Citation Nr: 21040874 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 20-08 950 DATE: July 7, 2021 REMANDED Entitlement to service connection for alopecia areata is remanded. REASONS FOR REMAND The Veteran served a period of active duty training for the United States Army Reserve from April 1961 to October 1961. He then served on active duty with the regular Army from October 1961 to August 1963. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2018 rating decision by the Regional Office (RO) of the United States Department of Veterans Affairs (VA). In August 2020, the Board remanded the issue of entitlement to service connection for alopecia areata for additional development. A VA skin disease examination was completed in April 2021, and the matter is again before the Board. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. 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. The Board finds that the Agency of Original Jurisdiction (AOJ) did not substantially comply with the August 2020 remand directives. As such, another remand is warranted. The VA examiner discussed the Veteran's medical history and referenced documented treatment for and complaints of hair loss in medical records, but did not discuss the lay statements of the Veteran regarding hair loss in service, or his specific allegations regarding the rubbing of a helmet liner or a relationship to a rash. Furthermore, although not specifically noted in the prior remand, the Veteran has also attributed his alopecia areata to nervousness and stress that he experienced in service. In a May 2019 statement, he reported stress associated with wearing his helmet for the reasons stated above. During a December 2019 informal hearing, he also recalled feeling stressed while in service because of his foot condition and related surgery, for which he is service connected. In a recent July 2021 statement, the Veteran further asserted his belief that his condition was related to stress experienced while he was on active duty. Accordingly, the examiner must provide a full rationale upon remand, considering the Veteran's statements. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the etiology of his alopecia areata; the claims folder must be reviewed in conjunction with such. The examiner must opine as to whether currently diagnosed alopecia areata is at least as likely as not related to service. Consideration must be afforded to the Veteran's lay statements, including 1) his contention that his helmet rubbed against his head in such a way that it caused a rash on his scalp and hair loss, and 2) his contention that his alopecia is related to stress during service, to include as due to a scalp rash caused by his helmet as well as due to his service-connected foot condition. The examiner should also consider VA treatment records indicating "alopecia with lower extremity rash," and address whether this indicates a possibility of association between the Veteran's alopecia and rashes, considering the heat rashes that the Veteran experienced in-service. A full and complete rationale must be provided for all opinion expressed. 2. Then, readjudicate the claim on appeal. If the benefit sought remains denied, issue a supplemental statement of the case and then return the matter to the Board, if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.P. Faris 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.