Citation Nr: 21030543 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 19-21 707 DATE: May 19, 2021 REMANDED Entitlement to service connection for a skin disorder, claimed as skin cancer, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1976 to April 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a rating decision issued by the Department of Veterans Affairs (VA), and has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107. The Veteran, his wife, and his attorney appeared before the undersigned Veterans Law Judge during a hearing in August 2020. A transcript of the hearing has been associated with the claims file. The Board notes that the Veteran initially filed a claim for skin cancer. However, applicable law dictates that a claim for benefits should not be limited to a particular diagnosis on a claims form, but must instead be considered broadly to encompass the functional impairment arising from a particular disorder. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Thus, the Board has recharacterized the issue on appeal. In October 2020, the Board remanded this matter for further development. The agency of original jurisdiction (AOJ) was asked to "secure for the record copies of complete updated clinical records of all VA and non-VA treatment the Veteran has received for the disorders on appeal" and to obtain a VA examination and medical opinion addressing whether the Veteran's skin disorder is related to toxic exposures during military service, including jet fuel. After reviewing the record on remand, the Board finds that substantial compliance is not established and further remand is necessary. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that the Board errs when it fails to ensure substantial compliance with remand directives). The Board notes that the Veteran's attorney submitted correspondence purporting to request another Board hearing in January 2021. In April 2021, the Board sent a letter asking for clarification as to whether they wanted another hearing. Subsequently, the attorney responded that her office wished to withdraw the hearing request. Accordingly, the Board finds that the request is withdrawn. 1. Entitlement to service connection for a skin disorder The Board finds that this matter must be remanded to procure outstanding private treatment records relevant to the Veteran's claim on appeal, and for an addendum medical opinion. See 38 U.S.C. § 5103A(b), (d). Initially, it appears that the Veteran's complete private medical records relating to skin cancer are not associated with the claims file. In May 2020, the Veteran filed a VA Form 21-4142 for "Skin Cancer Specialists" but did not provide an address or other contact information for VA to request the authorized records. Although the AOJ found that the Veteran had given incomplete provider information, it does not appear that the Veteran was ever notified or asked to clarify the address and contact information for the private treatment providers. In June 2019, the Veteran also mentioned seeking treatment from Avail Dermatology in 2017, but those records are not associated with the claims file. As such, further remand is necessary so that the Veteran may submit complete contact information for Skin Cancer Specialists, Avail Dermatology, and all other private medical providers for skin cancer in order for the Board to review these records in the current appeal. 38 U.S.C. § 5103A(b). After receiving the outstanding private medical records, the AOJ must obtain an addendum medical opinion addressing the nature and etiology of the Veteran's skin disorder, to include skin cancer or scars associated with lesion excision. See 38 U.S.C. § 5103A(d); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). This matter is REMANDED for the following actions: 1. Provide the Veteran with an opportunity to submit authorization for VA to obtain private medical records pertaining to treatment for his skin disorder, including from Skin Cancer Specialists and Avail Dermatology. If more details about the address and contact information of the providers are needed, contact the Veteran to request such information. All development associated with this directive must be documented in the claims file. 2. Obtain an addendum medical opinion from a dermatologist, if available, or any other clinician regarding the nature and etiology of the Veteran's skin disorder. ONLY IF the clinician believes that a VA examination is necessary to answer the question below should one be scheduled. The clinician is asked to review the claims file and to opine on the following: (a) Is it at least as likely as not that any diagnosed skin disorder, to include skin cancer or scars associated with lesion removal, had its onset during or is etiologically related to military service, to include exposure to fumes from jet fuel or solar radiation? A complete rationale should be provided for all opinions. The examiner is asked to consider and discuss relevant lay and medical evidence, to specifically include: The Veteran's lay contentions that exposure to fumes from jet fuel during military service caused his skin disorder The private opinion submitted by Dr. F.G. dated September 2020, finding that it is more likely than not that the Veteran's skin cancer is due to solar radiation and toxicant exposures during military service in 1976-79 The December 2020 VA examiner's opinion, finding that it is less likely than not that any diagnosed skin cancer is related to military service The clinician is reminded that the term "at least as likely as not," does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the clinician's expert opinion, it is as medically sound to find in favor of the proposition as it is to find against. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Reed, 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.