Citation Nr: 21015767 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 08-32 418 DATE: March 18, 2021 REMANDED Entitlement to a rating higher than 10 percent for multiple sebaceous cysts is remanded. Entitlement to service connection for dental extractions for compensation purposes is remanded. REASONS FOR REMAND The Veteran served on active duty for training from July to September 1987 and on active duty from April 1988 to January 1992 and from March 2005 to June 2006. He also had additional periods of National Guard service. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2007 rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO) in Montgomery, Alabama. This appeal was previously before the Board in May 2020. At that time, the appeal also included the issue of entitlement to service connection for a bilateral foot condition. The Board remanded the appeal in its entirety for further evidentiary development. Upon such requested development, the RO granted the Veteran’s service connection claim for a bilateral foot condition. As that decision represents a full grant of benefits sought, that issue is no longer in appellate status. 1. Entitlement to service connection for dental extractions for compensation purposes is remanded. The previous Board remands dated August 2014, May 2017, February 2018, and May 2020 note that a claim for service connection for a dental disorder is also considered a claim for VA outpatient dental treatment. See August 2014 Board Decision; see also Woodson v. Brown, 8 Vet. App. 352, 354 (1995); Mays v. Brown, 5 Vet. App. 302, 306 (1993). Accordingly, because the issue of entitlement to service connection for dental extractions for VA outpatient treatment purposes had been raised by the Veteran when he filed his service connection claim for dental extractions but had not been adjudicated by the Agency of Original Jurisdiction (AOJ), the Board referred the claim for service connection for a dental disorder for purposes of VA outpatient dental treatment to the AOJ for appropriate action. See 38 C.F.R. § 19.9(b). Despite this, it does not appear than action has, yet, been taken as concerning this claim. Accordingly, the claim for service connection for a dental disorder, for purposes of VA outpatient dental treatment, is referred to the AOJ for additional referral to the appropriate VA Medical Center (VAMC). The Board must defer adjudication of the service connection claim. 2. Entitlement to a rating higher than 10 percent for multiple sebaceous cysts is remanded. While further delay is regrettable, the Board finds that remand is required to obtain an addendum opinion regarding the Veteran’s medications for his service-connected sebaceous cysts. Currently, the Veteran’s service-connected sebaceous cysts are rated 10 percent disabling; in order to warrant a higher 30 percent rating, there must be evidence of either a skin disorder that affects 20 to 40 percent of the entire body or 20 to 40 percent of the exposed areas, or that requires systemic therapy such as corticosteroids or other immunosuppressive drugs for a total duration of 6 weeks or more, but not constantly, during the past 12-month period. 38 C.F.R. § 4.118, Diagnostic Code 7806. In the previous remand, the Board sought an opinion regarding whether the medications prescribed for the Veteran’s skin disability constituted systemic therapy. In the July 2020 addendum opinion, the examiner found that the Veteran’s topical medications were not considered immunosuppressive, systemic, or steroidal. However, the evidence indicates that in August 2016, the Veteran was prescribed an oral antibiotic to treat his cysts. Notably, at the September 2016 VA examination, the examiner noted that the Veteran used an oral medication to treat his cysts for at least 6 weeks but not constant. As the July 2020 addendum opinion did not address whether the Veteran’s oral medications were immunosuppressive or systemic in nature, remand is required to obtain such an opinion. The matters are REMANDED for the following action: 1. Associate with the claims folder updated treatment records. 2. Forward the Veteran’s claims folder to an appropriate clinician. The examiner should review the Veteran’s medication list and identify all medications used to treat his sebaceous cysts, to include the antibiotics prescribed in August 2016. The examiner should identify whether any of these medications are immunosuppressive and/or systemic in nature. 3. After properly documenting that the issue of entitlement to service connection for dental extractions for VA outpatient treatment purposes has been referred and after conducting any additional development, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Orie, 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.