Citation Nr: 21041406
Decision Date: 07/09/21	Archive Date: 07/09/21

DOCKET NO. 17-06 281
DATE: July 9, 2021

REMANDED

Entitlement to service connection for a skin condition, to include as due to herbicide agent exposure, is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Army from February 1966 to February 1968.  This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

Entitlement to service connection for a skin condition, to include as due to herbicide agent exposure

The Board previously remanded this issue in an October 2019 remand and directed the RO to schedule the Veteran for a VA skin examination.  The examiner was to identify all skin conditions and opine as to whether it is at least as likely as not any current skin disability was incurred in, caused, or otherwise related to the Veteran's active military service, to include exposure to Agent Orange.  Subsequently, a December 2019 VA examiner diagnosed the Veteran with recurrent basal cell carcinoma skin lesions, recurrent actinic keratosis lesions, and recurrent seborrheic keratosis lesions.  In his assessment, he indicated that none of these conditions would be considered "as presumptive issues relatable to herbicide/agent orange exposure.  Therefore, I would opine the Veteran's claimed skin condition (to include recurrent basale cell carcinoma skin lesions, recurrent actinic keratosis lesions, and recurrent seborrheic keratosis lesions) is/was not as likely as not directly incurred in, caused by, or otherwise related to his active-duty military service to include exposure to herbicide/agent orange."  The examiner's explanation relies solely on the fact that the diagnosed conditions are not on the list of diseases that are presumptively associated with exposure to herbicide agents and does not satisfactorily address the question of direct service connection.  See Stefl v. Nicholson, 21 Vet. App. 120 (2007).  Therefore, unfortunately, another remand is warranted to obtain an adequate opinion.  See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).

The matter is REMANDED for the following action:

Obtain an addendum opinion from an appropriate clinician.  The clinician is asked to provide a response to the following:

Are any of the Veteran's diagnosed skin conditions, to include recurrent basal cell carcinoma skin lesions, recurrent actinic keratosis lesions, and recurrent seborrheic keratosis lesions, at least as likely as not (50 percent probability or greater) related to service, specifically in-service exposure to herbicide agents?

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The examiner is advised that a negative opinion cannot be based solely on the fact that recurrent basal cell carcinoma skin lesions, recurrent actinic keratosis lesions, and recurrent seborrheic keratosis lesions are not on the list of diseases that are presumptively associated with exposure to herbicide agents.  Service connection can be established on a direct basis to exposure to herbicide agents.   

A complete rationale must be provided for any opinion rendered.

 

 

L. CHU

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R. Vemulapalli, 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.