). Accordingly, the Veteran should be provided a new VA examination to determine the nature and etiology of any currently present skin disability. The matter is REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination by a dermatologist or an examiner with sufficient expertise to determine the nature and etiology of any currently present skin disability. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and the review of the record, the examiner should first identify all skin disabilities present during the pendency of the claim, or proximate thereto. Then, for each skin disability identified, even if currently resolved, the examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent or better probability) that the skin disability had its onset during the Veteran's active service or is otherwise etiologically related to such service, to specifically include exposure to herbicides while serving in the Republic of Vietnam. In forming the opinion, the examiner should consider the Veteran's reported symptoms since service. The rationale for all opinions expressed must be provided. 3. Confirm that any VA examination and medical opinions provided comport with this remand and undertake any other development determined to be warranted. (Continued on the next page) 4. Then, readjudicate the appeal. If the decision remains adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Ware, 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.