Citation Nr: 21009507 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 19-08 412 DATE: February 22, 2021 ORDER Entitlement to service connection for a skin disorder, to include shingles, is granted. FINDING OF FACT The most probative evidence shows that the Veteran’s skin disorder began during service. CONCLUSION OF LAW The criteria for entitlement to service connection for a skin disorder, to include shingles, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 2000 to December 2013 and from June 2018 to September 2018, with additional service in the U.S. Army Reserve. He served in Afghanistan and Iraq and is a recipient of the Combat Infantryman Badge, Afghanistan Campaign Medal with 3 Campaign Stars, the Iraq Campaign Medal with two Campaign Stars, the Purple Heart, and other commendations. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 Department of Veterans Affairs (VA) Regional Office (RO), the Agency of Original Jurisdiction (AOJ). In the rating decision, the AOJ denied service connection for a skin disorder, to include shingles. This matter was previously before the Board in March 2020 at which time the Board denied entitlement to service connection for a skin disorder, to include shingles. The parties thereafter filed a Joint Motion for Partial Remand which vacated the Board’s decision as to this claim pursuant to an order from the United States Court of Appeals for Veterans Claims dated in September 2020. 1. Entitlement to service connection for a skin disorder, to include shingles Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). In order to establish service connection for the claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247, 253 (1999). The requirement of a current disability is "satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim." McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Analysis In the September 2020 Joint Motion for Partial Remand, the parties moved the Court to vacate that part of the March 13, 2020, decision of the Board of Veterans’ Appeals (Board) that denied entitlement to service connection for a skin disorder, to include shingles, and to remand the issue for readjudication. The parties agreed that the Board erred when it failed to discuss relevant evidence of record, rendering its statement of reasons or bases inadequate. 8 U.S.C. §7104(d)(1); Gilbert v. Derwinski, 1 Vet. App. 49, 57(1990). In its March 2020 decision, the Board found there was no evidence of a skin disorder at any time during the appeal. The Board determined that regarding the first element of service connection, a current disability, the Veteran’s medical records did not show a diagnosis of a skin disorder. However, the parties agreed that the Board failed to address an August 2018 outpatient medical record that documents the Veteran’s complaints of an itchy rash on his left lower extremity during service. The Court granted the JMPR and vacated that part of the Board’s decision that denied entitlement to service connection for a skin disorder, to include shingles, and remanded the issue for readjudication. Service treatment records reflect a complaint, diagnosis and treatment for herpes zoster while on active duty. A clinic note from February 2012 confirms that the Veteran was treated on active duty for a blistering rash on his right torso and upper extremity. He was treated with Valacyclovir and prednisone. An October 2012 medical note indicates the Veteran was seen for a painful rash that was present for six days. He reported a childhood diagnosis of chicken pox. The Veteran reported that one day after he went into the field, he started having aching pain in upper torso and back of neck. Two days later he had a rash. He described a painful burning rash in the upper right neck preceded by two days of upper right shoulder fatigue and achy pain. He stated he had aching constant pain, the rash didn’t itch, and it was sometimes painful to the touch. Valacyclovir was prescribed at that time. Multiple skin lesions were noted. Multiple pustules were noted. Lesions were noted with linear configuration on posterior right side of the neck and on the front of the right shoulder and the top of the right shoulder. Vesicles on erythematous base scattered on right upper shoulder were noted. An enlarged cervical lymph noted on the right side was noted. He was diagnosed with herpes zoster (shingles). He was treated with Valacyclovir and prednisone. A November 2012 entry in the service treatment record reflects the diagnosis of acute herpes zoster (shingles). A February 2014 health assessment record notes history of hives/rash. The Veteran reported history of unspecified rash. The record further notes ongoing rash and unspecified rash. The Veteran was referred to primary care physician for evaluation of ongoing rash. The Veteran was afforded a VA examination in October 2015 to evaluate the nature and etiology of his skin disorder. The examiner noted the diagnosis of shingles in 2012, which was treated with Valocyclovir and prednisone. The Veteran reported that in 2012, he developed a blistering rash to his right torso and upper extremity. He was treated and denied any recurrence. He denied any symptoms such as pain, numbness, or tingling to the site. The examiner noted the Veteran did not have visible skin conditions. The examiner found that the Veteran’s shingles resolved without residual disability. As noted in the Court’s remand, an August 2018 VA outpatient medical note indicates an active rash and other nonspecific skin eruption. The Veteran complained of slightly itchy rash on left shin for two days in the left lower extremity shin area. A rash with slight erythema was noted, non-vesicular, no cellulitic complications, and slight scaling. A rash was also noted on right bicep/deltoid area and right lower of shin with itching to both areas. The rash was treated with steroid cream. Military personnel records show the Veteran was on active duty from June 15, 2018, to September 15, 2018, when this medical note was created. The first and second elements required to establish service connection, a current diagnosis, and in-service incurrence, are met as the Veteran was diagnosed in 2012 with a skin disorder, to include shingles, during service. Although the 2015 examiner found this disorder had resolved, a February 2014 health assessment record indicated an ongoing rash requiring referral for evaluation. The element of a current disability is "satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim." McClain v. Nicholson, 21 Vet. App. 319 (2007). Further, the element of a current disability is met when the record contains a recent diagnosis of disability prior to the Veteran filing a claim for benefits based on that disability. Romanowsky v. Shinseki, 6, Vet. App. 289 (2013). In addition, subsequent August 2018 treatment records indicate diagnosis and treatment of an active rash and skin eruption. If a condition noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). The evidence shows that the Veteran was diagnosed with a skin disorder, to include shingles, during service, and has experienced continuing symptoms of a skin disorder, thereafter, as documented in treatment records. There is no evidence to the contrary concerning the etiology of the Veteran's skin disorder. Therefore, resolving all reasonable doubt in favor of the Veteran, the Board finds that service connection is warranted for a skin disorder, to include shingles. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 3.303. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Debra B. McLoughlin, 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.