Citation Nr: 21042578 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 18-34 764 DATE: July 13, 2021 REMANDED Entitlement to an increased rating for residual scars, status post basal cell carcinoma and squamous cell carcinoma (claimed as facial basal carcinoma, carcinoma in situ, and squamous cell) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1990 to June 1991 and from May 1995 to August 2014. The matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2014 rating decision. In March 2021, the Veteran testified before the undersigned Veterans Law Judge at a videoconference hearing. The Veteran's wife was also present for the hearing and offered testimony on the Veteran's behalf. A transcript of the hearing is of record. Entitlement to an increased rating for residual scars, status post basal cell carcinoma and squamous cell carcinoma (claimed as facial basal carcinoma, carcinoma in situ, and squamous cell) is remanded. The Veteran seeks an increased rating for residual scars, status post basal cell carcinoma and squamous cell carcinoma (claimed as facial basal carcinoma, carcinoma in situ, and squamous cell), for which he was granted service connection with an initial noncompensable rating effective September 1, 2014. The Veteran was afforded a VA Scars/Disfigurement examination in August 2014, during which a scar on the left forehead and a scar on the top of head, scalp, were noted. During the August 2014 examination, the VA examiner noted that the scars were not painful or unstable. The examiner noted the left forehead scar measured 3 x 0.2 centimeters; and the top of head, scalp scar measured 2 x 0.1 centimeters. The examiner noted that there was no elevation, depression, adherence to underlying tissue, or missing underlying soft tissue. They also noted there was hypopigmentation as well as induration and inflexibility of the forehead scar, for a combined total are of 0.6 square centimeters. The examiner noted there was no gross distortion or asymmetry of facial features or visible or palpable tissue loss, and that no scar or disfigurement results in limitation of function. See August 2014 VA examination report. The agency of original jurisdiction (AOJ) awarded service connection for these two scars in the above-referenced December 2014 rating decision. During his March 2021 hearing, the Veteran testified that he has had additional surgeries since his 2014 VA examination to remove cancer as well as corrective surgeries. He testified that in addition to the scars on his face and head, he has two scars on the back of his neck as well as two scars on his back a few inches below his neck. The Veteran testified that his initial surgery to remove the cancer, which caused his eye droop, was around 2017, and the plastic surgery to correct the temple was in July 2019. He testified that he thinks the healing process for a second surgery on the top of his head was affected by the scar tissue from the initial surgery. He testified that his scars have not healed well and that they cause him pain when he raises his eyebrows or wears a hat. He testified that his scars are uncomfortable to the touch and they cause discomfort when he is sleeping because it puts pressure on his forehead; additionally, the scars on his back are right on his shoulder blades and they are uncomfortable when he sits in a chair. See March 2021 Hearing Transcript. Given the Veteran's assertions of having undergone corrective surgeries and worsening symptoms at his hearing, and the fact that he was last examined by VA in August 2014, the Board believes an updated VA Scars/Disfigurement assessment should be scheduled so that a fully informed decision can be made as to the proper disability rating. The matter is REMANDED for the following action: 1. Obtain and associate with the file any outstanding VA treatment records. 2. Give the Veteran an additional opportunity to submit, or authorize VA to obtain on his behalf, any records of private treatment for his scars that are not already associated with the claims file. All appropriate steps should be taken to obtain identified records of private care. All efforts to obtain these records should be fully documented. 3. Schedule the Veteran for an examination to assess the severity of the Veteran's service-connected scars. The claims file should be sent to and reviewed by the examiner. The examiner should take a history from the Veteran as to the progression of his disability. The examiner should take care to distinguish symptoms of his service-connected scars from nonservice-connected scars. If post-service surgeries were indeed corrective of surgeries performed in service, and now manifest in additional symptoms or scarring, including neurological symptoms or disfigurement, this should be made clear. Or, if post-service surgeries have caused additional disability to the Veteran's service-connected scars, this should also be described in detail. (Continued on Next Page) 4. After completing the above actions, to include any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's appeal should be readjudicated based on the entirety of the evidence. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Fulmer, 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.