Citation Nr: 21021783 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 15-31 029A DATE: April 14, 2021 ORDER Entitlement to a rating in excess of 10 percent for acne vulgaris, with secondary scars on face and neck is denied. REMANDED Entitlement to service connection for chronic pulmonary disease (COPD) is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for erectile dysfunction is remanded. Entitlement to service connection for a kidney disorder is remanded. Entitlement to special monthly compensation (SMC) based on loss of use of creative organ is remanded. Entitlement to service connection for ischemic heart disease is remanded. Entitlement to service connection for peripheral neuropathy, right lower extremity, is remanded. Entitlement to service connection for peripheral neuropathy, left lower extremity, is remanded FINDING OF FACT Throughout the period on appeal, the Veteran’s acne has been resolved. To the extent scars have been reported, they have been superficial (and not deep); and not unstable (with frequent loss of covering of skin), painful; or including disfigurement. CONCLUSION OF LAW The criteria for a rating in excess of 10 percent for acne vulgaris, with secondary scars on face and neck have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.118, Diagnostic Code 7828. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1968 to May 1971. He served in Vietnam from May 1969 to May 1971. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The claims were previously remanded by the Board in September 2019 for additional development. Since the previous remand, the Veteran’s claims for service connection for an acquired psychiatric condition and diabetes mellitus, type II have been granted. Increased Rating 1. Entitlement to a rating in excess of 10 percent for acne vulgaris, with secondary scars on face and neck is denied. The Veteran was service connected for acne in a January 1984 rating decision. In a VA 21-4138 received by the VA in October 2014, the Veteran reported that he would like to claim a skin condition from Vietnam. The RO considered this to be a claim for increase. This claim was denied in a November 2014 decision. This appeal arises from disagreement with this decision. The Veteran’s acne vulgaris condition is rated under DC 7828. The Board notes that during the pendency of the appeal, the criteria for evaluating certain disabilities of the skin were revised, effective August 13, 2018. See 38 C.F.R. § 4.118, (Diagnostic Codes 7801, 7802, 7805, and 7806) (2017). However, DC 7828 was unaffected by the revisions, and DC 7828, to be discussed below, is the only applicable DC to address the disability at issue. As such, the revisions do not affect the Veteran’s claim for a higher rating. Under DC 7828, a noncompensable disability rating is warranted for superficial acne (comedones, papules, pustules, superficial cysts) of any extent. A 10 percent disability rating is warranted for deep acne (deep inflamed nodules and pus-filled cysts) affecting less than 40 percent of the face and neck, or; deep acne other than on the face and neck. The maximum 30 percent disability rating is warranted for deep acne (deep inflamed nodules and pus-filled cysts) affecting 40 percent or more of the face and neck. Or acne may be rated as disfigurement of the head, face or neck (DC 7800) or scars (DC’s 7801, 7802, 7803, 7804, 7805), depending upon the predominant disability. At the Veteran’s November 2014 VA skin examination, an examiner was asked whether the Veteran’s diagnosis of acne had progressed to a different condition. The examiner reported that while the Veteran previously had acne, he did not currently have any acne skin lesions. More specifically, the Veteran’s current diagnoses of seborrheic dermatitis and psoriasis were separate and distinct from his resolved scarring from his acne. At his November 2014 VA scars examination, it was reported the Veteran had no active skin lesions; but he had too many scars from prior acne to count. The scars were not painful, unstable, or with frequent loss of covering of skin over the scar. None of the scars were due to burns. The affected area measured 12 x 16 cm; and 8 x12 cm. Elevation, depression, adherence to underlying tissue, or missing underlying tissue was denied; along with abnormal pigmentation or texture of the head, or distortion of facial features or tissue loss for the head, face, and neck. The Veteran was reportedly being treated with medication, but it was for his nonservice connected condition of psoriasis. In June 2017 and October 2017, no suspicious lesions in the Veteran’s exposed skin area were reported at a private medical examination. The color of his skin was normal with normal skin moisture. A December 2017 private record indicated there were no rashes on the skin. In a