Citation Nr: 21013583 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 15-43 418 DATE: March 9, 2021 ORDER Service connection for a skin condition to include eczema, rashes, and folliculitis is denied. FINDING OF FACT The preponderance of the evidence weighs against finding that the Veteran has a current skin condition that is related to his service. CONCLUSION OF LAW The criteria for service connection for a skin condition to include eczema, rashes, and folliculitis have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.655. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service in the U.S. Marine Corps from September 1993 to September 2013. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision. These matters were previously remanded by the Board in September 2018 and June 2020 for further development. The Board notes that pursuant to the September 2018 and June 2020 Board remands, the Agency of Original Jurisdiction (AOJ) attempted to the schedule the Veteran for VA skin examinations to assist with the development of his claim. The record reflects that both scheduled examinations were canceled per the Veteran’s request. He has indicated that he will not attend a VA examination to assist with the development of his claim. Since the Veteran has not requested to reschedule the examination and given that the record is absent of good cause for the Veteran’s cancellation of the examination, the Board finds VA’s duty to assist has been satisfied. Consequently, the Board finds that there has been substantial compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that a remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with its remand instructions, and imposes upon VA a concomitant duty to insure compliance with the terms of the remand); see also D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that only substantial rather than strict compliance with the Board’s remand directives is required under Stegall). Service connection for a skin condition to include eczema, rashes, and folliculitis Legal Criteria Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d, 78 F.3d 604 (Fed. Cir. 1996). The Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. See Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Board determinations with respect to the weight and credibility of evidence are factual determinations going to the probative value of the evidence. Layno v. Brown, 6 Vet. App. 465, 469 (1994).The Board must assess the credibility and weight of all of the evidence, including the medical evidence, to determine its probative value, accounting for evidence that it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Equal weight is not accorded to each piece of evidence contained in the record; not every item of evidence has the same probative value. Factual Background & Analysis Service treatment records (STRs) reflect multiple complaints of skin rashes and diagnoses of eczema and folliculitis. Upon examination in 2013, the Veteran was diagnosed with status post (s/p) eczema quiescent, and s/p folliculitis, with a notation of a history of rashes. The examiner stated that the Veteran did not exhibit a current skin condition. The Veteran stated in the November 2015 substantive appeal (Form 9) that eczema and folliculitis developed during service after wearing a MOPP suit and receiving an anthrax vaccine. The Board remanded this claim in September 2018 for VA skin conditions examination to determine the nature and etiology of his claimed skin conditions. September 2019 VAMC treatment records documents multiple yellow, smooth papules scattered on his cheeks bilaterally (several with central umbilication). The Veteran was informed by the treating physician that this is likely sebaceous hyperplasia which is a cosmetic condition. An October 2019 Exam Scheduling Request Contention Cancellation form notes that the Veteran’s scheduled VA skin conditions examination was canceled per the Veteran’s request. The Board again remanded this claim in June 2020 noting that there was no direct communication with the Veteran stating that he wished to have his previously scheduled examination cancelled. The Board requested that the Veteran indicate whether he is willing to attend a VA skin examination in connection with this service connection claim. The AOJ requested and scheduled the Veteran for another VA examination in August 2020. A September 2020 EMS Request for Clarification notes that the Veteran does not wish to attend any VA examinations and requested that his case be adjudicated by VA. The Board finds that good cause has not been shown for the Veteran’s failure to report for his scheduled examination. The Veteran’s STRs treatment for various skin rashes during service and was intermittently noted to have folliculitis, cellulitis, heat rash and atopic eczematous dermatitis. September 2019 VAMC treatment records documents multiple yellow, smooth papules scattered on his cheeks bilaterally (several with central umbilication). Crucially, however, there is no competent medical evidence of record which tends to substantiate a nexus between any current skin conditions and any events or injuries during service, including treatment for various skin rashes. As discussed above, the Veteran has twice cancelled VA skin examinations and provided no good cause for doing so. While VA has a duty to assist the Veteran, including by obtaining examinations and opinions where appropriate, the duty to assist is a two-way street. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). Further, under VA regulations, if a Veteran fails to show up for an examination without good cause in a claim for service connection, the Board should decide the claim based on the evidence of record. 38 C.F.R. § 3.655. As such, the Board will not seek another VA opinion on this matter. The Board does not discount the Veteran’s lay contentions regarding a connection between his skin conditions and his service. Lay evidence may be competent on a variety of matters. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4. However, the record does not contain any competent medical evidence substantiating a link between any current skin conditions and his service. Critically, the Veteran has not been shown to have the medical training or expertise to provide a nexus opinion in this matter, as the issue is medically complex and requires specialized dermatological knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). For these reasons, the Board concludes that the claim for service connection for a skin condition must be denied. Because the preponderance of the evidence is against the claim, the doctrine of reasonable doubt is not applicable in the instant appeal. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kyle McKone 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.