Citation Nr: 21025548 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 14-13 481 DATE: April 28, 2021 REMANDED Entitlement to service connection for a cardiac disability, including cardiomyopathy, is remanded. Entitlement to service connection for a skin disability, to include dermatitis and tinea (jock itch), is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1975 to September 1978 with additional service in the Army Reserves, after completing active duty service in 1978 to September 1996. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a July 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge in September 2017. A transcript of the hearing is associated with the claims file. The Board previously remanded the issues on appeal in a January 2018 remand. At that time, the issue of entitlement to service connection for a right knee disability, was also on appeal. This claim was granted in full by the RO in a February 2020 rating decision; therefore, it is no longer on appeal. As discussed below, the Board finds that there has not been substantial compliance with its January 2018 remand and, therefore, it may not proceed with a determination on the merits at this time. See Stegall v. West, 11 Vet. App. 268 (1998). The Board directed the RO to request from the National Personnel Records Center, (NPRC) the Veteran’s Guard Unit or any other appropriate entity, any additional service treatment records. If any requested records were not available or the search for any such records otherwise yielded negative results, that fact was to be documented in the claims file. Efforts to obtain the records were to continue until it was determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records was to be verified and documented and required notice was to be provided to the Veteran and his representative. The record reflects the RO requested Service Treatment Records (STRs) and the entire personnel file from the NPRC in August 2019. This request noted the Veteran’s period of service with the Army was from September 1975 to September 1978. Additional personnel records were added to the file, including confirmation of the Veteran’s training at Ft. McClellan and orders for a chemical training exercise. Documentation from September 2019 indicates that all available requested records from NPRC were furnished. The RO submitted another request for information in March 2020 through the Personnel Information Exchange System (PIES) for the Veteran’s Reserve record. A response to this request does not appear to be in the file. Remand is necessary to ensure this request was completed. Additionally, in the January 2018 remand the Board directed that the Joint Services Records Research Center (JSRRC) or any other official source/agency deemed appropriate, provide any information that might corroborate the Veteran’s alleged in-service exposure to caustic and toxic substances during service. A July 2020 research request notes an exposure incident of September 1975 to October 1975, but includes additional dates in the “circumstances surrounding exposure” portion of the request. This document is cut off and not entirely legible in the file. The January 2021 response to this request indicates “Request Closed-No pending or associated EP.” It is unclear whether JSRRC performed the requested investigation. Remand is necessary to ensure this request was addressed. Furthermore, the January 2018 Board remand directed that the RO provide all periods of active duty and active duty for training (ACDUTRA) to the examiners. The record does not reflect this was completed. For this reason, and the reasons discussed below, remand is also warranted to obtain addendum medical opinions. 1. Entitlement to service connection for a cardiac disability, including cardiomyopathy A December 2019 VA examiner noted a diagnosis of cardiomyopathy and indicated a date of diagnosis of 1993. In the etiology section of the report, the examiner noted “toxins from Fort McClellan” as the etiology of the Veteran’s enlarged heart cardiomyopathy. In a July 2020 medical opinion, the examiner indicated the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, even, or illness. She explained that all available medical records were reviewed, and service treatment records were negative for a cardiac condition during active duty service. She noted that the Veteran separated from service in 1978 and the cardiac condition was diagnosed in 1993. The August 1978 separation examination report was negative for any heart conditions. She concluded there is no credible medical evidence to support a causal link between any hazardous exposure and the Veteran’s diagnosis of cardiomyopathy. The examiner did not consider any periods of ACDUTRA or address whether the Veteran’s cardiac disability was aggravated by any period of active duty or ACDUTRA service. Remand is warranted for an addendum opinion so the examiner may consider all periods of active duty and ACDUTRA service. 