private medical record in August 2018, itching and a rash were reported; but this was not attributed to the Veteran's acne condition. Notably, an examination of his skin revealed no suspicious lesions, bruises or evidence of scars. The Veteran reported in April 2019 testimony that the scarring from his face burned really badly when he shaved. He reported that when he shaved, he turned bright red. In January 2019, an overall examination of the Veteran’s skin reported no rashes. A March 2019 private medical record reports neither hives or any rashes were present. The Veteran underwent a VA examination for scars in January 2020. Scarring on his back from acne was reported, but scars or disfigurement of the head, face or neck was denied. An additional VA examination for skin was also done in January 2020. A diagnosis of acne reportedly resolved was made. The Veteran had not had any acne “for a long, long time.” To warrant a higher rating the Veteran’s acne symptoms would need to show there is deep acne (deep inflamed nodules and pus- filled cysts) affecting 40 percent or more of the face and neck. A review of the record does not indicate the Veteran’s acne symptoms warrant a higher rating. As noted above, the Veteran’s medical records, both VA and private, and the Veteran’s statements do not indicate the Veteran’s acne is even active. Moreover, the Veteran’s private medical records continuously reported the Veteran had no suspicious lesions or bruises. To the extent rashes were previously reported, the Veteran’s service-connected condition is limited to his acne and does not extend to his other diagnosed skin conditions. Consideration has been given as to whether a higher rating is warranted under another diagnostic code, namely since residual scarring from the resolved acne condition has been reported. While scarring has been reported, the lay and medical evidence of record does not reflect that his disability has resulted in scarring that is: deep(associated with underlying soft tissue damage), unstable (with frequent loss of covering of skin), painful, including disfigurement of the head, face, neck, or other areas; or having any other disabling effects not considered by DC 7828 or DCs 7800-7804. Therefore, a rating under DCs 7800-7805, including the criteria in effect prior to and after October 2018, is not warranted in this case. As such, based on the foregoing, the Board finds that a rating in excess of 10 percent is not warranted for the Veteran’s acne condition during the period on appeal. REASONS FOR REMAND SSA Records On a June 2010 VA 21-4138 Statement in Support of Claim, the Veteran reported that he is totally disabled for breathing problems through social security disability. A review of the claims record indicates these SSA files have not been associated with the record. VA has a duty to assist claimants in obtaining evidence to substantiate a claim. 38 C.F.R. § 3.159(c). VA will make as many requests as are necessary to obtain relevant records from a Federal department or agency. 38 C.F.R. § 3.159(c)(2). The key word, however, is relevant. The United States Court of Appeals for the Federal Circuit has specifically held that VA’s duty to assist is limited to obtaining relevant SSA records, and relevant records have been defined as “those records that relate to the injury for which the claimant is seeking benefits and have a reasonable possibility of helping to substantiate” the claim. Golz v. Shinseki, 590 F.3d 1317, 1321 (2010). Unfortunately, to that extent, another remand is needed to obtain any SSA records that are relevant to the Veteran’s claims. 2. Entitlement to service connection for special monthly compensation based on loss of use of creative organ is remanded. To the extent the Veteran’s claims for service connection for erectile dysfunction is being remanded, adjudication of the claim for special monthly compensation based on loss of use of creative organ is deferred as the claims are inextricably intertwined. The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. 2. Obtain updated VA and private medical records and associate them with the claims file. 3. Contact the SSA and request a copy of the relevant records in the Veteran’s SSA disability benefits file, including relevant associated medical records, and associate these records received with the claims file. All attempts to procure the records should be documented in the file. If the records cannot be obtained, any negative responses should be associated with the claims file, and the Veteran and his attorney should be notified of unsuccessful attempts to obtain the records, in order to allow the Veteran the opportunity to obtain and submit those records for review. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Wade 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.