Citation Nr: 21027181 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 16-23 713 DATE: May 4, 2021 ORDER Entitlement to service connection for acne with associated scars is denied. FINDING OF FACT The Veteran's disability of acne with associated scars pre-existed service and was not permanently aggravated as a result of her active service. CONCLUSION OF LAW The criteria for service connection for an acne disability with associated scars have not been met. 38 U.S.C. § 1110, 1111, 1131, 1153 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.306 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active Naval service from August 2010 to August 2014. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the Veteran submitted a timely notice of disagreement with the denials of entitlement to service connection for a back disability and a rash, and with the rating assigned for tinnitus in the January 2015 rating decision. However, in an April 2016 rating decision, the Veteran was granted entitlement to service connection for a back disability. There is no indication from the record that the Veteran has disagreed with the initial rating or effective date assigned in that decision. As such, that decision constitutes a complete grant of the benefit sought on appeal and the Board has limited its consideration accordingly. As to the remaining claims, in November 2016, the Veteran submitted a written withdrawal of those issues on appeal. The withdrawal request included the Veteran's name, file number, and an express request to withdraw the specific claims as noted, thus fulfilling all regulatory requirements for a proper withdrawal. 38 C.F.R. §§ 20.205. Based upon the valid written withdrawal submitted by the Veteran, there is no longer a case in controversy over which the Board has jurisdiction as to those claims, as the effective date of the withdrawal is the date upon which it was received. In this case, that date was November 3, 2016. 38 C.F.R. § 20.205(b)(3). Service Connection Acne with Associated Scars The Veteran contends that her disability of acne with resultant scars is related to her active duty military service. The Veteran's entrance examination reveals a notation of facial acne reported by the Veteran and also recorded by the examiner upon physical examination. See June 2010, Enlistment Examination. In Wagner v. Principi, 370 F.3d 1089, 1096 (2004), the United States Court of Appeals for the Federal Circuit held if a preexisting disorder is noted upon entry into service, the veteran cannot bring a claim for service connection for that disorder, but the veteran may bring a claim for service-connected aggravation of that disorder. In that case, 38 U.S.C. § 1153 applies and the burden falls on the veteran to establish an increase in disability during service. If the presumption of aggravation attaches, the burden shifts to the government to show by clear and unmistakable evidence that there has been no increase in the severity of the preexisting condition or that any increase was the result of natural progression. Id; see also 38 C.F.R. § 3.306(b). The Veteran does not argue that her claimed disability did not pre-exist service. Rather, on appeal, her representative argues that the administered VA examination reports of record are inadequate for failing to provide a determination as to the etiology of the claimed disability. This argument is unavailing as the examination reports provide a thorough analysis of the claimed disability, including a reasoned rationale for the opinions expressed therein. The Veteran was afforded a VA examination in October 2014. It was identified that the Veteran had limited facial acne at the time of examination and the Veteran reported that she had recently chosen not to treat the condition. The examiner opined that the claimed facial acne was not permanently aggravated beyond the normal progression, but did not expand upon the reasoning for finding so. The same examiner authored an addendum opinion in December 2014. That opinion explains that the origins of facial acne and related markings occur at the time of pustule healing and is not a residual that occurs long after the initial infection. The examiner relied upon the weight of medical literature, along with the in-person examination of the Veteran, and review of the records, in determining that the Veteran's acne and related facial scarring pre-existed service and is less likely than not caused by, related to, or permanently aggravated beyond the natural progression of the disability by military service in any way. The Veteran's service treatment records (STRs) do reflect that she was treated for facial acne during her active duty service. However, mere treatment of a pre-existing disability during service does not establish an increase in the disability. (Continued on the next page) The Board finds that the VA examination reports along with the STRs present the most competent and credible evidence of record and do not show an increase in the severity of the Veteran's facial acne with scars during service. As such, the presumption of aggravation does not attach. Wagner, 370 F.3d at 1096. Because the Veteran's pre-existing facial acne with scars was not aggravated by military service entitlement to service connection must be denied. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Sutherell, 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.