Citation Nr: 22018010 Decision Date: 03/27/22 Archive Date: 03/27/22 DOCKET NO. 12-14 192 DATE: March 27, 2022 REMANDED Entitlement to service connection for a skin disorder of the face, neck, and back (skin disorder) is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1964 to November 1967, to include service in the Republic of Vietnam. This matter originally came to the Board of Veterans' Appeals (Board) on appeal from a July 2010 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The procedural history of this claim has been outlined extensively in previous remands. Recently, in May 2018, the Board, denied the Veteran's claims of service connection for PTSD and a skin disorder. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). Before the Court issued a decision, in April 2019, the parties filed a joint motion for partial remand (JMPR). The joint motion would vacate and remand the issues of entitlement to service connection for PTSD and a skin disorder to the Board for adjudication consistent with the remand instructions. The Court granted the joint motion in April 2019. The Court did not vacate the issue of entitlement to service connection for a compulsive gambling disorder, as this claim was being remanded by the Board in May 2018 for additional development and adjudication. In August 2019, the Board remanded the issues of entitlement to service connection for PTSD and a skin disorder for further development consistent with the JMPR. The case returned to the Board for further appellate review. The Veteran's appeal of service connection for PTSD and for a compulsive gambling disorder were granted in July 2019 and a January 2021 rating decisions, respectively. Because those decisions represent a full grant of the benefit sought, these issues are no longer before the Board. Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). Regarding the Veteran's service connection claim for a skin disorder, unfortunately, another remand is required for a more comprehensive and fully informed medical opinion regarding the etiology of the Veteran's skin disorder. The Veteran asserts that his skin disorder is directly related to service. In his December 2010 Notice of Disagreement, the Veteran reported that he received treatment for a skin disorder while in service, despite such treatment and symptoms not being documented in service treatment records. Pursuant to the Board's July 2016 Remand, the Veteran attended a June 2017 VA skin examination. The examiner reported that the Veteran had seborrheic keratosis and dermatitis papulosa nigricans. The examiner reported that the Veteran had a historical diagnosis of tinea versicolor but did not have manifestations of tinea versicolor at the time of examination. The examiner provided opinions regarding the etiology of each skin disorder. Specific to the seborrheic keratoses, the Veteran reported that it was not present on active duty and developed in approximately the last 10 years. Regarding the dermatosis papulosa nigricans, the examiner noted that it was a common skin condition and the Veteran reported that it did not exist while in service or for many years after service. Regarding the tinea versicolor, the examiner notes that the Veteran had tinea versicolor at various times and that it was the result of an overgrowth of normal skin flora. The examiner indicated that after clinical evaluation, including a Wood's lamp examination, the Veteran did not have tinea versicolor at the time of examination. The examiner acknowledged the Veteran's report that despite the lack of any documentation in service treatment records, he did have tinea versicolor while in service. However, the examiner found that the presence of tinea versicolor in service did not indicate that any skin disorder during the claims period is directly related to service. The examiner specified, that even assuming the Veteran did have tinea versicolor, or another skin disorder in service, it was an acute and transitory condition, and thus unrelated to any current skin disorder. Regarding the Veteran's tinea versicolor, in the April 2018 Informal Hearing Presentation, the Veteran's representative pointed to the Merck Manual as it noted that "[r]ecurrence is almost universal after treatment because the causative organism is a normal skin inhabitant." Merck Manual, Tinea Versicolor. The Board finds that another VA examination and opinion is needed to discuss the medical literature regarding the recurring nature of tinea versicolor. The matters are REMANDED for the following action: 1. Obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Schedule a VA examination by a qualified examiner to determine the nature and etiology of any currently diagnosed skin disorder. All studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner should review the record prior to examination and elicit from the Veteran a detailed medical history. The examiner should identify all skin disorder(s), including any skin disorder present since service that has resolved. Then, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any skin disorder is medically related to service. In providing the requested opinion, the examiner is asked to address the various skin related complaints and treatment post-service for tinea versicolor and address the Veteran's statements of continued symptoms since service. The examiner must comment on the Merck Manual notes regarding tinea versicolor that "[r]ecurrence is almost universal after treatment because the causative organism is a normal skin inhabitant." Merck Manual, Tinea Versicolor. The examiner is also advised that the Veteran is competent to report symptoms and treatment. The examiner must provide the rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. Timothy Berryman Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Romero 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.