Citation Nr: 21013407 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 12-25 942 DATE: March 9, 2021 ORDER Entitlement to service connection for a skin disorder of the scalp is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, his skin disorder of the scalp is due to his active duty service. CONCLUSION OF LAW The criteria for service connection for a skin disorder of the scalp are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 2000 to September 2004. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this case in September 2016 and March 2019 for further development. In September 2015, the Veteran testified before a Veterans Law Judge (VLJ) who is no longer employed at the Board. A transcript of the hearing is of record. The Veteran was provided an opportunity for another hearing, but he indicated that he did not want another hearing and requested that the Board decide the case as soon as possible. In June 2018, the Veteran requested another hearing. In December 2018, the Veteran testified before the undersigned. A transcript is of record. Pursuant to the Veterans Claims Assistance Act (VCAA), VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. Given the Board’s favorable disposition of the claim, the Board finds that all notification and development action needed to fairly adjudicate the appeal has been accomplished. 1. Entitlement to service connection for a skin disorder of the scalp is granted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Generally, service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1166 – 67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Service treatment records do not show complaints of, treatment for, or a diagnosis of a skin disorder of the scalp. While it is noted that the Veteran had keloids on his earlobes, he has already been service connected for this skin disability. Military personnel records show that the Veteran was deployed to Iraq from April 2003 to July 2004. In a September 2009 lay statement, [REDACTED], a fellow servicemember who served with the Veteran in Iraq from April 2003 to July 2004, reported that the Veteran experienced a number of problems while in Iraq to include irritation with spots on the back of his head. As a result, the Veteran did not always wear his helmet or other head gear due to them aggravating his skin condition. In a November 2009 VA examination, the Veteran reported that his skin condition began in 2003 while he was serving in Iraq. He was not treated, but did not have to wear his helmet as much. He was diagnosed with tinea capitus after service in October 2008. The examiner diagnosed the Veteran with controlled tinea capitis. The clinical manifestations included swelling, pain, and drainage. In the September 2012 VA 9, the Veteran reported suffering from tinea capitis while in Iraq, even though he was not diagnosed until after service. He kept picking at a lump on his head while in Iraq, but did not receive treatment until after service because it continued to itch. At the September 2015 hearing, the Veteran reported he started noticing his tinea capitis in 2003. It started as a bump on the back of his head. He did not seek treatment for it in service because he was in Iraq and everything was fast paced, so he just dealt with it. He eventually received treatment from a dermatologist who stated that it was a staph infection. At the December 2018 hearing, the Veteran reported that he noticed flakiness and pus in his scalp while serving in Iraq. He did not receive treatment during service because he was in Iraq. There was so much going on around him (i.e., people dying and constantly getting attacked), he saw his health as unimportant and did not really think about the bump on his head. In a December 2019 VA examination, the examiner noted the Veteran and Mr. [REDACTED] lay statements, but found that the Veteran did not have symptoms or a skin condition at the time of examination. The examiner opined that it was less likely than not that the Veteran’s skin condition was due to service as there was no documentation of skin disease or skin issues during service. According to an August 2009 VA treatment record, the Veteran had a small scalp lesion that had been present since his return from Iraq reportedly. This was assessed as tinea capitis with probable post-inflammatory hyperpigmentation. In March 2010, it was noted that he had had tinea capitis for years. Based on a careful review of all the subjective and clinical evidence, the Board finds that resolving all reasonable doubt in favor of the Veteran, his service connection claim for a skin disorder of the scalp is warranted. The Board finds that the December 2019 VA examination has little probative value as to the etiology of the Veteran’s tinea capitis as the examiner did not address the statements from the Veteran and Mr. [REDACTED] regarding the onset of his skin disorder and based her opinion on the inaccurate factual premise that the Veteran did not have a skin disease or skin issues during service solely based on no documentation of the skin disorder of the scalp in service. As such, the December 2019 VA examination has little probative value as to the etiology of the Veteran’s skin disorder of the scalp. See Nieves Rodriguez, supra; Stefl v. Nicholson, 21 Vet. App. 120 (2007); Prejean v. West, 13 Vet. App. 444 (2000). Additionally, the Board finds that while service treatment records did not show complaints of, treatment for, or a diagnosis of tinea capitis, the lay statements from the Veteran and Mr. [REDACTED] are competent and credible as to the onset of the Veteran’s tinea capitis. Not only are their lay statements consistent with military personnel records showing that the Veteran was deployed to Iraq from 2003 to 2004, but Mr. [REDACTED] statements as to his observations of the Veteran’s skin disorder as consistent with the Veteran’s own reports of his symptomatology. Further, the Board finds it significant that the Veteran was diagnosed with tinea capitis only four years after his discharge from service. (Continued on the next page)   For the foregoing reasons, and resolving reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s tinea capitis had its onset during his active duty service. Accordingly, his claim for service connection for a skin disorder of the scalp is granted. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Ko, 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.