Citation Nr: 21070302 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 16-32 989 DATE: November 23, 2021 REMANDED Entitlement to service connection for a body rash is remanded. Entitlement to an increased rating in excess of 60 percent for chronic bronchitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 1966 to April 1970. The Board of Veterans' Appeals (Board) most recently remanded these issues in July 2020. It was previously remanded to the Board from the Court of Appeals for Veterans Claims (Court) in an April 2020 Order. The Veteran's records indicate that he has been diagnosed with prostate cancer. Prostate cancer is a presumptive condition for which service connection may be presumed for Veterans exposed to Agent Orange. The Veteran has not claimed service connection for prostate cancer, however, and the Board cannot grant service connection in the absence of a claim. If the Veteran wishes to explore service connection for his prostate cancer, he is encouraged to file a claim. 1. Entitlement to service connection for a body rash is remanded VA examined the Veteran in December 2019. The examiner opined that dermatitis and tinea cruris were not "skin conditions that have been accepted as presumptive to herbicide exposure." This is an inadequate rationale. It is possible for a non-presumptive condition to be caused by exposure to herbicides. The examiner may consider the research done as part of VA's determination of the list of presumptive conditions as part of his or her rationale but may not rely solely on VA's final list. See Polovick v. Shinseki, 23 Vet.App. 48, 52-53 (2009). An addendum opinion is required. 2. Entitlement to an increased rating in excess of 60 percent for chronic bronchitis is remanded. Following the Board's previous remand, the Agency of Original Jurisdiction increased the Veteran's rating from 30 percent to 60 percent. A higher rating is still available, so this increase has not mooted the claim. VA examined the Veteran after remand in April 2021. The examiner did not conduct a Diffusion Capacity of the Lung for Carbon Monoxide by Single Breath Method (DLCO (SB)) test. Not including this test can be acceptable under 38 C.F.R. § 4.96(d)(2) but requires the examiner to state that the test would not be useful or valid. Here, however, the examiner stated that a DLCO test was unavailable. Remand is warranted to correct this error. This is especially true where, as here, the Veteran's FEV-1 value of 42% is close to the 40% level that distinguishes the 60 and 100 percent evaluation criteria. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's skin rash is at least as likely as not related to presumed in-service herbicide agent exposure. The examiner may not rely solely on the absence of the condition from the list of presumptive conditions but must rather explain in terms of the Veteran's specific circumstances why the skin rash is or is not at least as likely as not related to herbicide exposure. A rationale for all requested opinions shall be provided. Reference to findings from identified studies is preferred over reference to medical literature in the abstract. If the examiner relies on his or her medical experience as a rationale, it is appropriate to identify specifics such as an estimate of the number of patients the examiner has seen with similar conditions, the time the examiner has been practicing in the field, or any relevant specialized education or training experiences that go beyond the examiner's degree or accreditation. If the examiner determines that an opinion cannot be rendered without result to mere speculation, then it should be clear in the examiner's remarks whether it cannot be determined from current medical authority or if an opinion could be rendered if additional facts were known. If additional facts are needed, the examiner shall state what facts, if known, would impact his or her ability to render an opinion and how. Simply stating that an opinion cannot be provided without resort to mere speculation is not acceptable without a detailed reason as to why this is so. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected chronic bronchitis. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. In doing so, the examiner must conduct a Diffusion Capacity of the Lung for Carbon Monoxide by Single Breath Method unless he or she finds that the test would not be useful or valid for the Veteran. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Saindon, 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.