Citation Nr: 21041445 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 18-10 045 DATE: July 9, 2021 REMANDED Entitlement to service connection for a thyroid disability, to include Graves' disease, is remanded. Entitlement to service connection for a skin disability, to include eczema and/or lichen simplex chronicus, to include as secondary to service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1965 to August 1967, to include service in the Republic of Vietnam. These matters are currently before the Board of Veterans' Appeals (Board) on remand from the United States Court of Appeals for Veterans Claims (Court). In February 2021, the parties filed a Joint Motion for Partial Remand (JMPR) to vacate and remand that portion of a May 2020 Board decision that denied the issues currently on appeal. In February 2021, the Court issued an Order granting the JMPR and remanding the appeal for action consistent with the JMPR. In May 2020, these matters came before the Board on an appeal from a July 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office. While further delay is regrettable, the Board finds remand of both claims is necessary in order to comply with the terms of the JMPR. 1. Entitlement to service connection for a thyroid disability, to include Graves' disease, is remanded. 2. Entitlement to service connection for a skin disability, to include and/or eczema or lichen simplex chronicus, is remanded. In May 2019, the Board remanded the claims so that VA examinations and opinions could be obtained. With respect to the Veteran's thyroid claim, the Board directed the examiner to discuss articles and medical treatises submitted by the Veteran that indicate possible links between exposure to herbicide agents or stressful events and the development of Graves' disease. With respect to the skin disability claim, the Board directed the examiner to discuss service treatment records showing erythematous, slightly-raised, tender patches on the Veteran's lower back. In November and December 2019, VA opinions and addendum opinions were provided. While the examiners referenced the evidence noted above, they did not provide discussion or medical analysis of this evidence. Furthermore, an examiner raised the possibility that the Veteran's skin condition could be causally related to a psychiatric condition, but did not provide an opinion as to whether it is caused or aggravated by the Veteran's service-connected posttraumatic stress disorder (PTSD). Accordingly, the Board finds remand is necessary so that new opinions may be provided which properly address the above-noted evidence as well as whether there is a relationship between the Veterans service-connected PTSD and a skin disability. Updated VA treatment records, as well as any relevant private treatment records identified by the Veteran, should be obtained and associated with the file. The matters are REMANDED for the following actions: 1. Ask the Veteran to identify all outstanding treatment records relevant to his thyroid and skin disability claims. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current thyroid disability, to include Graves' disease, had onset during service or is otherwise related to an in-service injury, event, or disease, to include exposure to herbicide agents and stressful events. In offering the opinion, the examiner must specifically consider the articles and medical treatises submitted in November 2014 and December 2018 which suggest a potential link between exposure to herbicide agents and/or stress and the development of Graves' disease. It is not sufficient merely to note the existence of these records; rather, the examiner must provide medical analysis of the records and reconcile them with any opinion provided. The examiner should also specifically address the Veteran's lay statements regarding the history and chronicity of his symptoms. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. 3. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current skin disability, to include eczema and/or lichen simplex chronicus, had onset during service or is otherwise related to an in-service injury, event, or disease, to include exposure to herbicide agents. The examiner should also address whether any current disability of the skin is at least as likely as not (a) caused by, or (b) aggravated by (worsened beyond natural progression) service-connected PTSD. In offering the request opinions, the examiner must specifically consider the service treatment record, which appears to be dated December 1966, showing findings of erythematous, slightly-raised, tender patches on the Veteran's lower back as well the private treatment records showing a diagnosis of eczema, first noted in June 2011. It is not sufficient merely to note the existence of these records; rather, the examiner must provide medical analysis of the records and reconcile them with any opinion provided. The examiner should also specifically address the Veteran's lay statements regarding the history and chronicity of his symptoms. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. D. Bruce, 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.