Citation Nr: 21040184 Decision Date: 07/02/21 Archive Date: 07/02/21 DOCKET NO. 16-15 507A DATE: July 2, 2021 REMANDED Entitlement to service connection for residuals of spider bites, other than loss of teeth, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1968 to June 1971 and July 1971 to July 1988. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing conducted by the undersigned Veterans Law Judge in March 2019. A transcript of the hearing has been associated with the claims file. This matter was previously before the Board in October 2019 and October 2020 and was remanded for additional development. The case is once again before the Board. Because the Board's remand instructions have not been complied with, this issue must be remanded again. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance). In October 2020, the Board, in part, denied entitlement to service connection for loss of teeth, claimed as residuals of spider bites and remanded the issue of entitlement to service connection for residuals of spider bites, other than loss of teeth. The Board remand requested that a VA examiner review the claims file and identify and provide an opinion as to the etiology of all skin disabilities or disorders manifested during or in close proximity to the appeal period, to include the 2012 diagnosis of cellulite and xerosis cutis. In December 2020, a VA examiner stated that the findings of cellulitis and xerosis in November 2012 and skin lesions and ecchymosis noted in May 2014 had resolved as evidenced by a January 2020 VA skin examination which did not reveal any diagnosed skin disorder. The examiner concluded the conditions were less likely than not a residual of the in-service spider bite but provided no rationale. In February 2021, the Veteran underwent an additional skin examination. The examiner found it less likely than not that the Veteran's skin conditions incurred in or were caused by the in-service spider bite. The examiner reasoned that there was no current diagnosis for a skin condition due to a spider bite and there was no evidence of a skin condition or residual scar from a spider bite. No further rationale was provided. The examiner further noted that the Veteran reported that his spider bite claim is not for a skin condition, but for loss of teeth and tooth decay. Although the issue was previously decided, the examiner opined that spider bites do not cause tooth decay, as tooth decay and resulting tooth loss of the teeth is caused by bacterial breakdown of the enamel tooth surface. The October 2020 Board requested an opinion as to whether the Veteran's skin conditions were related to service, to include residuals of a spider bite. To date, an examiner has not provided an opinion as to whether the November 2012 and May 2014 skin conditions are related to service, other than to state that the conditions have resolved and therefore not related to service. A remand by the Board confers upon the claimant, as a matter of law, the right of compliance with the Board's remand directives, and imposes upon the Board a duty to ensure compliance with the terms of the remand. Because the RO did not complete the directives outlined in the October 2020 remand, the Board finds that a remand for a new VA medical opinion is warranted. The question is whether the Veteran's November 2012 and May 2014 skin conditions are related to his in-service spider bite, regardless of whether the Veteran is currently symptomatic. The record is clear that the conditions have resolved. While the conditions are not currently present, the current disability requirement for service connection is satisfied when a claimant has a disability at the time of filing the claim or during the pendency of that claim, even if the disability has since resolved. McLain v. Nicholson, 21 Vet. App. 319 (2007). The Veteran's November 2012 and May 2014 conditions, though now resolved, were present in close proximity to the Veteran's claim and during the pendency of the appeal, respectively. Thus, an opinion, with adequate rationale, is necessary to determine if those skin conditions are related to the Veteran's service. The Board acknowledges the Veteran's statement that he is not claiming service connection for a skin condition; that his claim was for loss of teeth. See March 2021 VA examination. As noted above, the issue of service connection for loss of teeth, to include as due to spider bites, was denied in an October 2020 Board decision. While the Veteran stated that he was not claiming service connection for a skin condition, he has not submitted a notice of withdrawal consistent with 38 C.F.R. § 20.205. Therefore, the Board will continue to adjudicate this issue. The matters are REMANDED for the following action: Obtain an addendum opinion regarding the Veteran's claimed residuals of spider bite. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. Following a review of the complete record, the examiner is asked to address the following: Identify all skin disabilities or disorders manifested during or in close proximity to the appeal period, i.e., since approximately 2013. For each disability identified, to include the diagnoses of cellulitis and xerosis from November 2012 and skin lesions and ecchymosis from May 2014, the examiner is asked to opine whether it is as likely as not (50 percent or more probability) that the disability is a residual of the in-service spider bite reflected in the service treatment records. An opinion should be provided regardless of whether the Veteran's skin is currently symptomatic. In answering the foregoing, the examiner should consider the service treatment records, the post-service medical evidence, and the Veteran's lay statements regarding the onset and nature of his claimed disability. M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.V. Palatt, 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.