Citation Nr: 21006308 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 14-35 176A DATE: February 3, 2021 REMANDED Entitlement to a skin disability, to included dermatitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1967 to June 1970, to include service in the Republic of Vietnam. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2013rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. In June 2017, the Veteran testified under oath at a video conference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. This case was previously remanded by the Board in May 2018 and September 2020 for further development. Entitlement to a skin disability, to included dermatitis The Board previously remanded this matter in September 2020 in order to obtain a new VA medical opinion. In the remand, the Board Requested the following: Obtain a new medical opinion to address the etiology of the Veteran’s claimed skin conditions. An examination should be scheduled only if deemed needed by the examiner. The examiner is asked to identify all skin diagnoses contained in the record and for each diagnosis provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service to include exposure to herbicides The examiner was also required to specifically address the Veteran’s herbicide exposure while in service, as well as a September 1967 service treatment record that indicates that the Veteran was treated for a rash; in addition to specifically addressing the Veteran’s lay statements, including the statements pertaining to blistering and cherry angiomas. In September 2020, an addendum/clarification medical opinion was obtained. The September 2020 VA examiner opined cherry angiomas were not found in the Veteran’s service treatment records, and cherry angiomas are not a presumptive service-connected condition from agent orange, nor do they require treatment or cause disability. The Board finds this medical opinion is inadequate for several reasons. First, the remand directive required the VA examiner to “to identify all skin diagnoses contained in the record” and to “provide an opinion for each diagnosis.” Although the VA examiner addressed cherry angiomas, there was no identification of any additional skin diagnoses, nor was there any discussion or opinion provided for the skin diagnoses of record, to include seborrheic dermatitis and hemangiomas to the torso and bilateral arms. Second, the VA examiner failed to address the Veteran’s herbicide exposure as specified in the remand directives. Although the VA examiner briefly mentioned cherry angiomas not being a presumptive service connection condition for herbicide exposure, there was no further discussion of herbicide exposure. Lastly, the VA examiner also did not specifically address the September 1967 service treatment record or the Veteran’s lay statements about blistering. The only discussion of the Veteran’s service treatment records was in reference to the absence of cherry angiomas during service. There was no discussion of any of the Veteran’s other lay statements, including his statement about blistering in the sun. As the September 2020 medical opinion to be inadequate as it fails to comply with remand directives set forth in the September 2020 Board remand. Accordingly, a remand for a new medical opinion is warranted. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: 1. Obtain a new medical opinion, from a different examiner that the one who provided the September 2020 opinion, to address the etiology of the Veteran’s claimed skin conditions. An examination should be scheduled only if deemed needed by the examiner. The examiner is asked to identify all skin diagnoses contained in the record and for each diagnosis provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service to include exposure to herbicides. The examiner is asked to clarify whether the diagnosis of cherry angiomas noted by the Veteran is the same or a separate disability form the hemangiomas to the torso and bilateral arms diagnosed at the time of the May 2020 VA examination. The examiner is asked to specifically address the Veteran’s herbicide exposure while in service, as well as a September 1967 service treatment record that indicates that the Veteran was treated for a rash. The examiner must also specifically address the Veteran’s lay statements, including the statements pertaining to blistering and cherry angiomas. The examiner is advised that a rationale that a disability is not recognized by VA as one presumptively caused by exposure to herbicides/agent orange is not an adequate rationale. 2. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board EJ Richardson 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.