Citation Nr: 21015805 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 14-20 654 DATE: March 18, 2021 REMANDED Entitlement to service connection for hair loss, to include as secondary to service connected acquired psychiatric disorder, is remanded. Entitlement to service connection for alcohol abuse, to include as secondary to service connected acquired psychiatric disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty service in the United States Army from May 1987 to December 1989. This matter comes before the Board of Veterans’ Appeals (Board) upon appeal from an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2018 the Veteran filed a notice of disagreement (NOD) and in January 2019 the RO issued a statement of the case (SOC). In February 2019 the Veteran timely filed a substantive appeal. In an August 2018 decision, the Board remanded this issue for additional development. Unfortunately, as discussed below, the Board’s directives have not been substantially completed, and a remand is required.  Stegall v. West, 11 Vet. App. 268 (1998).  1. Entitlement to service connection for hair loss, to include as secondary to service connected acquired psychiatric disorder, is remanded. The Veteran is seeking service connection for alopecia areata. Specifically, he contends that his disability is related to his service-connected disabilities, to include his mental health condition that started during his military service and is related to his back disability. See June 2020 Correspondence. As noted above, in an August 2020 decision, the Board remanded this claim for additional development. Specifically, the AOJ was instructed to obtain a VA examination and opinion. Accordingly, in November 2020, the Veteran was afforded a VA examination and diagnosed with alopecia, that has progressively worsened since 1988. The examiner opined that the Veteran’s alopecia was less likely than not related to service or proximately due to his service-connected lumbosacral strain or bilateral knee disability. Unfortunately, the VA examiner failed to address the Veteran’s competent lay assertions that he has been experiencing hair loss since service. In addition, despite the Veteran’s assertions that he has been experiencing hair loss since service because of his mental health conditions, the examiner also does not provide an opinion as to whether the Veteran’s hair loss is proximately due to and/or aggravated by his service connected acquired psychiatric disorder. Accordingly, a remand is warranted for an addendum opinion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). 2. Entitlement to service connection for alcohol abuse, to include as secondary to service connected acquired psychiatric disorder, is remanded. The Veteran is seeking service connection for alcohol abuse. Specifically, he contends that his disability is related to his mental health condition. See June 2020 Correspondence. As noted above, in an August 2020 decision, the Board remanded this claim for additional development. Specifically, the AOJ was instructed to obtain a VA opinion. Accordingly, in October 2020, a VA examiner asserted that the Veteran does not meet DSM criteria for alcohol use disorder and therefore his condition was less likely than not due to service or proximately due to or aggravated by a service-connected disability. Unfortunately, this VA opinion is inadequate for adjudicative purposes. First, the examiner provides no rationale for her conclusory statement. Second the examiner fails to address the Veteran’s competent lay assertions regarding inservice treatment for alcoholism and continued drinking since service in his October 2020 mental health VA examination. Finally, the examiner fails to reconcile her statement with VA treatment records noting a diagnosis of alcohol use disorder and indicating that the Veteran receives medication to treat alcohol addiction. See September 2020 VA Treatment Record; August 2020 VA Treatment Record. Accordingly, a remand is warranted for an addendum opinion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matters are REMANDED for the following action: 1.   The AOJ should obtain a VA medical opinion from an appropriate clinician regarding the Veteran’s hair loss. The claims file and a copy of this Remand must be made available to the examiner. If an opinion cannot be obtained without an examination, then a VA examination should be afforded to the Veteran. The examiner should address the following: (a) The examiner should determine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s hair loss, had its onset during active service or is related to any in-service disease, event, or injury. (b) The examiner should determine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s hair loss, is (i) caused by or (ii) aggravated beyond natural progression by his service-connected acquired psychiatric disorder. In doing so the examiner should address the Veteran’s competent lay assertions. The examination report must include a complete rationale for all opinions provided. If the examiner cannot provide the requested opinion(s) without resorting to speculation, the report should expressly indicate this, and the examiner should explain why an opinion cannot be provided without resorting to speculation. 2.   The AOJ should obtain a VA medical opinion from an appropriate clinician regarding the Veteran’s alcohol use disorder. The claims file and a copy of this Remand must be made available to the examiner. If an opinion cannot be obtained without an examination, then a VA examination should be afforded to the Veteran. The examiner should address the following: (a) The examiner should determine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s alcohol use disorder, had its onset during active service or is related to any in-service disease, event, or injury. (b) The examiner should determine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s alcohol use disorder, is (i) caused by or (ii) aggravated beyond natural progression by his service-connected acquired psychiatric disorder. In doing so the examiner should address the Veteran’s competent lay assertions. See October 2020 VA Examination. The examination report must include a complete rationale for all opinions provided. If the examiner cannot provide the requested opinion(s) without resorting to speculation, the report should expressly indicate this, and the examiner should explain why an opinion cannot be provided without resorting to speculation. 3. After undertaking any additional development deemed necessary, the AOJ must readjudicate the claims on appeal. If any claim remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and afforded the requisite opportunity to respond before the case is returned to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Kaufer, Associate 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.