Citation Nr: 21041724 Decision Date: 07/10/21 Archive Date: 07/10/21 DOCKET NO. 14-40 407 DATE: July 10, 2021 REMANDED Entitlement to compensable rating prior to June 6, 2019, and in excess of 10 percent thereafter for angiokeratoma of fordyce with multiple small aneurysms, scrotum (previously rated as multiple small aneurysm, scrotum), is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from February 1985 to March 1992 and from June 1998 to July 2011. These matters come before the Board of Veteran's Appeals (Board) from an April 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran's claims were most recently remanded by the Board in September 2020. The Veteran's claims folder has returned to the Board for further appellate consideration. 1. Entitlement to compensable rating prior to June 6, 2019, and in excess of 10 percent thereafter for angiokeratoma of fordyce. With respect to the Veteran's claim of a compensable rating and an increase rating in excess of 10 percent for angiokeratoma of the fordyce, the Board remanded this claim in September 2020 in order for the Veteran to be provided a VA examination. Moreover, the VA examination was supposed to address if the Veteran had ever required the use of "systemic therapy" as defined in 38 C.F.R. § 4.118, Diagnostic Code 7821, in effect prior to August 13, 2018 and at any time since May 1, 2015. The Board remanded to obtain the Veteran's VA treatment records for the time period from November 2015 to the present. In order to obtain medical records from non-VA medical providers, the Board remand requested that the Veteran to fill out a VA Form 21-4142. A blank VA Form 4142 was sent to the Veteran after the September 2020 remand. See, e.g., Subsequent Development Letter dated September 16, 2020. Pursuant to the September 2020 remand, the Veteran was provided a VA examination for his angiokeratoma of fordyce in January 2021. However, the outstanding medical records in the remand, were never requested. The examiner's review of the record was not complete because the outstanding VA treatment records were never requested. See Stegall v. West, 11 Vet. App. 268, 271. Additionally, the Veteran never filled out and returned a VA Form 21-4142 for any private medical records associated with angiokeratoma of fordyce. The failure to obtain the outstanding VA treatment records establishes an incomplete record. Entitlement to a TDIU. With respect to the Veteran's TDIU claim, the Board remanded this claim in September 2020 in order for the Veteran to provide a VA Form 21-8940. The remand noted that the Veteran's TDIU claim was inextricably intertwined with the Veteran's rating claim. Pursuant to the September 2020 remand, the Veteran was provided a blank VA form 21-8940. See, e.g., Subsequent Development Letter dated September 16, 2020. The Veteran never submitted a filled-out VA Form 21-8940. The Board notes that the Veteran's TDIU claim is inextricably intertwined with the Veteran's angiokeratoma of fordyce claim. He shall be provided an opportunity to submit the form. The Veteran is informed that he has an obligation to cooperate. The matters are REMANDED for the following action: 1. Request that the Veteran submit a formal TDIU claim form (VA Form 21-8940). 2. Obtain the Veteran's VA treatment records for the period from November 2015 to the Present. If an attempt is made and none are available, provide the Veteran with notice. 3. Request the Veteran to complete a VA Form 21-4142 for all non-VA medical providers seen for his angiokeratoma of fordyce and its symptoms. Make two requests for the authorized records from all identified sources, unless it is clear after the first request that a second request would be futile. 4. If relevant records are obtained, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected angiokeratoma of fordyce. 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. The examiner should address the following: (a) Whether the Veteran's it has required the use of "systemic therapy" as defined by the provisions of 38C.F.R. §4.118, Diagnostic Code 7821, in effect prior to August 13, 2018, at any time since May 1, 2015. If yes, then state whether such systemic therapy was "like" or "similar" to corticosteroids or other immunosuppressive drugs, and, if so then: i. Identify each period of such therapy. ii. Indicate whether such treatments were required for less than six weeks during a 12-month period; six weeks or more, but not constantly, during a 12-month period; or constantly, or nearly constantly during a 12-month period. iii. Note for the purpose of address the above matters: "Systemic therapy" for VA purposes means "treatment pertaining to or affecting the body as a whole," as distinguished from topical therapy which means "treatment pertaining to a particular surface area that affects only the area to which it is applied. (b) Since August 13, 2018, if the Veteran's disorder was treated with systemic therapy (defined below), then identify each period of systemic therapy and i. Identify each period of such therapy. ii. Indicate whether such treatments were required for less than six weeks over the past 12-month period; six weeks or more, but not constantly, during the past 12-month period; or constantly, or nearly constantly during the past 12-month period. iii. Note: "Systemic therapy" for this purpose means "treatment that is administered through any route (orally, injection, suppository, intranasally) other than the skin" as distinguished from topical therapy which is "treatment that is administered through the skin. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Konieczny, Adam 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.