Citation Nr: 21010223 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 15-23 061 DATE: February 24, 2021 REMANDED Entitlement to service connection for basal skin cancer is remanded. Entitlement to service connection for actinic keratosis is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from March 1983 to March 1987 and thereafter served in the Air Force Reserve and National Guard, with a period of active duty for training (ACDUTRA) from July 1988 to November 1988, and a Federalized period of National Guard active service from May 1, 1992 to May 9, 1992. He has reported a period of active service from March 1992 to March 1998 and has alleged being on active duty in 2001/2002. Such service has not been verified by the service department. Notably, with respect to National Guard service, only periods of service when the member was called to Federalized service (such as here in May 1992) are qualifying service for VA compensation benefits. Reserve service is qualifying service for VA compensation benefits when the disability was incurred/aggravated in line of duty on ACDUTRA for disease or injury or on inactive duty training (INACDUTRA) for injury only. See 38 C.F.R. § 3.6. The Veteran has not identified (and the record does not reflect) any periods of Federalized National Guard service or Reserve ACDUTRA/INACDUTRA when there was a related injury or disease while he was in line of duty. These matters are before the Board of Veterans’ Appeals (Board) from a September 2013 rating decision from a Department of Veterans Appeals (VA) Regional Office (RO). In August 2018, the Board remanded the issues of service connection for basal skin cancer and actinic keratosis for further development. Specifically, to develop and confirm the exposures the Veteran alleged that caused his skin disorders. The Board then asked VA to make findings of fact for the record (regarding each exposure alleged by the Veteran) whether such occurred and the extent of the exposure. After the development, the Board requested that the Veteran be arranged for a dermatologic examination to determine the likely etiology of his skin disorders. A review of the claims file reveals that a remand is necessary before a decision on the merits of the claims can be reached for the following reasons. The Board is making no determination, express or implied, concerning the credibility of any evidence on file at this time. 1. Entitlement to service connection for basal skin cancer is remanded. 2. Entitlement to service connection for actinic keratosis is remanded. After the August 2018 Board decision, VA requested information from the Veteran regarding what he was exposed to that caused his skin disorders. The Veteran reported that he was exposed to high UV sun rays, highly cancerous dangerous chemicals, toxic chemicals, carbon monoxide from engine exhaust, asbestos, benzene, methylene chloride, hexavalent chromium, methyl ethyl ketone, and numerous paint chemicals. The JSSRC issued a formal finding for the claimed exposures in May 2020. The report noted that enlistment records show that the Veteran grew up in Hawaii in the 1970s and went to college in Florida in the 1980s prior to his enlistment in the Air Force Reserves in 1982 and later to active duty Air Force in 1983. It was found that during the active duty period of March 1983 to March 1987, UV exposure was highly likely, but chemical exposures were unknown at this time. The report then listed the military occupational specialties the Veteran held while he was in the Air Force, Air National Guard, and Air Force Reserves. The report listed how the Veteran was an administrative specialist from March 1983 to March 1987 and that there was no extreme UVA or chemical exposure conceded or fact found by the MOS identified. It then listed retraining for National Guard/Reserves in October 1987 and then how the Veteran was an aircraft elect systems in the Air Force Reserves from 1987 to 1992. It then listed that the Veteran had the MOS of aircraft armament during the May 1, 1992 to May 9, 1992 active duty service for Operation Garden Plot. It then listed that the Veteran was in the National Guard/Reserve with different MOS’s effective February 1997, January 2000, and May 2001. It was reported that the Veteran was sent to Hawaii effective February 1999 to 2004 and that the Veteran exited service in 2004. There was no indication of the active duty for training period of July 1988 to November 1988 in this list of periods of active duty, active duty for training, National Guard, and Reserves service. The report furthered that exposure to UVA rays that occurred one weekend a month and two weeks a year in active and active duty for training status was likely due to location and assignments. Exposure to exhaust and chemicals on flight-line/maintenance from one weekend a month and two weeks a year was unknown, but within the scope of the MOS’s depending on training exercises that are unverifiable. Because there was no indication of the July 1988 to November 1988 active duty for training period in this report, the Board must remand to obtain a thorough record and confirmation of whether the Veteran was exposed to UV rays, exhaust, and chemicals during his active duty for training period. Additionally, because the October 2020 VA examiner relied on the formal finding by JSSRC, it is necessary to provide the Veteran with a new VA examination so that the opinions will be based off of all information pertinent. The matters are REMANDED for the following action: 1. Develop the Veteran’s assertion that he was exposed to UV sun, exhaust, and chemicals due to all his military service. Include an analysis of whether the Veteran was exposed to UV sun, exhaust, or chemicals during his July 1988 to November 1988 active duty for training period. 2. Once the above development has been completed, provide the Veteran with a VA examination with an appropriate clinician (preferably a dermatologist). The Veteran’s entire record must be reviewed by the examiner in conjunction with the examination, and the examiner should be provided the findings by the AOJ regarding the nature and extent of the Veteran’s environmental/hazardous material exposures in service. On review of the record, the examination/interview of the Veteran, the examiner should respond to the following: (a.) Identify (by diagnosis) each current skin disability found (to include basal cell carcinoma and actinic keratosis)/ (Continued on the next page)   (b.) Identify the likely etiology for each skin disability entity diagnosed. Is it at least as likely as not (a 50 percent or greater probability) that the disability had its onset in, or is etiologically related to, the Veteran’s active service, to include as due to his exposures to environmental factors (such as UV sunlight and/or hazardous materials such as fumes, fuels, cleaning solvents, paint, etc. acknowledged by the AOJ in their findings for the record. Specifically address the textual materials the Veteran has submitted in support of his claims. (c.) The examiner must include a thorough rationale with all opinions and explain why or why not it is at least as likely as not that the Veteran’s skin disorders are etiologically related to military service. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Imam, 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.