Citation Nr: 22014299 Decision Date: 03/12/22 Archive Date: 03/12/22 DOCKET NO. 19-38 438 DATE: March 12, 2022 REMANDED Entitlement to an initial compensable rating for residual scar, posterior trunk, status-post basal cell carcinoma removal, is remanded. Entitlement to an initial compensable rating for residual scar, left knee, status-post meniscectomy/reconstruction, is remanded. Entitlement to an initial compensable rating for residual scar, left lateral eyes as secondary to the service-connected disability of basal cell carcinoma, is remanded. REASONS FOR REMAND The Veteran had active military service from June 1977 to September 1992, February 2005 to May 2007, and from May 2007 to April 2009. He is the recipient of several medals, including a Legion of Merit, Bronze Star Medal, Army Commendation Medal, and an Army Achievement Medal. The Veteran testified before the undersigned Veterans Law Judge during a December 2020 Board hearing. A copy of the transcript has been associated with the file. During the December 2020 Board hearing, the Veteran testified to a left arm scar as a result of a gunshot wound. However, this claim was not included on the VA Form 9, and therefore, is not currently before the Board on appeal. The Veteran and his representative are encouraged to file a separate claim for service connection for the gunshot wound scar on the appropriate standardized claim form should he wish to pursue that matter. The Veteran has a separate appeal stream that is in active status for entitlement to a rating in excess of 20 percent for a left knee condition; entitlement to a rating in excess of 10 percent for a right knee condition; entitlement to a rating in excess of 10 percent for a low back condition; entitlement to an initial compensable rating for skin cancer manifested by residual scars of basal cell carcinoma; entitlement to an initial compensable rating for sinusitis; entitlement to service connection for hypertension; entitlement to service connection for an ear condition; and entitlement to a total disability rating based on individual unemployability (TDIU). The Veteran was afforded a January 2017 Board hearing on these issues before a different Veterans Law Judge separate and apart from the appeal stream addressed in this decision. Those issues were subject to a July 2017 Board remand. As such, the adjudication of those issues will be made by the other Veterans Law Judge and shall not be the subject of discussion in this decision. The Board notes the Veteran has been in receipt of a 100 percent combined disability rating from May 1, 2009, and special monthly compensation (SMC) based on housebound status since May 1, 2009. 1. Entitlement to an initial compensable rating for residual scar, posterior trunk, status-post basal cell carcinoma removal, is remanded. 2. Entitlement to an initial compensable rating for residual scar, left knee, status-post meniscectomy/reconstruction, is remanded. 3. Entitlement to an initial compensable rating for residual scar, left lateral eyes as secondary to the service-connected disability of basal cell carcinoma, is remanded. The Veteran contends a higher rating is warranted for his scars. He contends his scar tissue is painful and affects his ability to function due to symptoms including pain and pulling. Hearing Transcript, Page 12-13. The Veteran was provided a VA Scars examination in October 2018. A posterior trunk basal cell removal scar and left lateral eyes basal cell removal scar were noted. The posterior trunk scar was reported as stable, not painful, and measured at 3 cm by 1 cm. The left lateral eyes scar was reported as stable, not painful, and measured at 0.2 cm by 0.1 cm. During his December 2020 Board hearing, the Veteran testified his VA Scars examination was inadequate, as the examiner did not measure his range of motion, examine the scars on his back or knee, and rushed through the examination without requesting information from the Veteran. See Hearing Transcript, Page 6. Regarding his facial scars, the Veteran's representative noted continual deep tissue removal that causes blistering, peeling, scabbing, and healing. She noted he has never gone six months free of treatment, however, the 2018 examiner wrote the condition was in remission and did not look at his prior history of continual therapy. She noted symptoms of tenderness and pulling. Regarding his knee scar, the Veteran's representative noted the Veteran has undergone three surgeries on his knee, resulting in extensive scar tissue. The Veteran testified his knee scar prevents full range of motion. Hearing Transcript, Page 11. Given the Veteran's testimony, the Board finds that another examination is needed to assess the current level of severity of his scars. Furthermore, during the October 2018 Scars examination, the examiner only addressed the Veteran's back and lateral eye scars and did not discuss or address the service-connected left knee scar. As such, this opinion is inadequate, and a remand for an additional VA examination is necessary prior to deciding this claim. Lastly, the Veteran testified to receiving treatment for his scars at a private medical facility. Those records have not been associated with the file. On remand, the RO should make efforts to secure any outstanding medical records. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the Veteran's claims folder. 2. With any necessary assistance from the Veteran, obtain any outstanding private treatment records, specifically records from John Hopkins University, and associate them with the Veteran's claims file. If any records are unavailable, notify the Veteran pursuant to 38 C.F.R. § 3.159(e). 3. After the necessary records development has been completed, schedule the Veteran for a VA examination with a qualified clinician, preferably with an examiner other than the one who performed the October 2018 examination, to determine the current severity of his service-connected left knee scar, left lateral eyes scar, and posterior trunk scar. The examiner should provide a full description of the (3) service-connected scar disabilities listed above and report all signs and symptoms necessary for evaluating the Veteran's disabilities under the rating criteria. 4. The examiner should indicate the number and size of all left knee, left lateral eyes, and posterior trunk scars. 5. The examiner should identify whether any scar is painful; unstable (with frequent loss of covering of skin over the scar); tender; or cause limited motion or other limitation of function of an affected body part, and if so, describe in detail the limitation(s) and extent and severity thereof. 6. Whether the Veteran experiences any flare-ups of his service-connected left knee scar, left lateral eyes scar, and posterior trunk scar. In this regard, the examiner must attempt to elicit information regarding the severity, frequency, and duration of any scar flare-ups, and the degree of functional loss during flare-ups. In providing an opinion, a full record review is necessary, with specific discussion of: (1) the Veteran's contentions that his knee scar limits his range of motion and is painful; (2) the history of his facial scars including the contentions of continual treatment for basal cell carcinoma that results in deep tissue removal that causes blistering, peeling, scabbing, and healing requiring both topical and systemic treatments. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Krista Johnson, 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.