Citation Nr: 22014470 Decision Date: 03/14/22 Archive Date: 03/14/22 DOCKET NO. 17-54 707 DATE: March 14, 2022 REMANDED Entitlement to service connection for a skin disorder, claimed as eczema is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Force from October 1986 to February 1996. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a videoconference hearing in November 2020 before the undersigned Veterans Law Judge (VLJ). A transcript of the proceeding is associated with the electronic claims file. This matter was previously before the Board in July 2021, when it was remanded for additional evidentiary development. Entitlement to service connection for a skin disorder, claimed as eczema is remanded. Regrettably, before deciding the appeal, the Board finds that remand is necessary in order to ensure compliance with its prior remand instructions. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran is seeking to establish service connection for a skin disorder, claimed as eczema. The Veteran contends his skin disorder is related to his active-duty service. In July 2021, the Board remanded the Veteran's claim for an addendum opinion. The Board directed the VA examiner to list all currently diagnosed skin disorders from October 2014 to the present and to provide an etiology opinion for any diagnosed skin disorder. The Board further directed the VA examiner to acknowledge and discuss the Veteran's contentions that his rash/skin conditions were later diagnosed as eczema and determine whether the Veteran's current skin disorders are related to symptoms of skin disorders in service, i.e., tinea, tinea pedis, tinea corporis, allergic reaction rash, and a nevus. In accordance with the July 2021 Board remand, an addendum opinion was obtained in December 2021. After a review of the Veteran's claims file, the VA examiner noted the following skin disorders, right palm tinea in April 1991, tinea corporis behind the knee in an undated STR, tinea pedis in December 1994, and probable eczema versus dermatitis of the lower extremities in February 2001. The VA examiner opined that the Veteran's skin disorder is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support of this opinion, the VA examiner simply reasoned that, during service, tinea corporis and tinea pedis was acute only and there is no evidence of chronicity of care with only subjective symptoms. Furthermore, there is no evidence of an eczema diagnosis during service. The Board finds this opinion to be inadequate as the basis for the rationale is the lack of a diagnosis in service. This rationale is inadequate as the absence of a diagnosis in service does not preclude service connection. Furthermore, the July 2021 Board remand directives specifically instructed the VA examiner to discuss the Veteran's contentions that his skin conditions in-service were actually symptoms of eczema, diagnosed later. The VA examiner also did not address the Veteran's allergic reaction rash (February 1992), a March 1991 complaint of "itchy" "bumps" (with a diagnosis of a nevus), and a November 1999 treatment record noting that the Veteran complained of a rash behind his right knee that he had experienced on and off for approximately 10 years, as instructed by the Board remand directives. Given these deficiencies, an addendum opinion is required with respect to the Veteran's service connection claim. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Bowling v. Principi, 15 Vet. App. 1, 12 (2001) (emphasizing the Board's duty to return an inadequate examination report "if further evidence or clarification of the evidence... is essential for a proper appellate decision"). As such a new opinion is needed prior to deciding the issue. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician, regarding the Veteran's skin disorders. The claims file and a copy of this remand must be made available to the examiner. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner should respond to the following: (a.) List all currently diagnosed skin disorders. "Current" includes the entire period on appeal, from October 2014 to the present. (b.) Is it as least as likely as not (50 percent probability or greater) that the Veteran's skin disorder was caused by or otherwise related to his active-duty service. An opinion should be provided for each currently diagnosed skin disorder. Please explain why or why not. In forming his or her opinion, the examiner is asked to specifically note the Veteran's service treatment records reflecting diagnoses of tinea (February to April 1991, right hand), tinea pedis(December 1994), tinea corporis (November 1994, right knee), allergic reaction rash (February 1992), a March 1991 complaint of "itchy" "bumps" (with a diagnosis of a nevus), and a November 1999 treatment record noting that the Veteran complained of a rash behind his right knee that he had experienced on and off for approximately 10 years. Additionally, the examiner is asked to discuss the Veteran's contentions that he experienced rashes in service that were diagnosed as eczema during post-service treatment. (Continued on the next page) The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). 2. After completing the above, and 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 claim should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case (SSOC) and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. C. Slaughter, 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.