Citation Nr: 21072352 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 08-32 418 DATE: December 2, 2021 REMANDED Entitlement to a rating higher than 10 percent for multiple sebaceous cysts is remanded. Entitlement to service connection for dental extractions for compensation purposes is remanded. REASONS FOR REMAND The Veteran had active duty for training from July to September 1987 and served on active duty from April 1988 to January 1992 and from March 2005 to June 2006. He also had additional periods of National Guard service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2007 rating decision of the Department of Veterans' Affairs (VA) Regional Office (RO) in Montgomery, Alabama. Most recently, this appeal was before the Board in March 2021. At that time, the Board remanded the claim for additional evidentiary development. As will be discussed in more detail below, the Board's remand directives were not followed and remand is required to ensure compliance. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding when a remand is issued, the Veteran is entitled, as a matter of law, the right to compliance with the remanded order). 1. Entitlement to service connection for dental extractions for compensation purposes The previous Board remands dated August 2014, May 2017, February 2018, May 2020, and March 2021 note that a claim for service connection for a dental disorder is also considered a claim for VA outpatient dental treatment. See August 2014 Board Decision; see also Woodson v. Brown, 8 Vet. App. 352, 354 (1995); Mays v. Brown, 5 Vet. App. 302, 306 (1993). Accordingly, because the issue of entitlement to service connection for dental extractions for VA outpatient treatment purposes has been raised by the Veteran when he filed his service connection claim for dental extractions but had not been adjudicated by the Agency of Original Jurisdiction (AOJ), the Board referred the claim for service connection for a dental disorder for purposes of VA outpatient dental treatment to the AOJ for appropriate action. See 38 C.F.R. § 19.9(b). Despite this, it does not appear that action has been taken concerning this claim. Upon the March 2021 Board remand, the AOJ completed a VA Form 10-7131, Request for Administrative and Adjudicative Action. In that form, the AOJ requested that the receiving VA clinic refer the Veteran's claim to the eligibility department to determine whether the Veteran was entitled to outpatient treatment. See VA Forms 10-7131 dated April 26, 2021 and July 1, 2021. However, while the status of the claim is marked "pending" on the forms, to date, it does not seem that any action has been taken to determine whether service connection for treatment purposes is warranted. Accordingly, the claim for service connection for a dental disorder for purposes of VA outpatient dental treatment is again referred to the AOJ for additional referral to the appropriate VA Medical Center (VAMC). The Board must again defer adjudication of the service connection claim. 2. Entitlement to a rating higher than 10 percent for multiple sebaceous cysts In the March 2021 remand, the Board sought an opinion regarding whether the medications prescribed for the Veteran's skin disability constituted systemic therapy. Specifically, the Board instructed the examiner to list all the medications related to the Veteran's skin disability and determine whether each medication was immunosuppressive or systemic in nature. In the May 2021 addendum opinion, the examiner failed to discuss the nature of the Veteran's relevant medications. Accordingly, remand is required to obtain such an opinion. The Board further notes that, in June 2021, the Veteran presented to the emergency room reporting a progressively enlarging cyst in his left preauricular area. At that time, his symptoms included worsening pain, along with his left ear swelling shut and diminished hearing in the left ear. He also had clear discharge from the left ear. Ultimately, the Veteran was hospitalized for three days for removal of a facial abcess. The Board finds that additional examination is necessary given this hospital admission. The matters are REMANDED for the following action: 1. Associate with the claims folder updated treatment records related to the disabilities on appeal. 2. Afford the Veteran additional examination of his skin. The examiner is requested to review the June 2021 emergency room treatment for a progressively enlarging cyst in the Veteran's left preauricular area and provide opinion whether this was a manifestation of service-connected sebaceous cysts. The examiner should evaluate the extent of involvement of his current sebaceous cysts, and identify any permanent residuals, if any, from the June 2021 infection that extended to the left ear. The examiner should review the Veteran's medication list and identify all medications used to treat his sebaceous cysts, to include the antibiotics prescribed in August 2016. The examiner should identify whether any of these medications are immunosuppressive and/or systemic in nature. 3. After properly documenting that the issue of entitlement to service connection for dental extractions for VA outpatient treatment purposes has been referred and after conducting any additional development, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Orie, 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.