Citation Nr: 21041726 Decision Date: 07/10/21 Archive Date: 07/10/21 DOCKET NO. 10-28 502 DATE: July 10, 2021 REMANDED The claim of entitlement to service connection for a skin disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1979 to April 2001. This appeal was most recently before the Board in December 2020, at which time the Board remanded the claim for additional development. The claim of entitlement to service connection for a skin disorder is remanded. The Board notes that a remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the 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). In December 2020, the Board remanded the claim to obtain a VA medical opinion supported by a complete rationale. The examiner was instructed to consider and discuss the Veteran's description of his in-service symptoms as well as his post-service symptoms, and his asserted theory that exposure to volcanic ash caused his skin disorder. The Board also instructed the examiner to determine if there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current disability. Pursuant to the Board remand, a VA medical opinion was provided in February 2021. The examiner opined that it was less likely than not that the Veteran's skin disorder had its onset during service or is causally or etiologically due to service, to include volcanic ash during service. The rationale was that the Veteran was seen once for pseudofolliculitis barbae in January 1997, with no other notations of a skin disorder during service. The VA examiner stated that this appeared to be an acute condition. The VA examiner also included medical literature to explain that skin irritation and reddening of the skin caused by volcanic ash is uncommon. Unfortunately, the VA examiner did not state whether there is a medical reason to accept or reject the proposition that the Veteran's injury and/or symptoms in service represented the onset of his current skin disorder. Accordingly, a remand is required to obtain the VA opinion. See Stegall v. West, 11 Vet. App. 268 at 271. The matters are REMANDED for the following action: 1. The AOJ should undertake appropriate development to obtain any outstanding records pertinent to the Veteran's claim. If any requested records are not available, the record should be annotated to reflect such, and the Veteran notified in accordance with 38 C.F.R. § § 3.159 (e). 2. Then, the AOJ should obtain an addendum medical opinion from the examiner who provided the February 2021 VA medical opinion. If this examiner is no longer available, then the claims file must be returned to a physician of similar expertise. Another examination of the Veteran should only be performed if deemed necessary by the person providing the opinion. All pertinent evidence of record must be made available to and reviewed by the examiner. Following a review of the relevant records and lay statements, the examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater degree of probability) that the skin disorder began in or is otherwise related to the Veteran's active duty service. In providing the opinion, the examiner MUST consider AND DISCUSS the following lay statements: (1) that for approximately 45 days the Veteran had a skin rash similar to hives that covered most of his body; (2) that medical professionals were unable to determine if the skin rash was caused by volcanic ash or the Puget Sound water; (3) the August 2012 buddy statement that the Veteran had a "bad body rash" that lasted for months; and (4) that he has been using cream for many years as treatment for his skin disorder. The examiner MUST also address if there is any medical reason to accept or reject the proposition that the Veteran's reported injury and/or symptoms in service and thereafter represented the onset of his current disability. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The examiner is advised that the Veteran's service treatment records for the period of service from 1979 to 1987 are unavailable; nevertheless, the Veteran is competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. The rationale for all opinions expressed must also be provided. If the examiner is unable to provide any required opinion, she or she should explain why. If an opinion cannot be provided without resorting to mere speculation, she or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, examiner should identify the additional information that is needed. 3. Then, the AOJ should readjudicate the issue on appeal. If the benefit sought on appeal is not granted to the Veteran's satisfaction, the Veteran and his representative should be furnished an appropriate supplemental statement of the case and be afforded the requisite opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. McKinley, 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.