Citation Nr: 21008226 Decision Date: 02/12/21 Archive Date: 02/12/21 DOCKET NO. 15-36 576 DATE: February 12, 2021 REMANDED An initial rating in excess of 10 percent for dermatitis and porphyria cutanea tarda.   REASONS FOR REMAND The Veteran served on active duty from July 1969 to June 1971. The case is on appeal from a March 2013 rating decision. In June 2018, the Veteran testified at a Board hearing. Most recently, in August 2020, the Board remanded the claim for additional development. An initial rating in excess of 10 percent for dermatitis and porphyria cutanea tarda. The Veteran is seeking an increased rating for his service-connected skin condition. He contends the currently assigned 10 percent rating does not reflect the severity of his skin condition. At the June 2018 Board hearing, the Veteran asserted that he experiences outbreaks of his skin condition on his several parts of his body, including his back, arms, legs, face, and neck. The Veteran was afforded an examination in March 2013. In February 2019, the Board found remand was warranted for a new examination as clarification was needed regarding the type of treatment, topical or systemic, the Veteran had received; the percentage of the Veteran’s total or exposed body area affected by his service-connected skin conditions; and whether the Veteran had any disfigurement of the face or any scarring, when considering the Veteran’s hearing testimony on the matters. In addition, the Board found that remand was warranted for a new examination as the Veteran reported experiencing regular flare-ups, but the examiner who provided the March 2013 VA examination did not attempt to elicit relevant information regarding functional loss the Veteran suffers during flare-ups as required by Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017) and Ardison v. Brown, 6 Vet. App. 405 (1994). Pursuant to the Board’s February 2019 remand, the Veteran underwent an additional examination in March 2019. However, the examiner who provided the March 2019 VA examination failed to follow the remand directives in their entirety as he did not attempt to elicit relevant information regarding functional loss during flare-ups. As a result, the Board remanded the case for compliance with the remand order. See Stegall v. West, 11 Vet. App. 268 (1998). The Veteran underwent an additional examination in October 2020 pursuant to the Board’s August 2020 remand. Concerning flare-ups, although the examiner noted the Veteran experiences flare-ups of a nonservice-connected condition, she did not address flare-ups regarding the Veteran’s service-connected skin conditions. Thus, in accordance with Stegall, remand for full compliance with the Board’s prior remand is warranted. In addition, the examiner who provided the March 2013 VA examination reported a diagnosis of porphyria cutanea tarda skin disorder which affected the Veteran’s face and arms and noted that the condition could affect any sun exposed area. However, neither the March 2019 VA examination nor the October 2020 VA examination addressed this diagnosis and appear to only consider skin conditions appearing on the face and the Veteran’s scalp. As such, a new examination addressing the Veteran’s porphyria cutanea tarda skin disorder is warranted on remand. In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain VA treatment records dated since February 2015. 2. Schedule the Veteran for a VA examination to address the severity of the Veteran’s service-connected skin condition. To the extent reasonable and practicable, coordinate with the Veteran to schedule the examination during an active stage of the disease. In doing so, the examiner should address: (1) the type of treatment for the condition, including whether it is topical, whether it is a corticosteroid, and whether it is systemic and/or immunosuppressive in nature or the equivalent; (2) the percentage area covered for both the dermatitis and porphyria cutanea tarda; (3) any disfigurement of the face; and (4) any associated scarring. If the examination is not during a flare-up, the effects of a flare-up should be estimated to the extent reasonably possible. If they cannot be, it should be explained why this is so. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Gray, 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.