Citation Nr: 22018930 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 16-49 541 DATE: March 30, 2022 ORDER Service connection for a skin condition, other than folliculitis barbae, is granted. FINDING OF FACT The Veteran's skin condition manifested by a skin rash had onset during active service. CONCLUSION OF LAW The criteria for service connection for a skin condition, other than folliculitis barbae, are met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1988 to July 1991. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board at which times it was remanded for further development. Entitlement to service connection for a skin condition, other than folliculitis barbae The Veteran contends that he first experienced a skin rash on his legs and thighs in service which persisted thereafter on an intermittent basis. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (d). Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b). Generally, in order to prove 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 Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Service connection may also be established for a Persian Gulf Veteran who exhibits objective indications of a qualifying chronic disability which became manifest either during active service in the Southwest Asia theater of operations during the Persian Gulf War, or to a degree of 10 percent or more not later than December 31, 2026; and by history, physical examination, and laboratory tests cannot be attributed to any known clinical diagnosis. 38 U.S.C. § 1117; 38 C.F.R. § 3.317 (a)(1). A "qualifying chronic disability" includes an undiagnosed illness or a medically unexplained chronic multisymptom illness that is defined by a cluster of signs or symptoms, such as chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders. 38 C.F.R. § 3.317(a)(2)(i). The term "medically unexplained chronic multisymptom illness" means a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology, such as diabetes and multiple sclerosis, will not be considered medically unexplained. 38 C.F.R. § 3.317 (a)(2)(ii). "Objective indications of chronic disability" include both "signs," in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification. 38 C.F.R. § 3.317 (a)(3). Signs or symptoms that may be manifestations of undiagnosed illness or medically unexplained chronic multisymptom illness include, but are not limited to, the following: (1) fatigue; (2) signs or symptoms involving skin; (3) headache; (4) muscle pain; (5) joint pain; (6) neurologic signs or symptoms; (7) neuropsychological signs or symptoms; (8) signs or symptoms involving the respiratory system (upper or lower); (9) sleep disturbances; (10) gastrointestinal signs or symptoms; (11) cardiovascular signs or symptoms; (12) abnormal weight loss; and (13) menstrual disorders. 38 C.F.R. § 3.317(b). For purposes of section 3.317, disabilities that have existed for six months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a six-month period will be considered chronic. The six-month period of chronicity will be measured from the earliest date on which the pertinent evidence establishes that the signs or symptoms of the disability first became manifest. 38 C.F.R. § 3.317 (a)(3)(4). Determinations as to service connection will be based on review of the entire record, to include all pertinent medical evidence. VA must also consider all favorable lay evidence of record. 38 U.S.C. § 5107(b); see also Layno v. Brown, 6 Vet. App. 465, 469-70 (1994) (a Veteran is competent to report on that of which he or she actually observed and is within the realm of his or her personal knowledge). In addressing the criterion of a current disability, a July 2019 VA examiner diagnosed the Veteran with acute urticaria. See July 2019 VA Skin Conditions Examination Report. Private treatment records document diagnoses of aquagenic urticaria and cellulitis of the chest wall. See August 2014 and February 2020 Private Treatment Record Records. Next, in addressing in service incurrence, as indicated above, the Veteran contends that he first experienced a skin rash on his legs and thighs in service which persisted thereafter. He further stated that the itchy rash appears on various regions of his skin, including on his back, legs, sides of torso, and ears at various times of the day, such as when showering. The Board notes that, as a layperson, the Veteran is competent to describe and identify skin symptoms, including a skin rash. See Layno, 6 Vet. App. at 470 (stating that a veteran is competent to report on all things of which he has personal knowledge derived from his own senses). The Veteran's service treatment records (STRs) document that the Veteran complained of a rash and itching of the groin during service. The Board finds the Veteran's lay statements regarding his in-service incurrence and continuity of symptomatology to be credible. In support of his claim, as stated above, the Veteran's STRs document that the Veteran complained of a rash and itching of the groin in during service. The Veteran's post-service VA and private treatment records document the Veteran's complaints of chronic symptoms. The Board acknowledges that the evidence of record includes VA examiner opinions stating that the claimed condition was less likely than not caused by or the result of active-duty service. However, the examiners based their opinion on a lack of treatment/diagnosis of a skin condition during service and/or a lack of a current diagnosis and did not address the Veteran's contentions regarding continuity of symptomatology. See Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007) (finding a medical examination inadequate where the examiner "impermissibly ignored the appellant's lay assertions that he had sustained a back injury during service"). Further, as stated above, the Veteran's STRs document that he complained of rash and itching of the groin in service. In short, the negative medical opinions of record are inadequate and given the Veteran's competent and credible lay statements regarding the chronic nature of skin condition, other than folliculitis barbae, that began in service, the Board resolves all doubt in favor of the Veteran and finds that service connection for a skin condition, other than folliculitis barbae, is warranted. A.M. CLARK Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith-Jennings, 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.