Citation Nr: 21024421 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 17-10 625A DATE: April 22, 2021 REMANDED Entitlement to service connection for a skin condition, (also claimed as rash with heat sensitivity, irritation, moles, cancerous growths, itching, welts, and nodules) to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1969 to September 1971, to include service in Vietnam. This matter comes before the Board of Veterans’ Appeals (the Board) on appeal from an October 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded this matter in January 2019 for further development. Unfortunately, as explained below, the Board is not satisfied that there was substantial compliance with its remand; therefore, the appeal must once again be remanded.  See Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008).  Entitlement to service connection for a skin condition, (also claimed as rash with heat sensitivity, irritation, moles, cancerous growths, itching, welts, and nodules) to include as due to herbicide exposure, is remanded. The Veteran underwent a skin diseases VA examination in October 2019. The examiner found that the Veteran did not have any current skin lesions on examination. The examiner also stated, “nor is there any credible evidence that any prior skin ailment was either incurred in, or caused or related to environmental exposure to herbicides during service.” First, the Board notes that the requirement that there be a current disability is satisfied when the disability is shown at the time of the claim or during the pendency of the claim, even if the disability subsequently resolves. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); see also Romanowsky v. Shinseki, 26 Vet. App. 289 (2013) (holding that when the record contains a recent diagnosis of disability prior to a veteran filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency). Accordingly, the Veteran's seborrheic keratosis of the bilateral upper extremities and actinic keratosis of the face, diagnosed in an April 2017 VA treatment note, are considered current diagnoses for VA compensation purposes. Second, the finding that any prior skin ailment was neither incurred in or caused or related to environmental exposure to herbicides during service is a generalized opinion and not specific to the diagnosed skin disorders from April 2017, and without rationale. Accordingly, the opinion is inadequate. As such, the Board must remand this matter once again to obtain a new medical opinion that adequately considers the complete medical and lay evidence of record when providing a well-reasoned medical opinion on the nature and etiology of the Veteran's skin condition. See Stegall, 11 Vet. App. at 268; see also Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The requested opinion must adequately address the nature and etiology of all skin conditions diagnosed during the pendency of the claim, even if not currently present or deemed resolved. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013). Accordingly, the matter is REMANDED for the following action: 1. Obtain a medical opinion from an appropriate medical professional, who has not previously examined the Veteran, to assess the nature and etiology of any skin disorder diagnosed during the appeal period. The examiner must review the Veteran's entire claims file and that review must be noted in the respective report. Thereafter, the respective examiner is asked to provide a medical opinion with regard to the following: (a) Identify all currently-diagnosed skin conditions, including those present during the pendency of the Veteran’s appeal even if currently resolved or in remission, to include seborrheic keratosis of the bilateral upper extremities and actinic keratosis of the face, diagnosed in April 2017. (b) With regard to all diagnosed skin condition, to include seborrheic keratosis of the bilateral upper extremities and actinic keratosis of the face, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the skin condition was incurred in or otherwise causally related to any event or circumstance of the Veteran’s military service, to include exposure to herbicide agents during service in Vietnam? The requested opinion must specifically consider and address the Veteran’s lay statements that he developed skin issues while in Vietnam and that he has continued to have recurrent problems ever since. The examiner is advised that the term “at least as likely as not” does not mean “within the realm of possibility.” Rather, it means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it. The examiner must provide a complete rationale for any opinions offered, citing to the examiner’s own expertise, medical principals, and/or evidence in the Veteran’s record, when necessary, to support the conclusion reached. If an opinion cannot be reached without resorting to speculation, the examiner must fully explain why that is so. The Board reminds the examiner that failure to comply with the directives outlined herein will render the opinion inadequate and will result in further remand of the Veteran’s claim. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Gates 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.