Citation Nr: 9924757 Decision Date: 08/30/99 Archive Date: 09/08/99 DOCKET NO. 97-25 743 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Sioux Falls, South Dakota THE ISSUE Entitlement to service connection for a skin disorder. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD B.E. Jordan, Counsel INTRODUCTION The veteran had active military service from January 1970 to September 1971. This appeal to the Board of Veterans' Appeals (Board) arises from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Sioux Falls, South Dakota. In May 1998, the Board remanded this matter to the RO for further development. This Board is satisfied that the RO has complied with the Remand directives. FINDING OF FACT Chronic tinea pedis and cruris and onychomycosis of the toenails had their onset during the veteran's service in Vietnam as a combat infantryman. CONCLUSION OF LAW Chronic tinea pedis and cruris and onychomycosis of the toenails were incurred during active service. 38 U.S.C.A §§ 1110, 1154(b), 5107(a) (West 1991); 38 C.F.R. §§ 3.303(b), 3.304(d) (1998). REASONS AND BASES FOR FINDING AND CONCLUSION The threshold question to be answered with respect to this appeal is whether the appellant has presented evidence of a well-grounded claim. 38 U.S.C.A. § 5107(a). A well-grounded claim is a claim that is plausible, that is, one that is meritorious on its own or capable of substantiation. Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). If a claim is not well grounded, the appeal must fail with respect to it, and there is no duty to assist the appellant further in the development of facts pertinent to the claim. Id., 38 U.S.C.A. § 5107(a); Grottveit v. Brown, 5 Vet. App. 91 (1993); Tirpak v. Derwinski, 2 Vet. App. 609 (1992). The initial burden is on the claimant to produce evidence of a well-grounded claim. 38 U.S.C.A. § 5107(a); see Grivois v. Brown, 6 Vet. App. 136 (1994); Grottveit at 92; Tirpak at 610-11. Where a determinative issue involves medical causation or a medical diagnosis, competent medical evidence to the effect that the claim is plausible or possible is required. Grottveit at 92-93. Further, in order for a claim to be considered plausible, and therefore well grounded, there must be evidence of a current disability (a medical diagnosis), of incurrence or aggravation of a disease or an injury in service (lay or medical evidence), and medical evidence of a nexus between the inservice injury or disease and a current disability. Epps. v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd 78 F.3rd 604 (Fed. Cir. 1996) (per curiam), Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992). Service connection may be granted for disability resulting from disease or injury incurred or aggravated during service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1998). The chronicity provisions of 38 C.F.R. 3.303(b) are applicable where evidence, regardless of its date, shows that the veteran had a chronic condition in service or during an applicable presumptive period and still has such condition. Such evidence must be medical unless it relates to a condition as to which lay observation is competent. If the chronicity provision is not applicable, a claim may still be well-grounded or reopened on the basis of 38 C.F.R. 3.303(b) if the condition is observed during service or any applicable presumptive period, continuity of symptomatology is demonstrated thereafter, and competent evidence relates the present condition to that symptomatology. Savage v. Gober, 10 Vet.App. 488 (1997) Under the provisions of 38 U.S.C.A. § 1154(b), service connection may be established in the absence of confirming service medical record entries where there is satisfactory lay or other evidence that an injury or disease was acquired in combat, if the evidence is consistent with the circumstances, conditions or hardships of such service. See 38 C.F.R. § 3.304(d) (implementing the statute). The United States Court of Appeals for Veterans Claims has held that "satisfactory lay or other evidence" under 38 U.S.C.A. § 1154(b) means "credible evidence." Caluza; see Collette v. Brown, 82 F.3d 389, 393 (Fed. Cir. 1996). Once a combat veteran's claim for service connection of a disease or injury alleged to have been incurred in or aggravated in combat service is well grounded, then, under section 1154(b), the claimant prevails on the merits unless VA produces "clear and convincing evidence" to the contrary-that is, unless VA comes forward with more than a preponderance of the evidence against the claim. Arms v. West, 12 Vet.App. 188 (1999) The report of the veteran's entrance examination in August 1969 is negative for a history, complaints, findings, or diagnoses pertaining to a skin disease. On examination, the skin was normal. In August 1970, the veteran was seen for a boil on the left elbow, which subsequently healed. In September 1970, jungle rot from the previous site of the abscess on the left elbow was found. Superficial inflamed lesions of both hands were recorded in October 1970. When examined for separation in September 1971, the veteran's skin was found to be normal. Private treatment records dated from August 1977 to September 1990 provide that the veteran was seen for recurrent ringworm of the inguinal area, thigh, and buttock. A VA Agent Orange examination report dated in March 1991 reflects that the veteran complained of a rash in his groin area and between his toes since service. The impression was tinea cruris and tinea pedis. A VA treatment record dated in August 1991 reflects that the veteran had probable tinea pedis and maceration. On examination in April 1997, the veteran reported no recurrence of the left elbow boil, but a recurrence of jungle rot in the groin area and on both feet. The diagnosis was no boils on the elbow found and tinea pedis. Additional VA records dated in April 1997 reflect that the veteran reported a history of a rash on both feet since Vietnam which the veteran claimed never cleared. When examined by VA in September 1998, the veteran indicated that he has had scaliness and itchiness in the feet and groin area since Vietnam. The diagnosis was chronic tinea cruris and pedis and chronic fungus/hyphae of the groin and feet. In an addendum to the September 1998 examination dated in November 1998, the examiner stated that medication had resulted in dramatic improvement in the veteran's tinea pedis and cruris. Onychomycosis of the toenails was also present. None of these conditions were thought to be related to Agent Orange exposure and were not reflected in the veteran's service medical records. As the veteran was a combat infantryman during his tour of duty in Vietnam, his accounts of experiencing skin problems in service are considered credible. Both his personal statements and post service treatment records show a continuity of ongoing skin pathology involving the feet and groin. Current medical reports confirm that he has chronic tinea pedis and cruris and onychomycosis of the toenails. Accordingly, his claim for service connection is well- grounded. 38 U.S.C.A. § 1154(b); 38 C.F.R. §§ 3.303(b), 3.304(d); Epps, Savage. Further, as clear and convincing evidence to the contrary has not been presented, it must be concluded that the veteran's current skin disorders, tinea cruris and pedis and onychomycosis of the toenails, had their onset during his period of military service and thus warrant service connection. 38 U.S.C.A §§ 1110, 1154(b), 5107(a) (West 1991); 38 C.F.R. §§ 3.303(b), 3.304(d); Arms. ORDER Service connection for tinea pedis and cruris and onychomycosis of the toenails is granted. WAYNE M. BRAEUER Member, Board of Veterans' Appeals