Citation Nr: 21005441 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 16-10 155 DATE: February 1, 2021 REMANDED Entitlement to service connection for a skin condition is remanded. Entitlement to service connection for hearing loss, right ear is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1969 to August 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at a Board hearing before the undersigned Veterans Law Judge in February 2019. A transcript of the hearing is in the Veteran’s file. This matter was previously before the Board in May 2019, at which time it was remanded for additional medical opinions. Entitlement to service connection for a skin condition is remanded. The Veteran essentially contends he has had Athlete’s foot; and cracked skin on his hands since service, which he considers reflecting the onset of current skin disability, and should be service connected. Post service records from 2002 show warts on the fingers and onychomycosis, and records in 2014 reference a rash of several years’ duration. Records from 2015 show the veteran reporting he used terbinafine for his toe nails for 10 years, and VA examination in 2015 show the examiner noted the Veteran was diagnosed and treated for seborrheic dermatitis, rosacea, verruca and onychodystrophy in 2014. The recent VA medical opinion from April 2020 addressing whether a skin disability was incurred in service, does not make clear the Veteran’s history was accurately understood. It seems to imply there was no record of any post service skin disability until 2014. Clarification is necessary. Entitlement to service connection for hearing loss, right ear is remanded. The Veteran contends his right ear hearing loss is due to noise exposure in service. The adverse medical opinion recently obtained in 2020, stressed the absence of hearing loss noted on the service hearing evaluations, as well as the absence of any evidence of a threshold shift in the Veteran’s hearing acuity at that time. The opinion, however, did not explain the significance of these facts in concluding that the Veteran’s post service hearing loss could not be linked to the noise exposure he experienced. Further clarification is necessary. The matters are REMANDED for the following action: 1. Ask the Veteran to identify any additional relevant records he wishes considered regarding this appeal, which records should be sought. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s skin disorders are at least as likely as not related to the symptoms he reported experiencing in service and since, which the Veteran described as Athlete’s foot; and dried cracked skin on his hands and fingers. The addendum report should include reasons for any opinion expressed, and indicate whether the known symptoms of any current diagnosis is similar to Athlete’s foot or presents as dried cracked skin. If it is necessary to examine the Veteran to obtain the requested opinion, that should be arranged. If the clinician completing the report is unable to provide an opinion without resort to speculation, he or she should state whether the inability is due to the limits of the person’s knowledge, the limits of medical knowledge in general or there is additional evidence that would permit the needed opinion to be provided. (Continued on the next page)   3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s right ear hearing loss disability is at least as likely as not related to the type of noise he experienced in service. The addendum report should include reasons for any opinion expressed, and bear in mind that the absence of evidence of a hearing loss disability during service does not on its own resolve the inquiry. If the opinion is averse to the claim, it should describe the significance of the absence of a hearing loss disability or hearing threshold shift reflected in the service examination reports. If the clinician completing the report is unable to provide an opinion without resort to speculation, he or she should state whether the inability is due to the limits of the person’s knowledge, the limits of medical knowledge in general, or there is additional evidence that would permit the needed opinion to be provided. 4. After any further development as may be indicated has been accomplished, readjudicate the issue on appeal. M. E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Jaigirdar, 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.