Citation Nr: 21025143 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 16-24 002 DATE: April 27, 2021 REMANDED Entitlement to service connection for a skin disorder, to include as a result of in-service asbestos exposure, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Navy from December 1987 to March 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2014 rating decision of an Agency of Original Jurisdiction (AOJ) of the Department of Veterans Affairs (VA). The Board previously considered this appeal in November 2018. The Board, at that time, determined that a June 2014 VA examination was inadequate "because the examiner did not address the Veteran’s complaint that his rash has never gone away, that his current problem is related to asbestos exposure, or whether his current problem is in anyway related to the skin rashes he experienced in service." Therefore, the Board remanded the appeal for a new examination. As background, the Board observes that homelessness, or at a minimum, the frequent changing of addresses, impacts this appeal. The Veteran's VA treatment records show he participates in the U.S. Department of Housing and Urban Development-VA Supportive Housing program. This collaborative program between the U.S. Department of Housing and Urban Development and VA combines U.S. Department of Housing and Urban Development housing vouchers with VA supportive services to help homeless Veterans and their families find and sustain permanent housing. Moreover, since the Veteran filed his claim in December 2013, VA has contacted him at 10 different addresses. This is the lens through which the Board evaluates the appeal since its November 2018 Remand. The Board mailed its November 2018 Remand to an Upland, California address. Nothing indicates non-delivery. On August 7, 2019, VA mailed the Veteran a letter to the same Upland, California address to which the Board mailed its November 2018 Remand. On August 17, 2019, the U.S. Postal Service retuned the August 7, 2019 letter to VA as undeliverable. An August 23, 2019 HUD-VASH note states the Veteran reported he needed a referral to emergency housing. On August 24, 2019, VA scheduled the Veteran for the VA examination the Board ordered in its November 2018 Remand. The Vet did not attend the examination. On October 4, 2019, a Report of General Information (RGI) states that VA called the Veteran at two phone numbers to discuss his missed examination, but it could not reach him at either number. The RGI lists the Upland, California address as the Veteran's address of record. On October 8, 2019, VA mailed the Veteran two copies of the same letter to confirm that it processed a change in his direct deposit information. VA mailed one copy to the Upland, California address, while it mailed the second copy to a Moreno Valley, California address. Nothing indicates non-delivery of either letter. On December 31, 2019, VA mailed the Veteran a letter to confirm that it processed a change in his direct deposit information. VA mailed this letter to a Loma Linda, California address. Nothing indicates non-delivery of this letter. On July 7, 2020, VA mailed the Veteran a Supplemental Statement of the Case for this appeal to the aforementioned Moreno Valley, California address. Nothing indicates non-delivery of the Supplemental Statement of the Case. On August 7, 2020, VA mailed the Veteran notice that it was returning his appeal to the Board. It used the aforementioned Moreno Valley, California address. Nothing indicates non-delivery of the letter. On August 26, 2020, the Board mailed the Veteran notice that it had received his appeal. It used a Riverside, California address. Nothing indicates non-delivery of the letter. The chronology demonstrates that VA was on notice, as of August 17, 2019, that the Upland, California address was no longer valid for the Veteran. Therefore, along with the evidence that indicates the Veteran was likely homeless on August 23, 2019, it is not surprising that he did not attend the August 24, 2019 examination. VA attempted to reschedule the examination by contacting the Veteran on October 4, 2019. The Board, if the record ended there, would adjudicate the claim based on the Veteran's failure to report. However, a mere four days later, VA, despite changing the Veteran's direct deposit information, was not clear where he resided because it mailed him the same letter to two addresses. Given this uncertainty and the likelihood that it impacted the scheduling of his examination, the Board will again order a new examination. Despite this action, the Board wants to be clear. Pursuant to Wood v. Derwinski, 1 Vet. App. 190, 193 (1991), VA's duty to assist the Veteran in prosecuting his claim is a two-way street. If he desires for VA to help him, he cannot passively wait for that help in those circumstances where he may or should have information that is essential in obtaining relevant evidence. He is obligated, as relevant here, to keep VA apprised of his current address and phone number. Without this information, VA cannot reliably communicate with him. If he fails to keep VA apprised of his current address and phone number, it may adversely affect his appeal. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Arrange for a VA examination with to determine the nature and etiology of the Veteran’s claimed skin disorder. If the Veteran fails to report for the scheduled VA examination without good cause shown, obtain an opinion from a qualified clinician. The electronic records, to include a copy of this remand, should be made available to and reviewed by the clinician, and an opinion as follows is requested: a. Identify each skin disorder diagnosed since December 2013, the date of the claim. b. For each skin disorder diagnosed, is it at least as likely as not (50 percent probability) that the diagnosed skin disorder began during service? Why or why not? c. For each skin disorder diagnosed, is it at least as likely as not (50 percent probability) that the diagnosed skin disorder is otherwise related to service, to include the in-service complaints and treatment of a skin disorder and as a result of exposure to asbestos? Why or why not? In answering this question, the clinician must expressly discuss the Veteran's in-service complaints and treatment of a skin disorder. In answering this question, the examiner must also expressly discuss the Veteran's in-service exposure to asbestos. As background, the Veteran’s personnel records show that the Veteran was aboard the USS Belknap CG-26 during part of his service. The Veteran served on active duty in the Navy and his primary Military Occupational Specialty (MOS) was a boiler technician. Based upon this information, the examiner MUST accept that the Board, in November 2018, found that the Veteran was exposed to asbestos. In answering this question, the examiner should also consider all pertinent medical and lay evidence, including statements from the Veteran. Please specifically review the dermatology treatment records from the VA Medical Center (VAMC). The Veteran noted during treatment at the VAMC in February 2014 that he had additional information he had not previously shared with the VA examiner. He stated that during his military service, he was exposed to asbestos during a time when his ship was docked, and he was tasked with removing it. This is when he first noticed a rash on his leg. He was told that this could possibly be related to his exposure and should have a biopsy done. This was close to the time he was to be discharged and did not follow up with the biopsy. (Continued on the next page)   The examiner set forth the complete rationale for all opinions. The rationale for a negative opinion must not be based solely on the lack of a relevant in-service diagnosis or clinical findings and must reflect consideration of the competent lay assertions of pertinent symptomatology from service to the present. Tiffany Dawson Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Sopko, 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.