Citation Nr: 21072767 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 19-20 969 DATE: December 6, 2021 ORDER Entitlement to an initial compensable rating for pseudofolliculitis barbae (PFB) is denied. REMANDED Whether new and material evidence has been received to reopen a previously denied claim of entitlement to service connection for an eye condition, claimed as blurred vision or a visual field defect, is remanded. FINDING OF FACT The Veteran's service-connected PFB affects less than 5 percent of his total body area or total exposed body area, has not required treatment during the appeal period, and has not resulted in functional impairments or disabling effects. CONCLUSION OF LAW The criteria for entitlement to an initial compensable rating for PFB have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Codes 7813-7806. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1969 to March 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was remanded in October 2019 to obtain records related to treatment at Ireland Army Hospital in 1970 and to obtain a new VA examination addressing the current nature and severity of the Veteran's PFB. While an adequate VA examination was obtained, and the RO made efforts to locate the missing treatment records, the RO was unable to obtain these records. As discussed more below, the remand instructions were not substantially complied with and further remand is necessary as to the eye condition claim. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to an initial compensable rating for pseudofolliculitis barbae (PFB) The Veteran seeks an initial compensable rating for his service-connected PFB, which is rated under Diagnostic Codes 7813-7806. Diagnostic Code 7813 directs that dermatophytosis, including of the beard area (tinea barbae), be evaluated under the General Rating Formula for the Skin. Diagnostic Code 7806 similarly directs that dermatitis or eczema be rated under General Rating Formula for the Skin. The General Rating Formula for the Skin directs that: A noncompensable rating is warranted when no more than topical therapy required over the past 12-month period and at least one of the following: characteristic lesions involving less than 5 percent of the entire body affected; or characteristic lesions involving less than 5 percent of exposed areas affected. Alternatively, adjudicators may rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability. 38 C.F.R. § 4.118. A 10 percent rating is warranted when at least one of the following is present: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected; or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period. The Board notes that the Veteran's PFB has not caused scarring or disfigurement of the head, face, or neck, as contemplated by the former and revised versions of Diagnostic Codes 7800 through 7805. Neither the Veteran nor the VA examinations show that he has scarring or disfigurement from his condition. Higher ratings under Diagnostic Codes 7800 through 7805, therefore, are unavailable in this case. The Veteran has been afforded two VA examinations in May 2018 and January 2020 to assess the nature and current severity of his service-connected PFB. At the May 2018 examination, the examiner marked that the Veteran's PFB did not caused scarring or disfigurement of head, face, or neck, and did not involve benign or malignant skin neoplasms. He had not received any treatment for his PFB in the 12 months prior. The examiner marked that his PFB affected less than five percent of both his total body area and total exposed body area, and specifically determined that it affected less than one percent of his total body area and three percent of his total exposed body area. At the January 2020 examination, the examiner marked that the Veteran's PFB did not caused scarring or disfigurement of head, face, or neck, and did not involve benign or malignant skin neoplasms. He had not received any treatment for his PFB in the 12 months prior. The examiner determined that his PFB affected less than five percent of both his total body area and total exposed body area, and observed that he had hyperpigmented papules and small pustules on his mandible and neck. The Veteran's private treatment records are associated with the claims file. Across his treatment with Dr. N.P. and Dr. T.N., he did not report any skin-related issues, and neither of these providers observed any skin-related abnormalities. Per his July 2019 VA Form 9, the Veteran reported that while serving in the Army, he was ordered to shave daily, which caused irritation, itchiness, bumps, and ingrown hairs. He indicated that the condition got so bad that he saw a doctor and was instructed to only use scissors to clip his hair rather than a razor. He further indicated that the problem still remains today. After review of the lay and medical evidence, the Board finds that an initial compensable rating is not warranted for the Veteran's service-connected PFB. The Veteran has not undergone any treatment for his PFB throughout the appeal period, and his PFB has not affected more than five percent of his total body area or total exposed body area. His PFB has not caused scarring or disfigurement such that a higher rating under Diagnostic Codes 7800 through 7805 would be warranted. Accordingly, the Veteran's claim of entitlement to an initial compensable rating for service-connected PFB is denied. REASONS FOR REMAND The Board finds that remand is necessary to afford the Veteran due process of law with respect to his missing service treatment records. As discussed in the Board's prior remand, the Veteran reported that he was treated at Ireland Army Hospital at Fort Knox for injuries to his face and eyes sustained during an explosion. The service treatment records currently associated with the claims file do not contain any such records. In January 2020, the RO requested records from Ireland Army Hospital, notified the Veteran of this request, and subsequently associated a reply indicating that no records were found with the claims file. However, the RO did not notify the Veteran of its inability to obtain the records pursuant to 38 C.F.R. § 3.159 (e)(1), which requires notice of: the identity of the records unable to be obtained; an explanation of the efforts made by VA to obtain the records; a description of further action VA will take regarding the claim, including notice that VA will decide the claim based on the evidence of record unless the claimant submits the records VA was unable to obtain; and the Veteran's ultimate responsibility to provide the records. Accordingly, while the Board sincerely regrets the additional delay, further remand is necessary to ensure compliance with the Board's prior remand directives. The matters are REMANDED for the following action: With respect to the January 2020 reply from Ireland Army Hospital, (a) notify the Veteran of the specific records that are unable to be obtained; (b) explain the efforts VA has made to obtain those records; and (c) describe any further action VA will take with respect to the claim in accordance with 38 C.F.R. § 3.159 (e)(1). MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Tierno 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.