Citation Nr: 18124007
Decision Date: 08/03/18	Archive Date: 08/03/18

DOCKET NO. 15-26 964
DATE:	August 3, 2018
Entitlement to an increased evaluation for hidradenitis suppurative, currently evaluated as 10 percent disabling is remanded. 
The Veteran, who is the appellant, had active service from May 1980 to July 1990.  
The Veteran appeared at a hearing before the undersigned Veterans Law Judge in January 2017.  A transcript of the hearing is of record.  
A review of the record reveals that the Veteran was afforded a VA scar examination in October 2015, which was performed in relation to her request for an increased evaluation for scars of the face.  At the time of the examination, the examiner reported the scarring related to the Veteran’s hidradenitis suppurative, impacted numerous body areas, not just the axillae.  The results of the examination have not been the subject of a supplemental statement of the case.  
In addition, treatment records added to the record subsequent to the examination demonstrate that the Veteran has now been prescribed a corticosteroid.  The record does not indicate whether this it solely topical in nature or systemic therapy.  
In addition, the Veteran and her representative, at the time of the hearing reported a worsening of the condition, indicating that she had to dress the affected areas on a continuous basis and that the wounds had persistent opening and drainage. 
Moreover, at the time of the hearing, the Veteran and her representative raised the issue of an extraschedular evaluation on the basis of the way the skin condition impacted her employment, indicating that the symptomatology listed in the rating code did not properly assess the impact of the disability.
The matter is REMANDED for the following action:
1. Undertake appropriate development to obtain all outstanding VA and/or private treatment records related to the Veteran's outstanding claim.  If any requested records are not available, the record should be annotated to reflect such and the Veteran notified. 
2. After the above records development has been completed, the Veteran should be afforded a VA skin examination to determine the current severity of her service-connected hidradenitis suppurative.  The entire record (to include this remand) must be reviewed by the examiner in conjunction with the examination. 
The examiner is asked to perform all indicated tests and studies, and indicate the percentage of the entire body or exposed areas affected by this condition.  The examiner should also comment on whether the Veteran's hidradenitis suppurative requires systemic therapy, such as corticosteroids or other immunosuppressive drugs; and, if so, the duration of any such systemic therapy.
The examiner should further indicate whether the Veteran's hidradenitis suppurative and/or scars resulting from the hidradenitis suppurative are deep or result in limited motion and define the areas affected by the condition in either square inches or square centimeters.  It should also be determined whether the Veteran's hidradenitis suppurative is unstable, is painful on examination or results in any other functional impairment, to include impact upon employment.
3. After completing (1) and (2) above, refer the matter of the Veteran's entitlement to a rating in excess of 10 percent for hidradenitis suppurative to the Director of Compensation Service, pursuant to the provisions of 38 C.F.R. § 3.321(b), for a determination as to whether an extra-schedular rating is warranted.  The Director is asked to discuss whether the schedular criteria are adequate to rate the disability, and, if not, whether there is evidence of any marked interference with employment in light of all pertinent lay and medical evidence.  In doing so, the Director is asked to address the Veteran's specific contentions and incorporate her personal information in the memorandum.
(Continued on the next page)
4. Review the claims file.  If any development is incomplete, including if the examination report does not contain sufficient information to respond to the questions posed, take corrective action before readjudication.  See Stegall v. West, 11 Vet. App. 268 (1998).
Veterans Law Judge
Board of Veterans’ Appeals

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