Citation Nr: 21010717 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 17-13 926 DATE: February 25, 2021 ORDER Entitlement to a compensable evaluation (10 percent) for dermatophytosis, dermatitis and post inflammatory hyperpigmentation prior to December 5, 2019 (date of claim), is granted. Entitlement to a disability rating in excess of 10 percent for dermatophytosis, dermatitis and post inflammatory hyperpigmentation is denied. FINDINGS OF FACT 1. The Veteran has been diagnosed with dermatophytosis, dermatitis and post inflammatory hyperpigmentation. 2. The dermatophytosis, dermatitis and hyperpigmentation is manifest by pigmentation on his body covering at least 5 percent, but less than 20 percent of the exposed area affected. CONCLUSIONS OF LAW 1. The criteria for a disability rating more than 10 percent for dermatophytosis, dermatitis and hyperpigmentation have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7806. 2. Prior to December 5, 2019 (date of claim), the criteria for a 10 percent rating for dermatophytosis, dermatitis and hyperpigmentation are met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.114, Diagnostic Code 7806. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 9, 1992 to September 8, 2000. The Veteran appeared in front of the Board of Veterans’ Appeals (Board) during a video conference hearing in February 2019. With respect to the Board hearing, the undersigned Veterans Law Judge (VLJ) clarified the issue on appeal, explained the criteria for evaluation of the service connection, enquired as to whether there was additional outstanding evidence, and held the record open for 90 days. These actions complied with any duties owed during a hearing. 38 C.F.R. § 3.103. In September 2019, The Board remanded this case for further development. The September 2019 remand required that the VA schedule the Veteran for an examination to determine the current severity of his service-connected skin disability and any updated VA treatment records. Accordingly, the Board’s remand instructions have been substantially complied with. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Evaluation of dermatophytosis, dermatitis and hyperpigmentation The Veteran’s disorder is rated as noncompensable under 38 C.F.R. § 4.118, Diagnostic Code 7806 prior to December 5, 2019 and 10 percent thereafter. Thereunder, a noncompensable rating is warranted for mild symptoms such as no more than topical therapy required over the past 12-month period and characteristic lesions involving less than 5 percent of the entire body affected. A 10 percent rating is warranted for moderate symptomatology with lesions involving at least 5 percent but less than 20 percent of the entire body affected or intermittent systemic therapy for a total duration of less than 6 weeks over the past 12-month period. A 30 percent rating is warranted if lesions involve 20 to 40 percent of the entire body or systematic therapy required for a total duration of 6 weeks or more, but not constantly over the past 12-month period. The Veteran was provided a VA examination in July 2015. The examiner noted that Veteran had been treated with topical mediation in the past 12 months and with miconazole nitrate 2 percent powder for 6 weeks or more, but not constantly. The examiner noted as well that less than 5 percent of the total body area had infections of the skin, while there were none in the exposed area. Further it was reported that there was no evidence of urticaria or hives. On a November 2015 medical note, the Veteran reported complaints of skin irritation and skin irritation. The Veteran reported that he uses OTC cream sometimes, but that the condition comes and goes. During a later November 2015 appointment, a VA doctor diagnosed Veteran with right and left forearm dermatitis. The doctor prescribed fluocinonide ointment to be applied twice daily and hydrophilic cream. On a December 2015 VA 21-4138 the Veteran reported that during the late November 2015 appointment the VA doctor had diagnosed him with atopic dermatitis and stated his skin was the equivalent of an 80-year-old man. A medical note was made May 2016 where Veteran’s chief complain was rash on bilateral arms, chest, back and legs with an onset of four days. The Veteran reported that he was taking Zyrtec and fluocinonide cream, but that they were not working. The VA doctor prescribed Veteran with Medrol and advised Veteran to continue using the prescribed medication. On December 2016, a VA examination was conducted to assess Veteran’s skin condition. The VA examiner reported that Veteran’s skin condition did not cause any scarring or disfigurement of the head, face or neck. Veteran reported that he was using topical medicine from podiatry on a constant/near-constant basis in the past 12 months. The VA examiner physically examined the Veteran reporting that there were less than 5 percent of Veteran’s total body area and none of Veteran’s exposed body area containing infections of the skin. The examiner concluded as well that Veteran’s condition of tinea pedis was resolved and his skin conditions did not impact his ability to work. A videoconference hearing in front of the Board was conducted in February 2019. Veteran stated that he was having monthly outbreaks and that VA examiners were only examining his hands and face. Veteran further reported that often when he shows up to the examination his skin is healed by use of steroid cream that leaves black marks. The Veteran was provided another VA examination December 2019. The examiner diagnosed the Veteran with dermatitis, dermatophytosis: tinea pedis and post inflammatory hyperpigmentation. The examiner noted that all regions of the Veteran’s body were affected by scars and that there were too numerous to count. The examiner further noted that 5 percent to less than 20 percent of the Veterans total body area and less than 5 percent of the Veteran’s exposed area had visible lesions. Examiner reported that there were no scars, lesions or disfigurements of the head, face or neck. Based on the foregoing, the Board finds that prior to December 9, 2019, a 10 percent rating is warranted for the skin disability. Here, the Veteran presented credible testimony regarding the severity of the disorder and that it tended to wax and wane with the use of medication. He also implied that prior examinations were not thorough. We conclude that the 2019 examination merely confirmed the Veteran’s reports rather than establishing an actual change in the disability. Accordingly, a uniform evaluation is warranted. The effective date is set by what the AOJ concluded was the claim of March 13, 2015. The Board further finds that a rating more than 10 percent is not warranted for the Veteran’s skin condition at any time during the appeal period under construction. Specifically, the Board finds that the evidence does not show that lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected or systemic therapy for a total duration of 6 weeks or more over the past 12-month period, which is required for a higher 30 percent rating. The Board acknowledges the Veteran’s statements as to experiencing monthly break outs all over his body. However, multiple VA treatment records during the period under consideration document minimal lesions during examination. Moreover, both VA examination indicate the absence of treatment besides usage of steroid cream. There are no medical findings to the contrary such that more than 5 percent of body covered by lesions. As such, the Board finds that a rating more than 10 percent is not warranted for the Veteran’s skin disability. Accordingly, the Board finds that a 10 percent rating is warranted for the Veteran’s skin condition prior to December 5, 2019, and a rating more than 10 percent is not warranted at any time during the appeal period under consideration. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Konieczny, Adam 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.