Citation Nr: 21009287 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 15-23 616 DATE: February 22, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for service-connected urticaria is remanded. Introduction The Veteran served honorably on active duty in the United States Navy from June 1986 to November 1988. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 Rating Decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California. When this matter came before the Board most recently in May 2020, the Board vacated its prior decision issued August 15, 2018, and remanded the matter for additional development, including obtaining VA treatment records from July 2017 to present and affording the Veteran another VA examination. The Board observes that the additional development has been undertaken, and the matter returns to the Board for further appellate review. While further delay is regrettable, for the reasons set forth below, the Board finds that remand is again required to ensure substantial compliance with the Board’s prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). REASONS FOR REMAND Entitlement to an initial disability rating in excess of 10 percent for service-connected urticaria is remanded. As the Board’s May 2020 remand stated, 38 C.F.R. § 4.118, Diagnostic Code (DC) 7825 for chronic urticaria was amended on August 13, 2018, such that a 30 percent rating is warranted where urticaria requires second line treatment (e.g., corticosteroids, sympathomimetics, leukotriene inhibitors, neutrophil inhibitors, thyroid hormone) for control. Prior to the amendment, a 30 percent rating was warranted where there are recurrent debilitating episodes occurring at least four times during the past 12-month period and requiring intermittent systemic immunosuppressive therapy for control. Id. As such, the Veteran’s increased rating claim must be considered under both sets of rating criteria for the skin, and whichever criteria is more favorable to the Veteran will be applied. Following the Board’s May 2020 remand, the Veteran was afforded another VA examination to address her claim for an increased initial rating for service-connected urticaria in October 2020. For the following reasons, the Board finds that the October 2020 VA examination was inadequate and, thus, there has not been substantial compliance with the Board’s prior remand directives. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Stegall, 11 Vet. App. at 271. First, neither the VA examiner’s report nor the October 2020 Supplemental Statement of the Case (SSOC) address the rating criteria as it existed prior to August 13, 2018; but rather, are limited to the revised rating criteria alone. Next, while the VA examiner reported the Veteran’s usage of oral antihistamines and “anti-itch lotion,” he did not complete the portion of the Skin Diseases Disability Benefits Questionnaire (DBQ) regarding first, second, and third line treatments and, instead, referred to VA treatment records for information about current treatment. Accordingly, this matter is REMANDED for the following action: 1. Schedule the Veteran for a VA medical examination with a physician, other than Dr. S.H., possessing the necessary expertise to fully assess and provide an opinion regarding the nature and severity of the Veteran’s service-connected urticaria for the entire period on appeal. The examiner must obtain a full history from the Veteran. It should be noted the Veteran is competent to attest to factual matters of which she has first-hand knowledge, such as observable symptomology. All pertinent symptomology must be reported in detail. Based upon a review of all pertinent documents in the Veteran’s claims file, including medical records, lay statements, and the examination results, the examiner must provide a full description of the disability and report all signs, symptoms, and treatment necessary for evaluating the Veteran’s service-connected urticaria under the rating criteria as it existed before and after August 13, 2018 (the date the rating criteria was last amended), and for the entire period on appeal. In offering the above opinion(s), the examiner must consider and discuss as necessary all pertinent lay and medical evidence of record including, but not limited to, the Veteran’s November 2020 statement regarding, inter alia, symptomology and treatment history. A complete and thorough rationale for any opinion(s) expressed must be provided. (Continued on the next page)   (Continued on next page) T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Worsham, Attorney Advisor 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.