Citation Nr: 21015125 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 19-27 613 DATE: March 16, 2021 ORDER Service connection for chloracne, arms and hands, is denied. Service connection for solar keratosis, face and arms, (claimed as skin rash, arms and hands) is denied. FINDINGS OF FACT 1. The preponderance of evidence indicates that the Veteran does not have chloracne. 2. The preponderance of evidence indicates that Veteran does not have solar keratosis that started in service or is otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for chloracne have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for solar keratosis (claimed as skin rash) have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1967 to April 1969, to include service in the Republic of Vietnam. This appeal arises from an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) and was remanded by the Board of Veterans’ Appeals (Board) in August 2020. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(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.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)); see also Hickson v. West, 12 Vet. App. 247, 253 (1999). Service connection for certain chronic disorders, including chloracne, may be established based upon a legal presumption by showing that it manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. Furthermore, if a veteran was exposed to herbicide agents (e.g., Agent Orange) during active service used in support of military operations in the Republic of Vietnam, presumptive service connection is warranted for certain specified diseases. 38 C.F.R. §§ 3.307, 3.309. A veteran who served in Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, will be presumed to have been exposed to an herbicide agent during such service unless there is affirmative evidence to the contrary. 38 C.F.R. § 3.307. Diseases deemed associated with herbicide agent exposure and afforded presumptive service connection include chloracne. In August 2020, the Board remanded the appeal in order to afford the Veteran a VA examination for his claimed skin conditions. However, the evidence shows that the Veteran canceled the examination requests. Additionally, a January 2021 report of general information reveals that the Veteran was not willing to report for an examination. Further, the Veteran’s representative, in a March 2021 brief, acknowledged that “[a]ll remand orders have been complied with and this case is ready to be returned to the Board for a final disposition.” Therefore, the Board finds that the duties to notify and assist have been met and that there has been substantial compliance with the August 2020 remand instructions. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Service connection for chloracne, arms and hands, is denied. On an August 2018 notice of disagreement and September 2019 VA Form 9, the Veteran contends that he “did not get an opportunity to attend military sick call to address rash breakout on hands and arms” and that such condition can be attributed to in-service Agent Orange and other chemical exposure. The Veteran’s service treatment records (STRs), to include reports of medical examination and medical history conducted on entrance to and separation from the military, are negative for any complaint, symptom, treatment, or diagnosis related to skin conditions, to include any rashes and chloracne. Furthermore, the evidence includes an October 2017 Environmental Agents Service (EAS) evaluation that indicates that the Veteran does not have a history of chloracne occurring within one year of exposure to Agent Orange or di/trichlorophenoxyacetic acid and dioxin. Furthermore, the Veteran’s VA treatment records do not show a diagnosis of chloracne, and the Veteran declined to attend a VA examination that could have assisted with his claim. Instead, in the January 2021 report of general information mentioned previously, the Veteran revealed that he has been given medication for his skin, which clears it up. Because the evidence does not show a current disability regarding chloracne, the remaining elements required for service connection need not be discussed here. The Veteran has not submitted evidence demonstrating the he currently has, or has ever had, chloracne. “In the absence of proof of a present disability, there can be no valid claim.” Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); see also McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (current disability element of a service connection claim is satisfied when a claimant has a disability at the time a claim is filed or during the pendency of the claim). The Board recognizes the Veteran’s belief that he has chloracne resulting from in-service herbicide agent exposure. However, he has not been shown to be competent, or have the requisite medical expertise, to provide an opinion regarding the diagnosis, or etiology, of a complex medical condition. As such, the question concerning a current chloracne disability in this case may not be competently addressed by lay evidence, and the Veteran’s opinion on this point is non-probative evidence. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). In sum, the Board finds the preponderance of the evidence does not support that the Veteran has chloracne, and thus, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). Therefore, service connection for chloracne is not warranted. 2. Service connection for solar keratosis, face and arms, (claimed as skin rash, arms and hands) is denied. As noted above, the Veteran contends that he experienced rashes in service but was not able to go to sick call and that such rashes are due to in-service herbicide agent exposure. At the outset, the Board notes that presumptive service connection is not warranted for solar keratosis as due to herbicide agent exposure. See 38 C.F.R. §§ 3.307, 3.309 The Veteran’s STRs, to include reports of medical examination and medical history conducted on entrance to and separation from the military, are negative for any complaint, symptom, treatment, or diagnosis related to skin conditions, to include any rashes. The October 2017 EAS evaluation, mentioned above, does show that the Veteran had light brown macular lesions, described as solar keratosis, on the face/arms with no jaundice. The Veteran’s VA treatment records are negative for any skin rash symptoms until October 2018, when the Veteran was given medication for a skin rash. At that time, the Veteran had the following complaints: “breakout” of his hands, the skin itches, used cortisone with some relief, and has been ongoing for several months. The Board acknowledges that the solar keratosis may be related to the recently VA-treated skin rash that the Veteran contends is related to service; thus, the Board remanded the issue for a VA examination in August 2020 for clarification and to address such contention. However, as already discussed, the Veteran declined such assistance, and instead, communicated that he has been given medication for his skin, which clears it up. See January 2021 Report of General Information. The Veteran has not been shown to be competent, or have the requisite medical expertise, to provide an opinion regarding the diagnosis, or etiology, of a complex medical condition. As such, the question concerning a current rash, to include solar keratosis, may not be competently addressed by lay evidence, and the Veteran’s opinion on this point is non-probative evidence. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Therefore, in view of the lack of in-service rash complaints, the many years since service that have passed before the Veteran sought rash treatment, and the lack of competent medical opinions regarding rash etiology, the Board finds the evidence weighs against the nexus element of service connection, on which this issue turns. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). Therefore, service connection for solar keratosis, face and arms, (claimed as skin rash, arms and hands) is not warranted. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Santiago, 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.