2. Entitlement to service connection for a skin disability, to include dermatitis and tinea (jock itch) A July 2020 VA opinion indicates the claims file is silent for any history of a skin condition during service. Therefore, it is less likely than not that the Veteran’s current skin condition is related to service. The examiner concluded there is no credible medical evidence to support a causal link between hazardous exposure and tinea. Tinea is a fungal infection. While the Veteran’s claim was for jock itch (tinea), a December 2019 VA skin examination indicates the Veteran was diagnosed with dermatitis in 1975. It is unclear if the examiner’s assessment that there is no causal link between hazardous exposure and tinea applies to dermatitis as well. Clarification is needed to determine whether the Veteran’s current condition is tinea, dermatitis, or both. If it is dermatitis, as noted in the December 2019 skin examination report, an addendum opinion is necessary to provide rationale that addresses dermatitis. Furthermore, remand is warranted for an addendum opinion so the examiner may consider all periods of active duty and ACDUTRA service and address whether the Veteran’s skin disability was aggravated by any period of active duty or ACDUTRA service. The matters are REMANDED for the following actions: 1. Verify and document whether the PIES request submitted in March 2020 by the RO was completed. If any requested records are not available or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified, and this should be documented for the record. Required notice must be provided to the Veteran and his representative. 2. Verify and document whether JSRRC performed an investigation in response to the July 2020 research request. If an investigation was not completed, ensure that an investigation is completed or document why it cannot be completed. If an investigation was completed document that and any findings of the investigation. 3. After undertaking the development listed above to the extent possible and any additional records are associated with the claims file, obtain an addendum opinion from a qualified clinician for cardiac disabilities. The agency of original jurisdiction (AOJ) must provide all periods of active duty and ACDUTRA to the clinician. The clinician should answer the following question: is it at least as likely as not (50 percent probability or greater) that the Veteran’s cardiac disability, to include cardiomyopathy, was caused by or aggravated by any period of service, to include asserted exposure to toxic or caustic substances? The Veteran’s statements, including that submitted in November 2019, must be considered. At that time he explained that he was exposed to caustic and toxic substances at Fort McClellan on and off for several years, and that while he was there he was exposed in general, indirectly through the air, soil, and water, but also directly because he was with the 415th chemical brigade WRUVAA and was directly exposed by having to continue to take classes with chemical weapons to keep up to date with his military occupational specialty. He was in chemical defense training facility training with nerve agents and biological agents while at Fort McClellan. He also handled hazmat material while there. The Veteran confirmed that he reported to Ft. McClellan for training or duty at least from: January 19-21, 1990; July 8-22, 1984; May 7-21, 1983; May 10-23, 1981; and May 5-17, 1991. He believed his time in January 1990 would have been longer based on his recollection that he was always there for two to three weeks at a time. There could have been more times that he reported to Fort McClellan other than the dates from the personnel records he submitted. 4. After undertaking the development listed in directives one and two above to the extent possible and any additional records are associated with the claims file, obtain an addendum opinion from a qualified clinician for skin disabilities. The AOJ must provide all periods of active duty and ACDUTRA to the clinician. The clinician must identify any skin disability the Veteran has had during the period on appeal. The clinician should address the Veteran’s claim of jock itch and the diagnosis of dermatitis noted in the December 2019 examination. After determining which diagnosis(es) the Veteran has had during the period on appeal, the clinician should answer the following question for each diagnosis: is it at least as likely as not (50 percent probability or greater) that any skin disability the Veteran has had during the period on appeal was caused by or aggravated by any period of service, to include asserted exposure to toxic or caustic substances? The Veteran’s statements, including that submitted in November 2019, must be considered. At that time he explained that he was exposed to caustic and toxic substances at Fort McClellan on and off for several years, and that while he was there he was exposed in general, indirectly through the air, soil, and water, but also directly because he was with the 415th chemical brigade WRUVAA and was directly exposed by having to continue to take classes with chemical weapons to keep up to date with his military occupational specialty. He was in chemical defense training facility training with nerve agents and biological agents while at Fort McClellan. He also handled hazmat material while there. The Veteran confirmed that he reported to Ft. McClellan for training or duty at least from: January 19-21, 1990; July 8-22, 1984; May 7-21, 1983; May 10-23, 1981; and May 5-17, 1991. He believed his time in January 1990 would have been longer based on his recollection that he was always there for two to three weeks at a time. There could have been more times that he reported to Fort McClellan other than the dates from the personnel records he submitted. 5. Thereafter, readjudicate the issues on appeal. If the determination remains unfavorable to the Veteran, he and his representative should be furnished a Supplemental Statement of the Case that addresses all evidence associated with the claims file since the last Statement of the Case. The Veteran and his representative should be afforded the applicable time period in which to respond. L. CHU Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Vemulapalli 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.