Citation Nr: 21014552 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 16-34 168 DATE: March 15, 2021 REMANDED Entitlement to service connection for a skin disorder of the feet, to include onychomycosis is remanded. REASONS FOR REMAND The Veteran had active duty in the United States Navy from November 1976 to March 1981, and from February 1983 to May 1985. This matter comes to the Board of Veterans’ appeals (Board) on appeal from a September 2014 rating decision. The appeal for this issue was last before the Board in November 2019, when the Veteran’s claim for entitlement to service connection for a skin disorder of the feet was denied. The Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). By Order dated October 2020, the Court partially vacated the Board’s November 2019 decision and remanded the matter to the Board for compliance with the instructions included in the October 2020 Joint Motion for Remand (JMR) by the parties. Entitlement to service connection for a skin disorder of the feet, to include onychomycosis The Veteran contends he is entitled to service connection for a skin disorder of the feet. While several VA opinions are of record, the October 2020 JMR parties directed the Board to remand this issue to the RO in order to obtain an additional opinion that explicitly considers the Veteran’s lay contentions regarding symptom onset. In the February 1983 enlistment examination for the Veteran’s second period of active service from February 1983 to May 1985, a clinician noted that the Veteran’s toenails were infected. An associated February 1983 dermatology consultation report stated in the impression that the Veteran had onychomycosis. Although the Veteran reported an onset one month earlier, the dermatologist found that the whole nail was so involved that the problem had been there for at least a year. The presumption of soundness therefore does not apply to the Veteran’s second period of active service for his claimed onychomycosis. See 38 U.S.C. §§ 1111, 1153; 38 C.F.R. § 3.306. However, a preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C. § 1153; 38 C.F.R. § 3.306. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a VA examiner regarding the etiology of the Veteran’s skin disorder of the feet. Only schedule the Veteran for an examination if deemed necessary. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and assertions. A clear explanation for all opinions based on specific facts of the case as well as relevant medical principles is needed. The Veteran is competent to attest to observable symptoms, and the examiner is asked to specifically consider these lay contentions in any opinion rendered. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should identify all current skin disorders of the bilateral feet, to include onychomycosis. The examiner should provide an opinion as to the following questions: (a.) For each identified disorder other than onychomycosis, is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during or is otherwise caused by the Veteran’s two periods of active service? (b.) If onychomycosis is identified, is it at least as likely as not (a 50 percent or greater probability), that the onychomycosis manifested during, or is otherwise related to, the Veteran’s first period of active service from November 1976 to March 1981? (c.) If onychomycosis is identified, the examiner should indicate whether the Veteran’s onychomycosis worsened or increased in severity during his second period of active service from February 1983 to May 1985. If the answer to question (c) is yes, is there is a specific finding that the increase in disability is due to the natural progress of the disease during the Veteran’s second period of active service from February 1983 to May 1985? 2. After completing the development requested above, and any other development deemed necessary, readjudicate the Veteran’s claim. If any of the benefits sought are not granted in full, the AOJ should furnish the Veteran and his representative with an SSOC and afford an opportunity to respond. The claims file should then be returned to the Board for further appellate review. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Fitzgerald, 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.