Citation Nr: 21025300 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 19-34 966 DATE: April 27, 2021 REMANDED Entitlement to service connection for a skin disability of the face and neck is remanded. Entitlement to service connection for a skin disability of the underarms and groin is remanded. Entitlement to service connection for a kidney disability is remanded. Entitlement to service connection for a bilateral ear disability, to include recurrent infections, is remanded. REASONS FOR REMAND The Veteran had active service from January 1962 to January 1964. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from September 2009, September 2014, and October 2017 rating decisions Regional Office (RO) of the Department of Veterans Affairs (VA). In February 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). The issues on appeal have been recharacterized as listed above to reflect better the Veteran’s contentions and the procedural history of this case. Service connection for a skin disorder of the face and neck Service connection for a skin disorder of the underarms and groin Service connection for a kidney disability Service connection for a bilateral ear disability, to include recurring infections As an initial matter, the Veteran treated with private providers for the conditions on appeal, and it is unclear whether the complete records from all relevant private providers have been obtained and associated with the claims file. As such, on remand, attempts to identify all private providers should be made and any outstanding records should be obtained. In this case, the RO has conceded that the Veteran’s active service included time served at DPG in 1962, and that he was possibly exposed to radiation and/or chemicals therein. Specifically, his personnel records show that he was sent to DPG in July 1962, and he has reported that he was there until October 1962. However, it does not appear that the RO attempted to verify any of his assertions of exposures to toxins, including radiation, mustard gas and lewisite, and various other chemicals, with any of the appropriate record-holding entities. Attempts should be taken to verify such exposure on remand, as he has submitted plenty of articles and evidence indicating some exposure could have occurred at DPG. Further, after the RO has developed the Veteran’s in-service exposures, VA examinations are needed for all claims on appeal to determine the nature and etiologies of the claimed conditions in light of the RO’s exposure findings. Accordingly, these matters are REMANDED for the following actions: 1. Ask the Veteran to complete a VA Form 21-4142 for all private providers who treated him for the conditions on appeal. Make two requests for all previously unobtained authorized records from all identified providers, unless it is clear after the first request that a second request would be futile. 2. Undertake appropriate development to verify whether the Veteran was exposed to toxic substances, including chemical agents—to include, but not limited to, mustard gas and lewisite, as well as radiation while serving at Dugway Proving Grounds from July 1962 through October 1962. 3. After all development has been fully completed pursuant to directives 1 and 2, above, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of any skin conditions of the face and/or neck he may have—and the nature and etiology of any skin conditions of the underarms and/or groin area he may have. The examiner is asked to clarify all skin conditions of the head, face and/or neck that the Veteran has been diagnosed with at any time during the appeal period (from February 2009 to present), to include carcinoma—and to clarify all skin conditions of the underarms and/or groin area that he has been diagnosed with at any time during the appeal period (from August 2017 to present). For each such diagnosed disorder, the examiner should opine: Is it at least as likely as not (i.e., 50 percent probability or greater) that any such diagnosed skin disability onset in, or is otherwise related to, any element of the Veteran’s active service, to include toxic exposures from his service in Dugway Proving Grounds in 1962? The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or is the result of an exhaustion of the limits of current medical knowledge in providing an answer to that particular question. 4. Also after all development has been fully completed pursuant to directives 1 and 2, above, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of any kidney disorder he may have. The examiner should clarify all kidney conditions that the Veteran has been diagnosed with at any time during the appeal period (from February 2009 to present) and, for each such diagnosed disability, should opine: Is it at least as likely as not (i.e., 50 percent probability or greater) that any such diagnosed kidney disability onset in, or is otherwise related to, any element of the Veteran’s active service, to include toxic exposures from his service in Dugway Proving Grounds in 1962? The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or is the result of an exhaustion of the limits of current medical knowledge in providing an answer to that particular question. 5. Also after all development has been fully completed pursuant to directives 1 and 2, above, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of any bilateral ear condition, including recurring infections, that he may have. The examiner is asked to clarify all ear conditions that the Veteran has been diagnosed with at any time during the appeal period (from January 2014 to present), and respond to the following questions for each such diagnosed condition: Is it at least as likely as not (i.e., 50 percent probability or greater) that any such diagnosed ear disability onset in, or is otherwise related to, any element of the Veteran’s active service, to include toxic exposures from his service in Dugway Proving Grounds in 1962? The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or is the result of an exhaustion of the limits of current medical knowledge in providing an answer to that particular question. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran also is advised that he has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Davidoski, Associate 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.