Citation Nr: 22018374 Decision Date: 03/29/22 Archive Date: 03/29/22 DOCKET NO. 17-59 098 DATE: March 29, 2022 ORDER Entitlement to service connection for a skin disability is denied. FINDING OF FACT The Veteran's skin disability is not etiologically related to active service. CONCLUSION OF LAW The criteria for service connection for a skin disability have not been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from June 1966 to June 1970, to include service in the Republic of Vietnam. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The electronic filing system contains records that were associated with the file by VA, rather than the Veteran, since the last readjudication of the claim without a waiver of initial review by the VA Regional Office. However, as the records are duplicative of those already received or are otherwise not pertinent to the claim adjudicated below, there is no risk of prejudice to the Veteran from proceeding without the waiver. Service Connection Skin Disability VA provides compensation for disability resulting from disease or injury incurred in or aggravated by service. This is referred to as a "service connection." 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to show a service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). Evidence is not in approximate balance or nearly equal, and therefore the benefit-of-the-doubt rule does not apply, when the evidence persuasively favors one side or the other. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). The Veteran has asserted that he has a skin disability as a result of his active service, to include exposure to herbicide agents while serving in the Republic of Vietnam. Post service evidence shows that the Veteran was diagnosed with junctional melanocytic proliferation in July 2008. The Board acknowledges that junctional melanocytic proliferation is not listed among the diseases presumed to be associated with herbicide exposure under 38 C.F.R. § 3.309(e); however, service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d); Combee v. Brown, 34 F. 3d. 1039 (Fed. Cir 1994). Therefore, the question at issue is whether the Veteran's skin cancer is directly related to service, to include any confirmed in-service herbicide exposure. On his service entrance examination, no abnormalities of the skin were noted and the Veteran raised no pertinent complaints. In December 1969, the Veteran sought treatment for a rash on his back and stomach. Records thereafter are silent for complaints, diagnoses, or treatment pertaining to a skin disability. On his June 1970 service separation examination, no abnormalities of the skin were found. Considering the pertinent evidence in light of the governing legal authority, the Board finds that the evidence is persuasively against the claim. The probative evidence does not show that the current skin disability is related to active military service. While a rash was documented in December 1969, the remaining service treatment records are silent for pertinent documentation. The Board infers from this that the in-service report represents an acute and transitory condition. Indeed, on his service separation examination, no abnormalities of the skin were found. The fact that he sought treatment for other conditions after service, but not a skin disability weighs against the credibility of any statements that the disability persisted since discharge. See AZ v. Shinseki, 731 F.3d 1303 (Fed. Cir. 2013) (recognizing the widely held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). The record does not include an opinion on the matter of service connection. VA must provide a medical examination and medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the VA to make a decision on the claim. See McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006). Here, the Board finds that there is no indication, other than the Veteran's general assertions of service connection, of an association between the current skin disability and service. However, he does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of such medically complex disabilities. See, e.g., Kahana v. Shinseki, 24 Vet. App. 428, 437 (2011). His statements alone are thus insufficient to warrant a medical examination as this would, contrary to the intent of Congress, result in medical examinations being "routinely and virtually automatically" provided to all veterans claiming service connection. See, e.g., Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). Consequently, VA is under no duty to obtain a medical opinion addressing direct service connection as to this disability. Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance and entitlement to service connection for a skin disability is not warranted. 38 U.S.C. § 5107 (b) (2012); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). J. Smith Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umez-Eronini, 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.