Citation Nr: A24042809 Decision Date: 08/01/24 Archive Date: 08/01/24 DOCKET NO. 210513-160361 DATE: August 1, 2024 REMANDED Entitlement to a compensable rating for pseudofollicullitis barbae (PFB) is remanded. Entitlement to a 10 percent evaluation based upon multiple, noncompensable service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to March 1982. These matters come before the Board of Veterans' Appeals (Board) on appeal from a May (11th) 2020 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In the May 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Based upon the selection of the Evidence Submission docket, the Board may consider the evidence of record as of May 11, 2020, the date of the rating decision on appeal, and evidence submitted with or within 90 days of the VA's receipt of the VA Form 10182 on May 13, 2021. See 38 C.F.R. § 20.303. If the Veteran submitted evidence that was added to the record after February 13, 2020, and before VA received the Form 10182 on May 11, 2021, or 90 days after VA's receipt of the VA Form 10182 on May 13, 2020, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501. 1. Entitlement to a compensable rating for PFB is remanded. An August 2018 VA examination noted a diagnosis of PFB affecting the Veteran's face and anterior neck, as well as a diagnosis of eczema located on the face and behind the ears. The Veteran had constantly or nearly constantly used topical corticosteroids and also constantly used topical clindamycin for the treatment of his PFB. The examiner reported that the Veteran's PFB affected between 20 and 40 percent of his total body area but was over 40 percent of the exposed area. The examiner specifically described the PFB condition as inflammatory dark reaction surrounding ingrown facial hairs. 08/01/2018, C&P Exam. More recently, a February 2020 VA examination noted that the Veteran had constantly or nearly constantly used topical corticosteroids. The examiner reported that the Veteran's PFB affected less than 5 percent of his total body area and less than 5 percent of the exposed area. The examiner described the PFB condition as causing scabbing and swelling of the face and that the condition is prominent along the jawline and neck. 02/08/2020, C&P Exam. The VA treatment records indicate that an April 2018 examination the Veteran's skin revealed PFB causing symptoms of the skin around the neck, scalp, eyebrows, ears, nasal folds, and beard. 01/07/2020, CAPRI, page 104. The Board finds that, in conjunction, the August 2018 and February 2020 VA examinations do not adequately describe the severity of the Veteran's PFB. Specifically, although both VA examiners indicate that the skin condition prominently affects the Veteran's face and neck, but their findings are in conflict as to whether the PFB affects less than 5 percent or more than 40 percent of the exposed area. Accordingly, the Board finds that the August 2018 and February 2020 VA examinations are inadequate and this is a pre-decisional duty to assist error. 38 C.F.R. § 20.802(a). As such, a new examination is to be conducted and opinion obtained as to the severity of the Veteran's PFB. 2. Entitlement to a 10 percent evaluation based upon multiple, noncompensable service-connected disabilities is remanded. The claim for a 10 percent rating based on multiple, noncompensable, service-connected disabilities is inextricably intertwined with the preceding matters, and thus its disposition is deferred. See generally, Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered). These matters are REMANDED for the following action: Schedule the Veteran for an in-person examination by an appropriate clinician, and an examiner that did not conduct any of the prior examinations, to determine the current severity of his service-connected pseudofolliculitis barbae (PFB). The examiner is asked to provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. Additionally, the examiner is asked to provide an opinion addressing the conflicting findings from the August 2018 and February 2020 VA examinations as to whether the PFB affects less than 5 percent or more than 40 percent of the exposed area. A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Han, David The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.