Citation Nr: 22015474 Decision Date: 03/17/22 Archive Date: 03/17/22 DOCKET NO. 17-40 660 DATE: March 17, 2022 REMANDED Entitlement to service connection for a skin condition, to include psoriasis and seborrheic dermatitis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1997 to August 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas, which denied service connection for psoriasis (claimed as psoriasis of the scalp). The Board has recharacterized the Veteran's claim for service connection as a claim for service connection for a skin condition, to include psoriasis and seborrheic dermatitis. See Clemons v. Shinseki, 23 Vet. App. 1, 4 (2009) (holding that the scope of a claim includes any disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and other information of record). Entitlement to service connection for a skin condition, to include psoriasis and seborrheic dermatitis, is remanded. The Board most recently remanded the Veteran's claim in October 2021, after finding that the first VA examiner's opinion rendered in this case was inadequate as it had relied upon the incorrect factual premise that the Veteran was not diagnosed and treated for psoriasis in 2006-07, nor had the examiner addressed in-service records of treatment for skin rashes. Following the Board's remand, the Veteran was afforded a new examination. Yet again, the examiner relied upon the incorrect factual premise that the Veteran was not diagnosed and treated for psoriasis in 2006-07, and again the examiner did not address the records showing in-service treatment for skin rashes. Moreover, the examiner's opinion is inadequate as the examiner's opinion relies upon the absence of medical records treatment in service, without consideration of the Veteran's lay statement of having experienced symptoms during service but she did not recall ever seeking treatment for her scalp. Compare December 2021 C&P Examination and March 2016 Notice of Disagreement (Veteran asserts continuous symptoms of psoriasis or a scalp condition since service). Thus, the examination did not substantially comply with the Board's October 2021 instructions. Stegall v. West, 11 Vet. App. 268, 271 (1998). Although further delay is regrettable, the Veteran is to be afforded an adequate VA examination and opinion before an adjudication on the merits. This matter is REMANDED for the following action: Obtain an addendum medical opinion regarding the nature and etiology of the Veteran's skin disability from an appropriate VA clinician. A new in-person examination is not necessary unless deemed needed by the examiner. The examiner is to review of the complete record to become familiar with the Veteran's relevant medical history. Then, the VA clinician is to provide an answer to the following: (a.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a skin disability (to include psoriasis and seborrheic dermatitis) which was incurred in or is otherwise related to her active service? To assist the VA clinician in answering the above, the Board points the following to assist in formulation of the opinion: The examiner's rationale is to reflect consideration of the Veteran's lay statements of having experienced symptoms of a scalp condition during service for which she did not seek treatment. The examiner's opinion should also reflect consideration of documented instances of in-service treatment for rashes in November 1999, October 2001 (uploaded to claim file March 18, 2009) and November 1997 (uploaded to claim file April 19, 2016). The examiner's opinion should also reflect consideration of service medical records showing post-discharge treatment for seborrheic dermatitis in September 2006, and a rash and dermatophytosis in March 2007 (uploaded to claim file April 19, 2016). The examiner's opinion should also reflect consideration of private records showing treatment for psoriasis of the scalp in May and July 2012 (uploaded to claim file May 2, 2013). A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are require), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Hermsdorfer, 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.