Citation Nr: 21012467 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 05-35 233 DATE: March 4, 2021 REMANDED Entitlement to service connection for a skin disability is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1962 to August 1966, from June 1967 to June 1970, and from October 1970 to October 1973. The substituted appellant is the Veteran’s surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2004 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan. The Board notes that in November 2008 , the Veteran provided testimony on his skin condition at a Board hearing before a now retired Veterans Law Judge (VLJ). In a November 2020 letter, the opportunity to request another Board hearing was offered and a response was not received. Further, in the January 2021 Written Brief Presentation, the appellant’s representative did not request a new Board hearing. Thus, the Board will proceed with adjudication of the claim. In an October 2016 Board decision, the Board reopened the claim for service connection for a skin condition and remanded the claim for service connection for skin condition for development. In July 2019 the Board again, remanded the claim for development. 1. Entitlement to service connection for a skin disability is remanded. The Board regrets the additional delay, but finds that remand is again necessary. In the July 2019 Board remand, the Board determined that the May 2018 VA skin examination was inadequate because the examiner did not adequately address the onset of the Veteran’s skin ailments. Furthermore, the examiner did not address the past treatment of lichen simplex chronicus, among several other dermatological conditions, in the VA medical records. The examiner also did not examine the Veteran for tinea pedis, which the Veteran claimed in his February 2005 Notice of Disagreement (NOD). Finally, the examiner did not address the Veteran’s argument in the NOD that he suffered from “jungle rot” while stationed in Vietnam, which may have contributed to his current skin condition. Therefore, the Board remanded the matter for a VA opinion and directed that the examiner must identify each skin disorder experienced during or proximate to the appeal period. The examiner should discuss the diagnoses of actinic keratosis, lichenified dermatoses, lichen simplex chronicus, dermatochalasis, eczema, alopecia, lichen planus, and pruritus in the Veteran’s medical records. The examiner should also discuss the Veteran’s claim that he has tinea pedis. Additionally, the examiner was directed to provide an opinion as to whether it is at least as likely as not that the Veteran has a skin disability that is related to his active service and a rationale was to be provided for the opinion. Thereafter, in a September 2019 VA examination report the examiner determined the skin disorders the Veteran experienced during the appeal period were seborrheic dermatitis, lichenified eczema, actinic keratosis, and lichenified dermatoses. While the examiner included a list of general information about actinic keratosis, lichenified dermatoses, lichen simplex chronicus, dermatochalasis, eczema, alopecia, lichen planus, and pruritus, the examiner did not provide any explanation in support of why as it specifically related to this Veteran, the examiner limited his diagnoses to seborrheic dermatitis, lichenified eczema, actinic keratosis, and lichenified dermatoses and did not find the Veteran had any current lichen simplex chronicus, dermatochalasis, alopecia, lichen planus, and pruritus disabilities. Moreover, the examiner did not provide discussion of these diagnoses of actinic keratosis, lichenified dermatoses, lichen simplex chronicus, dermatochalasis, eczema, alopecia, lichen planus, and pruritus being in the Veteran’s medical records. Further, although the examiner diagnosed the Veteran with seborrheic dermatitis, lichenified eczema, actinic keratosis, and lichenified dermatoses, the examiner only provided a nexus opinion addressing the Veteran’s seborrheic dermatitis, stating that it was not related to military service. Notably, the examiner did not provide a nexus opinion for the Veteran’s lichenified eczema, actinic keratosis, and lichenified dermatoses. A September 2020 VA skin examination report has also been associated with the record; however, this examination report indicated the Veteran’s only diagnosis was lichen simplex chronicus. There was no discussion of September 2019 VA examiner’s diagnoses or why the examiner did not find that the Veteran had any current actinic keratosis, lichenified dermatoses, dermatochalasis, eczema, alopecia, lichen planus, and pruritus disabilities. Lastly, the September 2020 examiner did not provide any nexus opinion. Accordingly, the Board finds that remand for addendum opinion is needed. The matter is REMANDED for the following action: 1. The AOJ should arrange for a VA medical opinion to determine the nature and likely cause of any skin disability. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis, all skin disabilities present during the appeal period, (from August 2003). The examiner should discuss: (1) any diagnoses of actinic keratosis, lichenified dermatoses, lichen simplex chronicus, dermatochalasis, eczema, alopecia, lichen planus, and pruritus in the Veteran’s medical records and (2) the September 2019 VA examiner’s diagnoses of seborrheic dermatitis, lichenified eczema, actinic keratosis, and lichenified dermatoses. (b.) For each skin disability diagnosed, is it at least as likely as not (50% or greater probability) that such disability was either incurred in or otherwise related to the Veteran’s military service? Please explain why. 3. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Schick, 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.