Citation Nr: 21022161 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 14-19 771A DATE: April 14, 2021 REMANDED Entitlement to service connection for a skin disability is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1990 to January 1993 in the Navy. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) located in Montgomery, Alabama. In June 2017, the Veteran was afforded a videoconference hearing before the undersigned. A copy of the hearing transcript has been associated with the record. 1. Entitlement to service connection for a skin disability is remanded. This matter was previously before the Board in December 2018, when the claim of entitlement to service connection for dermatitis was remanded for further development, to include an adequate VA examination. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In this regard, the Board instructed in December 2018 that the VA examiner provide an addendum opinion addressing the Veteran’s statement that she experienced symptoms of dermatitis in service and has had similar symptoms ever since. The Veteran was afforded a VA examination in September 2019. The examiner opined that that the Veteran’s skin disability was less likely than not incurred in or caused by service, reasoning that there are no chronic ongoing diagnosis, complaints, or treatment for dermatitis secondary to allergic reaction to cleaning solvents during service noted in the Veteran’s available service treatment records. The examienr further stated that if the Veteran’s dermatitis had been as a result of an allergic reaction secondary to cleaning solvents during service, this reaction would have been acute and occurred immediately or shortly after contact with the cleaning solvents and would have resolved when the Veteran stopped using the solvents. The examiner also noted that such an allergic reaction would not have continued after separation from the military, when the Veteran no longer had any contact with the solvents, nor would it first appear several years after separation from the military. The Board notes, however, that neither in the examiner’s medical opinion nor in the associated examination were the Veteran’s statements regarding continuity of symptoms referenced or considered. As a layperson, the Veteran is competent to describe her experience of dermatitis, eczema, a rash, as well as observable symptoms of pain and itching. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). An additional skin examination dated in August 2020 was associated with the record. A different examiner diagnosed the Veteran with psoriasis rather than dermatitis. This examiner opined that the Veteran’s psoriasis is less likely than not due to an allergic reaction in service, reasoning that none of the Veteran’s service records discussed any type of rash – and if a rash was due to contact dermatitis, it would have been present soon after contact. The Board finds this examination, too, to be inadequate for adjudication purposes. The examiner’s rationale is entirely based on an absence of medical evidence in service records, and does not discuss the Veteran’s competent lay statements of record. See Ledford v. Derwinksi, 3 Vet. App. 87 (1992) (holding that the absence of complaints or treatments in service for hearing is not fatal to a claim for service connection for the same); See also Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (“If the Board concludes that the lay evidence presented by a veteran is credible and ultimately competent, the lack of contemporaneous medical evidence should not be an absolute bar to the veteran’s ability to prove his claim of entitlement to disability benefits based on that competent lay evidence”). Consequently, the matter must once again be remanded for an adequate VA medical opinion. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA and private treatment records pertinent to the Veteran’s skin disability. 2. Thereafter, forward the entire claims file, including a copy of this remand, to an appropriately qualified VA examiner for an addendum opinion to further determine the nature and etiology of the Veteran’s skin disability, to include dermatitis and psoriasis. Based on a review of the claims file, the examiner is requested to provide an opinion on whether it at least as likely as not (50 percent or greater probability) that the Veteran has a skin disability that began in or is otherwise caused by or related to service. In providing the requested opinion, the examiner must specifically address the Veteran’s competent and credible statement that she experienced symptoms of dermatitis in service and has had similar symptoms ever since. The Veteran is competent to report lay observable symptoms. The Board underlines that lack of diagnosis during service is not a bar to service connection, and lack of contemporaneous medical evidence is insufficient rationale for a negative etiological opinion. A complete rationale must be given for all opinions and conclusions. Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Comninos, Georgio 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.