Citation Nr: 18124021
Decision Date: 08/03/18	Archive Date: 08/03/18

DOCKET NO. 15-28 991
DATE:	August 3, 2018
Entitlement to an initial evaluation in excess of 10 percent for service-connected scars is remanded.
The Veteran served on active duty from March 1969 to April 1976. 
In his August 2015 substantive appeal, the Veteran limited the issue on appeal to increased rating for scars.  See August 2015 VA Form 9.  
In an April 2014 rating decision, the Veteran was granted service connection for scars and assigned a 10 percent evaluation, effective September 17, 2013.  See April 2014 rating decision.  The Board notes that the Veteran is currently in receipt of a 10 percent rating for prurigo (skin condition); however, the prurigo disability is not on appeal.  The Veteran is seeking an increased initial disability rating for his scars (associated with prurigo).  He has reported being told by Dr. J.G. that he has scars on 5 percent to 20 percent of his body and that his condition has affected his entire body.  See August 2015 and October 2015 VA Form 9.  The Veteran indicated that, at his April 2014 VA scars examination the only pictures that were taken were of his neck and no other areas.  The Veteran contends that he has scars on both of his arms, both of his legs, both of his shoulders, his stomach, his scalp, and other locations on his neck, ears, and scalp.  
Significantly, the Veteran has submitted photographs of himself with captions wherein he suggests he has right shoulder scar(s) in February 2018, right cheek scar(s), right ear scar(s), left leg scar(s) below the knee in February 2018, right leg scar(s), back scar(s) in February 2018, left leg and knee scar(s), right shoulder and neck scar(s) in February 2018, right forearm scar(s) in February 2018, stomach scar(s) in 2018, left side of neck scar(s) in February 2018, right arm scar(s) in February 2018, and unstable scar(s) in 2018. 
Moreover, in August 2014, December 2014, and June 2015 VA dermatology outpatient notes, Dr. J.G. indicated that the Veteran has a couple of excoriated papules on the forehead and left side of his nose.  Examination of his neck, chest, back and abdomen revealed depigmented areas on his upper back.  His arms revealed a lot of depigmented areas.  He exhibited on his arms a couple of scattered excoriated papules without any primary lesions and the same was true for his legs.  He had a couple of excoriated papules on the left side of his neck.
This evidence reflects a possible worsening of the Veteran’s scars disability.  In light of the evidence of possible worsening since the last April 2014 VA examination, a new VA examination is warranted to assess the current manifestations of the Veteran’s scars.  Caffrey v. Brown, 6 Vet. App. 377, 381 (1994); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997).
The matter is REMANDED for the following action:
1. Obtain outstanding relevant VA and private treatment records and associate them with the claims file.
2. Then, schedule the Veteran for an appropriate VA examination in order to determine the current severity of his service-connected scars.  The complete claims file must be provided to the examiner for review in conjunction with the examination, and the examiner should note that it has been reviewed.  The VA examination report should include any applicable criteria necessary to rate the scars disability on appeal.
Particularly, the examiner is requested to consider the Veteran’s lay statements that his scars/disfigurements are on areas of his body other than his head, face, neck, and that these scars/disfigurements are unstable.  Additionally, the examiner should consider Dr. J.G.’s dermatology treatment notes. 
The examiner should provide a complete rationale for any opinion provided.
3. After completing the above action and any other necessary development, the claim must be readjudicated.  If the claim remains denied, a Supplemental Statement of the Case must be provided to the Veteran and current representative.  After the Veteran has had adequate opportunity to respond, the appeal must be returned to the Board for appellate review.
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S. Schick, Associate Counsel 

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