Citation Nr: 22020102 Decision Date: 04/04/22 Archive Date: 04/04/22 DOCKET NO. 18-55 027 DATE: April 4, 2022 REMANDED Entitlement to service connection for bilateral hand dermatitis (claimed as bilateral hand condition issues) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1968 to May 1970. He testified at a hearing before the Board of Veterans' Appeals (Board) in October 2021. A copy of the hearing transcript is of record. The Veteran seeks service connection for skin disorders that he contends had their onset during military service. During his October 2021 Board hearing, he testified that he first noticed symptoms of swelling and cracked skin of both hands during service and that since then he has experienced recurrent cracked and bleeding lesions involving the hands, fingers, and legs. The Board finds that the evidence currently of record is insufficient to decide these claims and that further evidentiary development is needed before a decision can be reached on the merits. Service treatment records show that in 1969 the Veteran was treated for symptoms of scaling and itchy hands attributed to probable contact dermatitis and treated with Kenalog ointment. Post service clinical records document the Veteran's reports of chronic finger and hand lesions since being in Vietnam. See VA Primary Care Outpatient Note dated September 22, 2008. Subsequently dated records show that during routine health maintenance in 2015, the Veteran complained of hand dermatitis which he attributed to service as well as jungle rot and fungal infections of the toes. The examiner also noted the Veteran had been seen in the dermatology clinic for hand eczema and prescribed an ointment. Examination of the hands revealed evidence of "mechanic hands," and xerosis, as well as cracking and fissures consistent with eczema. There was also evidence of onychomycosis of the right toenails and dermatitis over the left shin. See VA Primary Care Outpatient Note dated July 24, 2015. When examined by VA in May 2016, the examiner noted the Veteran's report that since he had been out of military service, he continued to have a rash on the hands. However, they went on to conclude that the Veteran's claimed hand dermatitis was unrelated to service as the post-military medical evidence was silent for continuity and chronicity of the condition. See VA Skin Diseases Disability Benefits Questionnaire (DBQ). In this case the Board finds the VA opinion inadequate as the examiner failed to adequately address the Veteran's statements about his continued skin problems since service. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (that reports of symptomatology are not supported by contemporaneous clinical evidence does not render them inherently not credible); see also Miller v. Wilkie, 32 Vet. App. 249, 262 (2020) (holding when an examiner fails to address lay evidence, and the Board doesn't find the Veteran not credible or not competent to offer that evidence, the proper remedy is for VA to get a new exam). As the opinion does not fully consider the Veteran's lay testimony that he experienced continuing skin problems since service, this matter must be remanded for an additional opinion. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). By this remand, the Board makes no determination, express or implied, as to the credibility of any statements on file. The matters are REMANDED for the following action: 1. Obtain all clinical records, both VA and non-VA, pertaining to treatment of the Veteran for any skin problems prior to September 2008 that are not already in the claims file. 2. Schedule the Veteran for appropriate VA examination. The examiner should elicit a detailed history regarding the onset and progression of relevant symptoms, and the examination report should include a discussion of the Veteran's documented medical history. Any medically indicated testing should be accomplished and the results included in the examination report. The examiner should identify all current skin disorders and address the dermatitis, onychomycosis, xerosis, and eczema diagnoses already of record and state whether it is at least as likely as not (a probability of 50 percent or greater) that such diagnosed skin disorder is related to the documented in-service dermatitis. In providing the requested opinion, the examiner must discuss: a) the objective medical findings in service treatment records documenting treatment for contact dermatitis in 1969; b) the Veteran's October 2021 testimony about continuing skin problems after service; c) the Veteran's belief that his currently diagnosed skin disorders including dermatitis, onychomycosis, xerosis, and eczema represent a continuation of the skin problems he experienced during service; and d) the Veteran's post-service employment as a mechanic. The examiner should provide a clear rationale for the opinion offered, including discussion of the facts of this case and any medical studies or references relied upon. He/She is reminded the Veteran's lay statements of symptoms during and since service must be considered in formulating the requested opinion. If the Veteran's reports are discounted, the examiner should provide a rationale for doing so (e.g., whether there is any medical reason to accept or reject his contentions). If the examiner is unable to provide an opinion without resorting to speculation, they must provide a reasoned explanation for such conclusion. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.R. Bryant 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.