Citation Nr: 21014155 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 15-04 692 DATE: March 11, 2021 REMANDED Entitlement to service connection for a skin rash, claimed as jungle rot, to include as due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran had active service from February 1968 to December 1971. In February 2018, the Veteran testified at a videoconference hearing at the Regional Office (RO), before the undersigned Veterans Law Judge. In July 2018, June 2020, and November 2020, the Board remanded this issue for further evidentiary development. 1. Entitlement to service connection for a skin rash, claimed as jungle rot, to include as due to exposure to herbicide agents is remanded. In the November 2020 remand, the Board requested a supplemental VA opinion from the July 2020 examiner (or other appropriate examiner if that examiner was not available). As a result, the case was returned to July 2020 VA examiner who, in November 2020, issued an “Addendum/Clarification Disability Benefits Questionnaire” (DBQ) that provides essentially the same opinion and rationale that was offered in the July 2020 Medical Opinion DBQ. This is problematic because, as noted in the prior remand, there are discrepancies in the rationale that must be addressed, to specifically include an acknowledgement that VA treatment records show that in March 2004, diagnoses of urticaria and tinea corporis were related to a rash observed on the Veteran’s legs and ankles; and that in January 2012, a diagnosis of dermatitis was noted when the Veteran was seen for a history of skin rash of the legs and ankles, which was further described in February 2012 as nummular. Although VA treatment records show treatment and diagnoses related to the feet and ankles, the VA examiner again rendered an opinion based on an inaccurate factual predication, maintaining that VA treatment records “stop short of offering a diagnosis or treatment of” the Veteran’s report of a history skin rash of the feet and ankles, and that “no time do the medical records suggest that . . . [nummular dermatitis or pytosporum folliculitis] . . .are related to any condition involving the feet or ankles (for which no medical diagnosis has been made)”. Once VA undertakes to provide an examination when developing a service-connection claim, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303 (2007). The Board also emphasizes that a remand confers on the claimant a legal right to substantial compliance with the remand order. Stegall v. West, 11 Vet. App. 268, 271 (1998). Although additional delay is regrettable, another remand is required to obtain an adequate supplemental VA opinion from a different examiner. The matters are REMANDED for the following action: Forward the Veteran's claims folder to a different examiner than the examiner who provided opinions in 2019 and 2020, for a supplemental opinion. The examiner should review the claims folder, to include the remand above, and provide an opinion as to whether it is it at least as likely as not (i.e., 50 percent probability or greater) that any current rash or skin condition is related to active service, to include his presumed exposure to herbicide agents/Agent Orange therein. The examiner must explain the rationale for any opinion(s) given. The examiner is advised that the Veteran is competent to report that he has experienced rash/skin symptoms since his service in Vietnam, and that these reports must be accepted as true. The examiner is also advised that VA treatment records dating back to at least 2004 appear to show that the Veteran has reported a history of skin rash of the feet and ankles since Vietnam, and that he received treatment and a diagnosis for a rash on the legs and ankles, including in March 2004 (tinea corporis and urticaria) and in January/February 2012 (dermatitis, and also described as nummular rash). If the examiner is unable to provide the requested opinions without resort to speculation, the examiner should so specify, along with an explanation as to why that is so. If the examiner determines that the requested opinion may not be rendered without an examination of the Veteran, such should be scheduled A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Casula 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.