BVA9500663 DOCKET NO. 93-05 555 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUES 1. Entitlement to an increased evaluation for acne rosacea, currently evaluated as 10 percent disabling. 2. Entitlement to service connection for an acquired psychiatric disability. 3. Entitlement to service connection for alcohol abuse. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD K. Ehrman, Associate Counsel REMAND The veteran served on active duty from November 1967 to July 1969. Additional development of the record is required so as to comply with the duty to assist the veteran in the development of facts pertinent to his claim under 38 U.S.C.A. § 5107 (West 1991), and to comply with the United States Court of Veterans Appeals (the Court) recent jurisprudence. The veteran contends that his service-connected acne rosacea, currently evaluated as 10 percent disabling, includes constant itching, constant scabbing and pain while lying down, and many facial inflammations ("much more than 5 or 6"). He further contends that this service-connected disability results in marked disfigurement of the face, and has caused anxiety and embarrassment so as to result in an acquired psychiatric disability and alcohol abuse as secondary disabilities. The RO's January 1993 statement of the case failed to address the issue of secondary service-connection under 38 C.F.R. § 3.310 (1993). Additionally, and for the reasons discussed below, the Board finds that additional VA psychiatric and dermatologic evaluations of the veteran are necessary to comply with the duty to assist the veteran in the development of his claims. The veteran was afforded a Department of Veterans' Affairs (VA) psychiatric examination in June 1992. However, the report regarding that examination indicates that the veteran's claims folder was not available, and the extent and etiology of the given diagnoses were not clear. The examiner diagnosed anxiety disorder with depressive features, not otherwise specified, "associated with physical condition," and the diagnosis of alcohol abuse was also made. It is not clear whether the examiner's reference to a "physical condition" relates to the veteran's service-connected acne rosacea disability or alcohol abuse. Furthermore, the etiology of the veteran's alcohol abuse is not clearly noted in the June 1992 VA examination report, and the relationship, if any, between the veteran's service-connected acne rosacea, and alcohol abuse is not clear. With regard to the veteran's claim for entitlement to an increased rating for acne rosacea, currently evaluated as 10 percent disabling, the VA psychiatric and dermatologic examination reports of June 1992 are in conflict, and additional evaluation of the veteran is necessary to determine the severity of this service-connected disability. The psychiatric examiner noted a "chronic skin condition of the face and scalp," which was "both disfiguring and painful." However, the dermatologic examiner noted no such disfigurement, and noted only 5 to 6 inflammations of the scalp, with minimal crusting and no exudation or drainage. This conflict is not resolved by review of the earlier September 1990 VA dermatologic examination report, since that examiner noted papules on the cheeks, chin (in beard), and forehead, with a clear scalp. The Board is accordingly of the opinion that the veteran should be scheduled for complete VA dermatologic and psychiatric examinations. The Court has held that it is the duty of the VA to assist veterans in the development of facts pertinent to their claims. In view of the foregoing, and in accordance with the duty to assist the veteran in the development of his claims mandated by 38 U.S.C.A. § 5107 (West 1991), this case is REMANDED for the following: 1. The veteran should be scheduled for a VA dermatologic examination. All indicated tests and studies should be performed, and the claims folder must be made available to the examiner for use in the study of the case. The examiner is to make a specific determination as to whether the veteran's service connected acne rosacea includes exudation, constant itching, extensive lesions, marked deformity of one or both sides of the face, systemic or neurologic manifestations, or unsightly deformity of the eyelids, lips, or auricles. The examiner is to set forth all findings and conclusions, along with rationale and support for the diagnosis entered, in a clear, comprehensive and legible manner, with reference to supporting evidence. Color photographs should be included. 2. Upon the completion of the above requested development, the veteran should be scheduled for a VA psychiatric examination. All indicated tests and studies should be performed, and the claims folder must be made available to the examiner for use in the study of the case. A definitive diagnosis should be entered, with indication of the etiology of alcohol abuse, if found, and with a description of the relationship, if any, between alcohol abuse, service-connected acne rosacea, and any acquired psychiatric disability, if found to exist. Symptoms resulting exclusively from service-connected disability should be distinguished from symptoms resulting from nonservice-connected disabilities, if possible. The examiner is to set forth all findings and conclusions, along with rationale and support for the diagnosis entered, in a clear, comprehensive and legible manner, with reference to supporting evidence. 3. Thereafter, the RO should readjudicate the issues of: Entitlement to an increased rating for acne rosacea, currently evaluated as 10 percent disabling; entitlement to service connection for an acquired psychiatric disability; and, entitlement to service connection for alcohol abuse, secondary to service connected disability. The RO should specifically consider the laws and regulations pertaining to secondary service connection, including 38 C.F.R. § 3.310 (1993). If the decision, in whole or in part, remains adverse to the veteran, he and his representative should be provided a supplemental statement of the case, as to any issue to which a notice of disagreement has been provided, and the veteran and his representative should be afforded an opportunity to respond thereto. The supplemental statement of the case should include a citation to the law and regulations pertaining to secondary service connection. Evidence recently submitted and not previously considered should be reviewed. Thereafter, if indicated, the case should be returned to the Board for appellate consideration. No action is required on the veteran's part until further notice. H. N. SCHWARTZ 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) (1993).