BVA9507809 DOCKET NO. 90-05 163 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Huntington, West Virginia THE ISSUE Entitlement to service connection for a chronic skin disorder, to include as a residual of Agent Orange. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Michael P. Vander Meer, Associate Counsel INTRODUCTION The veteran served on active duty from February 1969 to February 1971, with service in Vietnam from August 1969 to August 1970. This appeal arises from a November 1989 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Huntington, West Virginia. This case was last before the Board of Veterans' Appeals (Board) in September 1990, at which time the claim was remanded to the RO pending the issuance of new instructions pertaining to adjudication of the claim secondary to exposure to Agent Orange. A rating decision entered in May 1994 denied service connection for a chronic skin disorder secondary to Agent Orange exposure, and a Supplemental Statement of the Case was issued the same month. A hearing was held before a hearing officer at the RO in November 1994, and his decision was entered the following month. A Supplemental Statement of the Case was issued in December 1994. The appeal was returned to and redocketed at the Board in March 1995. REMAND The veteran contends that he has a chronic skin condition which is of service origin. He further elaborates that he may have chloracne, which he feels is related to inservice exposure to Agent Orange. Service medical records reflect that the veteran was seen in 1970 for rashes involving the legs and groin area. Subsequent to service, in conjunction with treatment rendered the veteran in September 1974 by William D. McLean, M.D., he was assessed as having erythema multiforme involving areas including his thighs. Correspondence from Stephen K. Milroy, M.D., dated in May 1994, reflects examination findings including excoriation involving the buttock. Most recently, when seen for VA outpatient treatment in October 1994, the diagnoses included chronic eczematoid dermatitis for which the affected areas were unspecified. On assessing the foregoing clinical evidence in conjunction with the veteran's contentions, and inasmuch as the veteran is shown to have received treatment for a skin condition involving the lower extremities within several years of having been treated in service for rashes involving the lower extremities and groin area, the Board is of the opinion that a VA dermatology examination, as specified in greater detail below, should be performed before an appellate decision is made. Accordingly, the case is REMANDED for the following: 1. The RO should contact the veteran and request him to identify the names, addresses and approximate dates of treatment by any non-VA health care provider(s), to include Stephen K. Milroy, M.D., who may possess additional records pertinent to his claim. Thereafter, in light of the response received and after obtaining any necessary authorization, the RO should take appropriate action to obtain copies of any clinical records indicated. In any event, the RO should obtain copies of all clinical records reflecting treatment rendered the veteran since October 1994 at the VA Medical Centers in Huntington and Beckley, West Virginia. 2. Thereafter, the RO should arrange for the veteran to undergo a VA examination by a specialist in dermatology to determine the nature and extent of any current skin disorder(s). Photographs are requested of any areas affected by any ascertained skin disorder(s), and a diagnosis of chloracne should be specifically included or excluded. Any special diagnostic studies deemed necessary should be performed. In addition, the examiner is specifically requested, after reviewing the record to include service medical evidence as well as all clinical reports pertaining to treatment rendered the veteran by Dr. McLean over an approximately 15-year duration beginning in 1974 and the May 1994 statement by Dr. Milroy, to offer an opinion as to whether it is at least as likely as not that any currently diagnosed skin disorder(s) is(are) related to rashes involving the lower extremities and groin for which the veteran was treated in service. It is imperative that a copy of this REMAND be provided to the examiner, and the claims folder must be made available to the examiner for review prior to the examination. The rationale for all opinions expressed should be fully explained. 3. The RO should then review the report pertaining to the VA examination performed in response to the previous directive to ascertain whether such examination is in compliance with the Board's examination instructions. 4. Then, after undertaking any development deemed necessary in addition to that specified above, the RO should readjudicate the issue on appeal. 5. If the benefit sought on appeal is not granted to the veteran's satisfaction, the veteran and his representative should be provided a Supplemental Statement of the Case. The veteran should be provided appropriate notice of the requirements to perfect an appeal with respect to any issue addressed therein which does not appear on the title page of this decision. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. In taking this action, the Board implies no conclusion, either legal or factual, as to the ultimate outcome warranted. No action is required of the veteran until he is otherwise notified. F. JUDGE FLOWERS Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. 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) (1994).