Citation Nr: 22011671
Decision Date: 03/01/22	Archive Date: 03/01/22

DOCKET NO. 17-28 478A
DATE: March 1, 2022

REMANDED

Entitlement to a compensable rating for tinea pedis and tinea corporis (claimed as skin disorder-entire body) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from September 1987 to August 1994.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veteran Affairs (VA) regional office.

Although the Board regrets the additional delay, a remand is necessary to ensure there is a complete record on which to decide the Veteran's claim.

The Veteran contends that his service-connected skin disability symptomatology warrants a compensable rating.

The Veteran underwent VA examination in connection with this claim most recently in January 2017.  He reported an undiagnosed skin irritation patch on his foot on which he used an unnamed anti-fungal cream.  The examiner noted that Veteran did not have evidence of a flare-up of tinea corporis or tinea pedis at that time.  See April 25, 2018 CAPRI.

At his August 2021 hearing, the Veteran reported the affected areas on his body had increased in size since 2014 and additional diagnoses. His VA treatment records supports his testimony. An April 2018 dermatology resident progress note noted that the Veteran has a history of large plaque parapsoriasis.  See June 4, 2018 CAPRI. March 2019 biopsy results showed a diagnosis of stage IA mycosis fungoides.  See May 6, 2019 CAPRI.

Evidence of worsening symptoms will trigger a remand for a current examination in an increased rating claim.  See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). As hearing testimony suggests a worsening of symptoms and medical records show a new diagnosis of the Veteran's skin disorder, a remand is necessary to afford the Veteran a VA examination to determine the current level of severity of his service-connected skin disability. Moreover, symptomatology attributed to a nonservice-connected disability cannot be differentiated from symptomatology attributed to a service-connected disability unless medical evidence does so. Mittleider v. West, 11 Vet. App. 181, 182 (1998) (per curiam). The Board must also obtain an opinion as to whether the large plaque parapsoriasis or mycosis fungoides are a part of his service-connected disability, and, if not, whether the symptoms of those disorders may be differentiated from the symptoms of his service-connected disability.

The matter is REMANDED for the following action:

1. Obtain any outstanding VA treatment records relevant to the Veteran's skin disorder(s) and associate the records with the claims file.

2. Schedule the Veteran for an examination by an appropriate clinician to determine the current level of severity of his service-connected skin disorder(s).  The examiner should provide:

a) A full description of the extent and severity of the Veteran's service-connected tinea pedis and tinea corporis.

b) A full description of the extent and severity of the skin symptoms caused by his large plaque parapsoriasis and his mycosis fungoides. If the symptoms attributable to these disorders cannot be distinguished from the Veteran's tinea pedis and tinea corporis, the examiner should so state. 

c) An opinion whether either his large plaque parapsoriasis or his mycosis fungoides are part of or a progression of his service-connected tinea pedis and tinea corporis.

The complete rational for all opinions expressed must be provided.

 

 

J. B. FREEMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C.L. Hamilton, 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.