Citation Nr: 21024717 Decision Date: 04/26/21 Archive Date: 04/26/21 DOCKET NO. 15-06 739 DATE: April 26, 2021 REMANDED Entitlement to a compensable evaluation for bilateral hand dermatitis is remanded. REASONS FOR REMAND The Veteran had active duty service from May 2001 to March 2003. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in July 2018. A transcript of that hearing has been associated with the claims file. The Board previously remanded the Veteran’s claim in November 2018 after the Veteran testified that he had been taking an oral steroid, methylprednisolone, for his skin condition, during his July 2018 hearing. Although the Veteran was afforded a VA examination in May 2019, that examiner noted that the Veteran’s skin condition was treated with topical medication only. However, the Veteran’s VA medical records show that he was prescribed a Medrol Dosepak in January 2018 during an appointment for both dermatitis and pain in the hand joints and low back, and methylprednisone is listed as a pending medication in January 2018. It is unclear to the Board whether the Medrol and/or methylprednisolone was prescribed as a result of the Veteran’s service connected bilateral hand dermatitis or for another medical issue. As such, a VA medical opinion should be obtained in order to provide clarity as to the treatment prescribed for the Veteran’s bilateral hand dermatitis. Additionally, as noted in November 2018 remand directives, a VA medical opinion is needed to address whether any topical treatments used by the Veteran are medications are systemic therapies affecting the body as a whole. Accordingly, the case is REMANDED for the following action: 1. The agency of original jurisdiction (AOJ) should obtain any outstanding VA medical records and associate them with the claims file. 2. After the above development has been completed, the AOJ should obtain a VA medical opinion for the Veteran’s bilateral hand dermatitis. A physical examination is only needed if deemed necessary by the VA examiner. The examiner is requested to review all pertinent records associated with the claims file. The examiner should note that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the appellant, the examiner should provide a fully reasoned explanation. The examiner should identify the medications used to treat the Veteran’s bilateral hand dermatitis since January 2013 to present and indicate whether they are topical, corticosteroid, or immunosuppressive. With regard to any topical treatments, the examiner should address whether any such medications are systemic therapies, in that they affected the body as a whole. The examiner is also asked to specifically discuss the Medrol Dosepak/methylprednisolone prescribed in January 2018 and discuss whether that medication was prescribed for the Veteran’s bilateral hand dermatitis. If so, the examiner should include this medication when addressing the foregoing questions as to whether they are topical, corticosteroid, immunosuppressive, or systemic. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important “that each disability be viewed in relation to its history [,]” 38 C.F.R. § 4.1, copies of all pertinent records in the appellant’s claims file, or in the alternative, the claims file, must be made available to the examiner for review. 3. After completing these actions, the AOJ should conduct any other development as may be indicated. J.W. ZISSIMOS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Rideout-Davidson, 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.