Citation Nr: 9910827 Decision Date: 04/20/99 Archive Date: 04/30/99 DOCKET NO. 96-08 223 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to service connection for a skin disability. REPRESENTATION Appellant represented by: AMVETS ATTORNEY FOR THE BOARD Nadine W. Benjamin, Counsel INTRODUCTION The veteran served on active duty from May 1968 to December 1974. This matter comes to the Board of Veterans' Appeals (Board) on appeal from rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. REMAND The veteran seeks service connection for a skin disability. The Board notes that he was treated in service for skin complaints in 1972 and 1974. Athlete's foot and urticarial lesions were found. VA medical records show that the veteran was examined in 1986 and he gave a 10-15 year history of skin problems of the hands and right foot. The examiner found tinea pedis/manum. When the veteran was examined by VA in March 1995, the skin was found to be warm and dry and without lesions. The veteran apparently underwent a VA Agent Orange examination recently since a letter dated in December 1995 from a VA facility in Oklahoma City, Oklahoma to the veteran shows that the veteran had recently participated in the VA Agent Orange registry and that the results of his physical examination, laboratory tests and consultations had been reviewed. It was noted that the veteran was found to have dyshidrosis of the hands and feet; and onychomycosis, fungal infection of the fingernails and toenails. The examination report, the laboratory reports and the consultation reports have not been associated with the claims file. The VA records are deemed to be evidence of record and, if shown to be relevant to the issue on appeal, should be considered in conjunction with the veteran's appeal. See Bell v. Derwinski, 3 Vet. App. 391 (1992). The finding that a claim of entitlement to service connection for a skin disorder is well grounded requires that the veteran submit evidence showing the incurrence or aggravation of a disease or injury in service, evidence of continuing symptomatology since service, and medical evidence of a current disability. In addition, the veteran must submit medical evidence of a relationship between the continuing symptomatology and the current disability, unless the relationship is of the type as to which a lay person's observation is competent. Savage v. Gober, 10 Vet.App. 488, 495-98 (1997). A skin rash is a disorder to which a lay person is competent to provide evidence because it is an observable condition. Falzone v. Brown, 8 Vet. App. 398 (1995). The veteran's service medical records show that he was treated for skin complaints. VA records show treatment in the 1980's with a history given dating back to service. The veteran has stated that he has had skin complaints continuously since service. For the purpose of determining whether a well-grounded claim has been submitted, the statements of the veteran is deemed to be credible. King v. Brown, 5 Vet. App. 19, 21 (1993). There is competent evidence therefore, of the incurrence of a skin disorder in service, continuing symptomatology of a skin disorder since service, and a current skin disability. In Bowers v. Derwinski, 2 Vet. App. 675, 676 (1992) and Ardison v. Brown, 6 Vet. App. 405 (1994), The United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999)(hereinafter, "the Court") indicated that, whenever possible, examinations of disabilities subject to periodic exacerbation and improvement should be scheduled when the conditions are most disabling. To ensure that VA has met its duty to assist the veteran in developing the facts pertinent to his claim and to ensure full compliance with due process requirements, the case is REMANDED to the RO for the following development: 1. The veteran should be contacted and requested to provide the names, addresses and approximate dates of treatment for all VA and non-VA health care providers who have treated him for any skin complaints since service. With any necessary authorization, the RO should attempt to obtain and associate with the claims folder copies of all pertinent treatment reports identified by the veteran, which are not currently of record. Of particular interest are VA records of examination for Agent Orange exposure, specifically discussed in the December 1995 letter from a VA facility in Oklahoma City to the veteran, as noted above. 2. The veteran should be afforded a VA dermatology examination to determine the nature of any skin disorder which may be present and to obtain a medical opinion as to the relationship, if any, between the skin disorder treated during service and any current skin disorder. The claims file and a separate copy of this remand must be made available to and be reviewed by the examiner in conjunction with the examination. The examination should include any diagnostic tests or procedures deemed necessary for an accurate assessment. The examiner should conduct a thorough dermatology examination and provide a diagnosis for any skin pathology found. The examiner should also provide an opinion, based on the examination and the evidence in the case file, on whether it is at least as likely as not that any current skin disorder found is etiologically related to the skin disorder that was treated during service. The examiner should provide the rationale for his/her opinion. 3. After the examination has been completed, the RO should review the examination report to insure that it complies with the directives of this remand, and if not, it must be returned for corrective action. 4. Then the RO should take any other necessary action, and readjudicate the issue on appeal. After completion of the requested actions, the RO should review the evidence and determine whether the veteran's claim may be granted. If not, the veteran and his representative should be provided with an appropriate Supplemental Statement of the Case. After allowing the veteran appropriate time to respond, the case should be returned to the Board for further appellate review, if otherwise in order. By this remand, the Board intimates no opinion as to the final outcome warranted. No action is required of the veteran until he is notified by the RO. F. JUDGE FLOWERS Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1998).