Citation Nr: 21032086 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 14-08 870 DATE: May 25, 2021 REMANDED Entitlement to service connection for a skin condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1968 to September 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Board issued a May 2019 decision denying the claim for service connection. In June 2019, the U.S. Court of Appeals for Veterans Claims (CAVC) granted a joint motion for remand (JMR) and remanded the case. In an October 2020 decision, the Board, in accordance with the CAVC decision, remanded the case for an addendum medical opinion. The RO issued a February 2021 supplemental statement of case (SSOC) and returned the case to the Board. 1. Entitlement to service connection for a skin condition is remanded. Although the Board is aware this case has been on appeal since March 2014 and additional delay is regrettable, an additional remand is necessary to allow the Board to make a fully informed decision regarding the Veteran's claim. In the October 2020 remand, the Board stated that the October 2015 VA examination was inadequate because it failed to provide an opinion as to whether the Veteran's current skin condition began in service. Additionally, the examiner did not provide adequate rationale for their negative nexus opinion as they did not explain why the absence of in-service treatment or notation on exit from service was dispositive, they did not discuss the Veteran's reports of recurring skin symptoms since service, and did not explain the scientific data with respect to their statement that no scientific data supported a correlation with tinea versicolor and Agent Orange exposure. Therefore, the Board remanded the case and directed the RO to obtain an addendum medical opinion. In a January 2021 VA addendum medical opinion, the examiner concluded that the Veteran's skin condition was less likely than not related to his reported skin symptoms in service and/or exposure to herbicide agents. The examiner stated that their opinion was based upon the review of the C-file, including medical records and the Veteran's military service, however they provide no explanation for why the evidence supported their conclusions. The Board finds the medical opinion does not substantially comply with the October 2020 remand directives, and therefore is inadequate. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions). The matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from an appropriate clinician to determine the nature and etiology of the Veteran's skin condition. The claims file must be made available for review, and the examination report should reflect that such review occurred. After reviewing the claims file the examiner must: a. Discuss the Veteran's statements regarding his in-service symptoms and reoccurring skin symptoms since service and document the Veteran's contentions in the examination report. b. Provide an opinion whether the Veteran's skin condition is at least as likely as not (50 percent or more) related to his reported skin symptoms during service. If the examiner provides a negative opinion and relies on the absence of in-service treatment as dispositive, the examiner must discuss the Veteran's reports of recurring skin symptoms and his contentions of ongoing symptomatology. c. Provide an opinion whether the Veteran's skin condition is at least as likely as not (50 percent or more) related to in-service exposure to herbicide agents. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered. If the examiner rejects the Veteran's reports, the examiner must provide a reason for doing so. A rationale for all opinions expressed should be provided as the Board is precluded from making medical findings. A discussion of the facts and the medical principles involved will be of considerable assistance to the Board, including citation to any supporting medical treatises. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Aubee, 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.