Citation Nr: 21006759 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 15-14 876A DATE: February 5, 2021 REMANDED The claim of entitlement to service connection for tinea versicolor is remanded. REASONS FOR REMAND The Veteran had active service from January 1966 to January 1968. He died in June 2016. The appellant has been substituted for the Veteran in this appeal. The Board has remanded this appeal on two occasions, in June 2019, and in September 2020. In the September 2020 remand, the Board acknowledged that an opinion had been obtained as the result of the June 2019 remand; however, the Board determined that the opinion was not adequate for the purpose of deciding the claim. It pointed out that, while the examiner indicated that there was no evidence of chronic, progressive complaints of a skin condition during service or after discharge, the record did in fact contain an assessment of probable tinea versicolor in October 1983. The Board additionally noted that an opinion is inadequate when it relies on the absence of medical evidence alone. The Board also discussed the Veteran’s Vietnam service and noted that he was presumed to have been exposed to herbicide agents during service, including Agent Orange. It acknowledged that while tinea versicolor was not among those diseases that are presumptively associated with herbicide agent exposure, direct service connection on the basis of exposure was not precluded. The Board directed that an additional opinion be obtained, to include consideration of the October 1983 treatment and the Veteran’s exposure to herbicide agents. In September 2020, a VA clinician reviewed the record and determined that tinea versicolor and the Veteran’s reported itchy skin were less likely than not incurred in or caused by “service exposure”. She acknowledged a September 1967 report of itchy skin and the assessment of tinea versicolor in October 1983. She then discussed the various risk factors for tinea versicolor and provided some general information regarding that condition. Unfortunately, this discussion does not adequately set forth the medical principles underlying her conclusion that the claimed skin condition is not related to service. Moreover, she did not specifically discuss the question of whether any diagnosed skin condition was related to the Veteran’s presumed exposure to herbicide agents during service. The Board therefore concludes that an additional opinion must be sought. The matter is REMANDED for the following action: 1. Request an opinion from a qualified clinician regarding the nature and etiology of the Veteran’s skin condition. It is up to the discretion of the reviewing clinician if a physical examination of the Veteran is required to address the questions posed below. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the clinician. Following review of the claims file, and physical examination of the Veteran, if deemed necessary, the reviewing clinician should provide an opinion regarding whether it is at least as likely as not (50 percent probability or more) that the Veteran’s skin condition is related to service, to include the Veteran’s presumed exposure to herbicide agents in Vietnam. The reviewing clinician should consider the Veteran’s treatment for skin problems in October 1983. The complete rationale for all opinions should be set forth, and a discussion of the facts and medical principles underlying any opinion must be included. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 2. Then, readjudicate the claim. If the decision remains adverse to the appellant, he should be furnished with a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Barone, 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.