Citation Nr: 21070763 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 10-00 469 DATE: November 26, 2021 REMANDED Entitlement to service connection for a skin disorder, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1969 to March 1971 and from September 1974 to July 1976, to include service in the Republic of Vietnam. The matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2015, the Board remanded the matter for the issuance of a statement of the case (SOC), pursuant to Manlincon v. West, 12 Vet. App. 238 (1999). The Board notes that the Veteran was scheduled for a Board hearing in April 2021. However, in an April 2021 correspondence, the Veteran withdrew his request for a Board hearing. The Board again remanded the matter for further development in May 2021. The Veteran contends that his skin disorder is secondary to his conceded in-service herbicide exposure. Pursuant to the Board's May 2021 remand directives, the Veteran was afforded a VA examination in July 2021, in which he was diagnosed with lichen simplex. The Veteran reported that he started having dry, scaly rashes to the bilateral upper extremities in 1977. He also reported that his rashes are intermittent and when they heal the areas become hypopigmented. The examiner opined that the Veteran's skin condition was less likely than not incurred in or caused by service. The examiner noted that the Veteran's service treatment records (STRs) noted treatment for cystic acne on his back in June 1969 and treatment for a skin rash on his face in December 1969; no further follow-up treatment was noted in service. The examiner further noted that the Veteran was diagnosed and treated for lichen simplex in 2013 and 2017 and that the Veteran reported that his skin condition began after he helped his brother move. The examiner concluded that the Veteran's current skin condition, lichen simplex, was diagnosed post military service and is not one of the conditions listed as being related to the long-term effects of Agent Orange exposure. The Board finds that the July 2021 VA examiner's rationale is not adequate, as the basis for the opinion appears to be that because lichen simplex is not a presumptive condition, service connection is not permitted. A rationale that simply notes that the condition is not a presumptive disease is not an adequate medical opinion. Additionally, the Board notes that the Veteran was diagnosed and treated for lichen simplex in November 2012 and a September 2013 dermatology consultation noted lichen simplex chronicus on the arms and legs for more than 30 years. Therefore, remand is warranted in order to obtain an addendum medical opinion that addresses whether the Veteran's skin condition is related to his service, to include conceded herbicide exposure on a non-presumptive basis. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matter is REMANDED for the following action: 1. Obtain any updated VA treatment records. 2. Thereafter, obtain an addendum medical opinion by an appropriate medical examiner to determine the nature and etiology of the Veteran's skin disorder. If the examiner determines that another physical examination is necessary, such an examination should be scheduled. Following a review of the claims file, the examiner is asked to opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's skin disorder manifested in or is otherwise etiologically related to service, to include as due to his conceded herbicide exposure. Please explain why or why not. The examiner should consider that the Veteran was diagnosed and treated for lichen simplex in November 2012 and a September 2013 dermatology consultation noted lichen simplex chronicus on the arms and legs for more than 30 years. In rendering the requested opinion, the examiner should not rely solely on whether the condition is one for which a presumption is established and, instead, state whether it is the result of herbicide exposure even though it is not on the list of presumptive diseases. A complete rationale must be provided for all opinions expressed. If the examiner is unable to provide an opinion without resort to speculation, an explanation as to why this is so should be provided and any additional evidence that would be necessary before an opinion could be rendered should be identified. Jenna Brant Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Robinson, 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.