Citation Nr: 21021290 Decision Date: 04/12/21 Archive Date: 04/12/21 DOCKET NO. 15-35 298 DATE: April 12, 2021 REMANDED Service connection for a skin disability is remanded. Service connection for hair loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the Marine Corps from November 2007 to November 2011. The Veteran testified before the undersigned Veterans Law Judge during a July 2019 hearing. These matters are on appeal from an April 2015 rating decision. These claims were remanded by the Board in December 2019 to attempt to obtain additional records and to afford the Veteran VA examinations.  The Board will discuss the compliance of the Agency of Original Jurisdiction (AOJ) with its instructions below.  In its December 2019 decision, the Board also remanded claims for service connection for a right ankle disability, a right knee disability, and a left knee disability.  In a November 2020 rating decision, the AOJ granted service connection for lateral collateral ligament sprain of the right ankle, left knee strain, and right knee strain. These issues are no longer before the Board.   Some of the Veteran’s service treatment records, including but not limited to the separation examination from his period of active duty service, appear to have been lost. The Agency of Original Jurisdiction (AOJ) has documented its efforts to locate the complete records. In cases where records once in the hands of the government are lost, the Board has a heightened obligation to explain its findings and conclusions and to carefully consider the benefit-of-the-doubt rule where applicable. See O’Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). Because of the missing records, the analysis below has been undertaken with this heightened duty in mind. The case law does not, however, lower the legal standard for proving a claim for service connection but rather increases the Board’s obligation to evaluate and discuss in its decision all of the evidence that may be favorable to the Veteran. See Russo v. Brown, 9 Vet. App. 46 (1996). 1. Service connection for a skin disability is remanded. 2. Service connection for hair loss is remanded. Once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide one that is adequate for purposes of the determination being made. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran was afforded a VA examination for skin diseases in August 2020 and the clinician’s opinions that the Veteran’s skin disability and hair loss were less likely than not incurred in or caused by active duty service were based primarily on silence in service treatment records; this was the reason the clinician gave for disregarding the Veteran’s lay statements. This is an inadequate rationale, particularly when the Veteran’s service treatment records are partially missing; in its remand instructions the Board specifically instructed the clinician that “a lack of documented treatment in service, while probative, cannot serve as the sole basis for a negative finding.” A remand is warranted for new medical opinions. The matters are REMANDED for the following action: 1. Arrange for an opinion by an appropriate clinician who has not previously examined the Veteran for the purpose of determining the etiology of the Veteran’s skin disability. The entire claims file and a copy of this remand must be made available to the clinician for review. A new examination is only required if deemed necessary by the clinician. The clinician must provide an opinion as to whether it is as likely as not (a probability of 50 percent or greater) that any current skin disability had its origin in service or is related to the Veteran’s active service. Although an independent review of the claims file is required, the Board calls the clinician’s attention to the following: a. The Veteran’s report in his November 2011 claim, which VA received two days after his separation from active duty service, of dry skin “all over” the top of his body. b. VA treatment records from November 2013, noting the Veteran’s report of a history of eczema in the form of a rash on his throat and an occasional rash on his chest, with the treatment provider’s note that the report “sounds like tinea versicolor.” c. VA treatment records from March 2017, noting the Veteran’s reports of eczema and pruritis and the treatment provider’s diagnosis of “suspect tinea versicolor.” d. The Veteran’s testimony during the July 2019 hearing regarding the onset, nature, and continuity of his symptoms. The rationale for any opinion expressed should be provided. Note that the Veteran’s service treatment records are partially missing and a lack of documented treatment in service, while probative, cannot serve as the sole basis for a negative finding. If an opinion cannot be made without resort to speculation, the clinician should so state and provide reasoning as to why this is so. 2. Arrange for an opinion by an appropriate clinician who has not previously examined the Veteran for the purpose of determining the etiology of the Veteran’s hair loss. The entire claims file and a copy of this remand must be made available to the clinician for review. A new examination is only required if deemed necessary by the clinician. The clinician must provide an opinion as to whether it is as likely as not (a probability of 50 percent or greater) that any current disability manifested by hair loss had its origin in service or is related to the Veteran’s active service. Although an independent review of the claims file is required, the Board calls the clinician’s attention to the following: a. The Veteran’s report in his November 2011 claim, which VA received two days after his separation from active duty service, of hair loss. b. The Veteran’s testimony during the July 2019 hearing regarding the onset, nature, and continuity of his symptoms. The rationale for any opinion expressed should be provided. Note that the Veteran’s service treatment records are partially missing and a lack of documented treatment in service, while probative, cannot serve as the sole basis for a negative finding. If an opinion cannot be made without resort to speculation, the clinician should so state and provide reasoning as to why this is so. 3. Ensure that the directives specified in this remand have been implemented.  If they have not, appropriate corrective action must be undertaken before readjudication. Stegall v. West, 11 Vet. App. 268 (1998).  The AOJ is advised that a medical opinion that relies on the fact that a disability is not mentioned in treatment records is inadequate. 4. Then, readjudicate the claims.  If any decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response.  Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Ryan Frank, 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.