Citation Nr: 9911801 Decision Date: 04/29/99 Archive Date: 05/06/99 DOCKET NO. 94-18 237 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUE Entitlement to service connection for chloracne as the result of herbicide agent exposure. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD James A. Frost, Counsel INTRODUCTION The veteran served on active duty from March 1968 to September 1969, with service in the Republic of Vietnam. This appeal to the Board of Veterans' Appeals (Board) arises from a rating decision in March 1993 by the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. In March 1996, the Board remanded this case to the RO for further development of the evidence. The case was returned to the Board in February 1999. FINDINGS OF FACT 1. The veteran has chloracne. 2. He served on active duty in Vietnam. 3. The evidence is in equipoise on the issue of whether chloracne was manifested to a compensable degree within one year of his last exposure to a herbicide agent. CONCLUSION OF LAW With benefit of the doubt, chloracne may be presumed to have been incurred during service in Vietnam. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1998). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991). Applicable regulations provide that if a veteran was exposed to a herbicide agent during active service, chloracne or other acneform disease consistent with chloracne shall be service connected, if the requirements of 38 C.F.R. § 3.307(a)(6) are met, even though there is no record of such disease during service. 38 C.F.R. § 3.309(e) (1998). 38 C.F.R. § 3.307(a)(6)(iii) (1998) provides that a veteran who, during active service in the Republic of Vietnam, has a disease listed at 38 C.F.R. § 3.309(e) shall be presumed to have been exposed during such service to a herbicide agent, unless there is affirmative evidence to establish that he was not exposed to any such agent during that service. For a grant of presumptive service connection for chloracne, the condition must become manifest to a compensable degree within one year after the last date of the veteran's exposure to a herbicide agent. 38 C.F.R. § 3.307(a)(6)(ii) (1998). In the veteran's case, service medical records show treatment for athlete's foot in April 1968. The service medical records were otherwise negative for skin problems. At an examination for service separation, no skin disease was noted. During VA hospitalization in December 1969, the veteran's skin was noted to be hot and dry; a skin rash was not reported. At a VA examination in May 1970, scaling and peeling of the skin was found, with maceration between the 4th and 5th toes, diagnosed as dermatophytosis of the feet. No skin rash elsewhere on the body was found. A rating decision in July 1970 granted service connection for dermatophytosis of the feet. A VA outpatient treatment note in April 1986 showed skin lesions, diagnosed as acute rosacea and folliculitis of the back and abdomen. At a VA examination in September 1986, multiple 2-millimeter pustules and multiple 2- to 5- millimeter papules in the belt line area were found. In December 1992, Antreas Mesrobian, M.D., medical director of a prison in Illinois, where the veteran was incarcerated, reported that he has seen the veteran since May 1988 for a skin rash. In September 1992, a biopsy of abdominal skin tissue was diagnosed as an epidural inclusion cyst with inflammation. Dr. Mesrobian offered an opinion that the veteran's skin lesions were chloracne, probably due to Agent Orange exposure. In December 1992, the veteran stated in a letter to his representative that he first noticed chloracne in November 1969. While this case was in remand status, the veteran received an Agent Orange examination at a VA medical center in December 1996. Diagnoses included chloracne. In addition, lay statements by the veteran's parents and sister were submitted. They all stated that, within several months of his return from Vietnam and separation from service in September 1969, the veteran had the same skin condition which years later was diagnosed as chloracne. The veteran has chloracne, a disease listed at 38 C.F.R. § 3.309(e), and he served in Vietnam. He is thus presumed to have been exposed to a herbicide agent during active service. 38 C.F.R. § 3.307(a)(6)(iii). Therefore, chloracne shall be service connected in his case if the condition was manifested to a compensable degree within one year of his last exposure to a herbicide agent. As service personnel records show that the veteran was in Vietnam at least as late as June 1969, if chloracne was manifested by November 1969, as the veteran has stated, that would be within the one-year presumptive period. The issue thus becomes whether chloracne was manifested to a compensable degree within one year of his last exposure. Chloracne would be rated as analogous to eczema. 38 C.F.R. § 4.20 (1998). A 10 percent rating would require exfoliation, exudation or itching, involving an exposed surface or an extensive area. 38 C.F.R. § 4.118, Diagnostic Code 7806. On the one hand, chloracne was not diagnosed by a physician during the one-year presumptive period. However, on the other hand, the veteran and his family members have asserted that he had the condition now diagnosed as chloracne within the presumptive period, and that it involved an extensive area. The Board finds that the evidence is in equipoise on the issue of whether chloracne was manifested to a compensable degree within one year of the veteran's last exposure to a herbicide agent. As required by law, the doubt on this issue will be resolved in the veteran's favor, and service connection for chloracne will be established. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5107(a) (West 1991); 38 C.F.R. §§ 3.307, 3.309. ORDER Service connection for chloracne is granted. BRUCE KANNEE Member, Board of Veterans' Appeals