Citation Nr: 21005360 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 15-42 185 DATE: February 1, 2021 REMANDED Entitlement to an initial compensable rating prior to October 22, 2020 and in excess of 10 percent thereafter for pseudofolliculitis barbae is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 2007 to September 2012. His military personnel records indicate he attended the United States Naval Academy prior to active duty service and he had additional service in the United States Navy Reserve. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) which granted service connection for pseudofolliculitis barbae and assigned a noncompensable rating, effective October 22, 2012. In August 2018, the Veteran testified during a Board hearing before the undersigned Veterans Law Judge. In February 2019 and April 2020, the Board remanded the appeal for further development. In an October 2020 rating decision, the RO increased the Veteran’s rating for pseudofolliculitis barbae and assigned a 10 percent rating from October 22, 2020. Although a higher rating has been assigned by the RO, the increased rating claim remains in appellate status as the maximum rating has not been assigned. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Entitlement to an initial compensable rating prior to October 22, 2020 and in excess of 10 percent thereafter for pseudofolliculitis barbae is remanded. Pursuant to the Board’s most recent remand directives in April 2020, the Veteran was afforded a VA examination in October 2020. The Board asked the examiner to determine the current nature and severity of his pseudofolliculitis barbae and to the extent possible, the Veteran should be scheduled for a dermatological (skin) examination during an active period of flare of his pseudofolliculitis barbae. In conducting the examination, the examiner was specifically instructed to identify the medications the Veteran used to treat his skin disability since October 2012, as the Veteran reported he tried not to shave too often, takes topical medications as a preventative measure before and after shaving, and that he gets huge bumps all over his face and neck and bleeds a lot within two days if he does not take his medication. He also reported residual scarring on his face and neck from shaving and that his face and neck are more irritated and hurt worse when it is hot, and he has flare-ups. See August 2018 Board Hearing Transcript at 13. Additionally, the examiner was instructed that if the examination was conducted during a non-active stage of the Veteran’s pseudofolliculitis barbae, to please estimate the portion of the Veteran’s body affected by his pseudofolliculitis barbae during an active stage, based on the examination, to include the Veteran’s reports. However, the October 2020 examiner only identified medications used that precedes the appeal period and failed to identify medications the Veteran has reported using since October 2012 or addressed his lay statements and although the examination was conducted during a non-active stage, the examiner did not estimate the portion of the Veteran’s body affected by his pseudofolliculitis barbae during an active stage, as specifically requested by the Board. Thus, a new VA examination and opinion is needed on remand to ensure substantial compliance with the Board’s April 2020 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Finally, any outstanding treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding private treatment records. 3. Then schedule the Veteran for a VA examination with an examiner other than the December 2019 and October 2020 examiners to determine the current nature and severity of his pseudofolliculitis barbae. To the extent possible, the Veteran should be scheduled for a dermatological (skin) examination during an active period of flare of his pseudofolliculitis barbae. The claims file and a copy of this remand must be made available to the examiner for review. All findings should be reported in detail. Following a review of the record, the examiner should identify the medications the Veteran has used to treat his skin disability since October 2012 and the duration of such treatment. See August 2018 Board Hearing Transcript at 13 (Veteran reports taking topical medications as a preventive measure before and after shaving). For any such medication, the examiner must determine how often the medication was used in a one-year period. The examiner should indicate whether each medication is topical, corticosteroid, or immunosuppressive drug. The examiner should then indicate whether such treatment constitutes systemic therapy, i.e., affecting the body as a whole, or is like or similar to corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs. If the examiner determines that the medication is topical, the examiner should also address whether it was (1) administered on a large enough scale such that it affected the body as a whole; (2) the method by which the treatment works; and (3) its side effects in determining whether the medication could be considered systemic therapy. If the examination is conducted during a non-active stage of the Veteran’s pseudofolliculitis barbae the examiner is requested to estimate the portion of the Veteran’s body affected by his pseudofolliculitis barbae during an active stage, based on the examination, to include the Veteran’s reports. A rationale for any opinion offered should be provided and the examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Asante 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.