Citation Nr: 21041254 Decision Date: 07/08/21 Archive Date: 07/08/21 DOCKET NO. 18-34 349 DATE: July 8, 2021 REMANDED Entitlement to a rating in excess of 30 percent for pseudofolliculitis barbae (PFB) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from February 1979 to February 1983. This appeal comes to the Board of Veterans' Appeals (Board) from a Department of Veterans Affairs (VA) December 2013 rating decision of the Agency of Original Jurisdiction (AOJ). In June 2019 the Board denied the Veteran's claim for a rating in excess of 30 percent for his skin condition. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). The Court, in a June 2020 decision, set aside the June 2020 Board decision and remanded the Veteran's claim back to the Board for further development. In December 2020, the Board remanded the claim for additional evidentiary development. The appeal has been returned to the Board for consideration following issuance of a May 2021 supplemental statement of the case. Entitlement to a rating in excess of 30 percent for PFB is remanded. A June 2009 rating decision granted service connection for PFB at 30 percent from November 24, 2008. In Apri 2013, VA received a claim for increase. See VA Form 21-4138 (April 2013). A December 2013 rating decision denied the claim. In January 2014, VA received a notice of disagreement (NOD) with that decision. See VA Form 21-41-38 (January 2014); NOD (January 2014). This appeal arises from the Veteran's disagreement with the initial rating assigned for PFB. See VA Form 9 (May 2018). In December 2020, the Board remanded the Veteran's claim to afford him a new VA examination. As part of the Board's remand instructions, the examiner was directed to address the impact and any functional loss caused by any flare-ups of his pseudofolliculitis barbae. The May 2021 VA examination report does not comply with this remand directive, despite the fact that the Veteran has previously reported flare-ups of his skin condition. Additionally, the Board instructed that the examination should address the nature, frequency, and duration of use of any medications, such as topical creams, ointments, and soaps, prescribed to treat the Veteran's condition. While the examination report shows that the Veteran currently used topical corticosteroids on a constant basis, it does not identify any other current or past medications, despite the fact that the records reflects that the Veteran has used a variety of topical creams and soaps during the period on appeal. It is also unclear from the available record whether any of the Veteran's medications should be considered systemic. The Veteran is entitled to substantial compliance with the terms of the Board's Remand. See Stegall v. West, 11 Vet. App. 268 (1998). Furthermore, once VA undertakes an examination, an adequate one must be produced. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213 (1992). Accordingly, a remand is required to afford the Veteran a new VA examination. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the severity and extent of his service-connected skin condition. If possible, the AOJ shall coordinate with the Veteran to attempt to schedule such an examination to take place while he is experiencing a flareup of his skin condition. The examiner shall be provided with a copy of the Veteran's claims file, as well as a copy of these remand directives. The examiner shall address the following: a. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. To the extent possible, the examiner should describe the impact and any functional loss caused by flareups of the Veteran's skin condition. b. The examiner should also address the nature, frequency, and duration of use of any medications, such as topical creams, ointments, and soaps, prescribed to treat the Veteran's condition during this appeal period from November 24, 2008 to the present. For any topical therapy used during the appeal period from November 24, 2008 to the present, the examiner should clarify (1) whether the topical treatment affects the body as a whole in treating this Veteran's skin condition; and (2) whether the given treatment is "like" a corticosteroid or other immunosuppressive drug." See Burton v. Wilkie, 30 Vet. App. 286 (2018). Only the second question need be addressed if the treatment is clearly systemic. If an answer to a question cannot be expressed without resort to speculation, the clinician must so indicates and then fully discuss why an opinion is not possible, to include whether there is additional evidence that could enable an answer, or whether the inability to provide an answer is based on the limits of medical knowledge. C.A. SKOW Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.D. Anderson, 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.