DERMATITIS OR ECZEMA

Summary

The Veteran served from December 1997 to December 2017. This case involves an appeal concerning the Veteran's service-connected eczema. Initially granted a 30 percent rating in June 2022, the Veteran's evaluation was reduced to 0 percent in December 2024. The Veteran appealed this reduction, seeking to restore the 30 percent rating and also claiming an increased evaluation for his eczema. The Board reviewed evidence including treatment records from Naval Hospital Guantanamo Bay, a private DBQ completed via telehealth, and a VA examination. The Board found the December 2024 reduction improper, restoring the 30 percent rating. This decision was based on lay evidence and a private DBQ indicating continued symptoms, worsening over time, and significant body area affected by eczema, which contradicted the VA examiner's finding of quiescent disease with no objective evidence. The Board applied the benefit of the doubt in the Veteran's favor for the reduction issue. However, the claim for an increased evaluation beyond 30 percent was remanded. The remand is necessary because of conflicting medical evidence regarding the severity and treatment of the eczema between the private DBQ and the VA examination, requiring an addendum opinion to reconcile these discrepancies and address the Veteran's reported worsening symptoms and treatment regimen.

Rationale

Reduction from 30% to 0% found improper; Lay evidence and private DBQ indicated continued symptoms and worsening; Contradicted VA examiner's finding of quiescent disease

Full Decision Text

Citation Nr: A26040374
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 251223-617877
DATE: April 29, 2026

ORDER

Restoration of the 30 percent rating for eczema, effective March 1, 2025, is granted.

REMANDED

Entitlement to an increased evaluation greater than 30 percent for eczema is remanded. 

FINDING OF FACT

The evidence of record at the time of the December 2024, rating decision to reduce the rating for the Veteran's eczema from 30 to 0 percent did not reflect improvement in his ability to function under the ordinary conditions of life and work. 

CONCLUSION OF LAW

The reduction in rating from 30 percent to 0 percent for eczema, effective March 2025, was not proper. 38 U.S.C. §; 38 C.F.R. § 3.344.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served from December 1997 to December 2017.  These matters are before the Board of Veterans' Appeals (Board) on appeal from a December 2024 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In March 2024 the Veteran submitted a claim for increase, and in December 2024, the evaluation of eczema was reduced from 30 to 0 percent disabling effective March 1, 2025.  

In January 2025, the Veteran submitted a VA Form 20-0996, seeking review of the December 2024 decision.  In April 2025, the AOJ issued the HLR decision on appeal which considered the evidence of record at the time of the prior December 2024 decision.

VA received the Veteran's VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in December 2025.  The Veteran elected the Direct Review docket.  Therefore, the Board may only consider the evidence of record at the time of the December 2024 decision, which was subsequently subject to HLR. 38 C.F.R. § 20.301.  If evidence was submitted during the period after the AOJ issued the December 2024 decision, which was subsequently subject to HLR, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

The Board acknowledges that rating reduction claims are distinct from increased rating claims. See Dofflemyer v. Derwinski, 2 Vet. App. 277, 279-80 (1992). However, in this case, both the propriety of the rating reduction and the increased rating claim is on appeal.  Notably the Veteran sought an increased rating of eczema in, which was then reduced in a December 2024 decision.  The Veteran then elected HLR, which the RO framed as entitlement to a compensable evaluation.  

Based on the procedural posture of the case, and interpreting in a manner most beneficial to the Veteran, the Board therefore finds that both the reduction and increased rating aspects of the claims are in appellate status. 

1. Reduction- eczema.

The Veteran contends that the disability rating assigned for service-connected eczema should not have been reduced from 30 to 0 percent.

In a June 2022 rating decision, the AOJ granted service connection with a 30 percent rating for eczema, effective January 20, 2022.  In March 2024 the Veteran submitted a claim for increase.  

In July 2024, the AOJ proposed to reduce the assigned rating to 0 percent.  A notification letter containing all the information required by 38 C.F.R. § 3.105(e), including the proposed reduction in compensation payable and 60-day response period, was sent to the Veteran and his representative in August 2024.  In a December 2024 rating decision, the AOJ reduced the rating from 30 percent to 0 percent, effective March 1, 2025.

As the procedural protections of 38 C.F.R. § 3.105(e) have been satisfied, the Board turns to the question of whether the rating reduction for service-connected eczema was proper.

At the time of the December 2024 rating decision, the 30 percent rating for the Veteran's service-connected eczema had not been in effect for more than five years.  Where a rating has been in effect for less than five years, "[r]examinations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating." 38 C.F.R. § 3.344
 the AOJ reduced the rating from 30 percent to 0 percent, effective March 1, 2025.

As the procedural protections of 38 C.F.R. § 3.105(e) have been satisfied, the Board turns to the question of whether the rating reduction for service-connected eczema was proper.

At the time of the December 2024 rating decision, the 30 percent rating for the Veteran's service-connected eczema had not been in effect for more than five years.  Where a rating has been in effect for less than five years, "[r]examinations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating." 38 C.F.R. § 3.344(c).

The June 2022 AOJ decision granted an increase of 30 percent for eczema, relying primarily on treatment records from the Naval Hospital Guantanamo Bay.  These records indicate in January 2022, the Veteran was started on Dupixent injections every other week for 6 months.  A 30 percent was assigned on account of systemic therapy, required for 6 weeks or more. 

In June 2024 the Veteran supplied a completed disability benefit questionnaire (DBQ).  The DBQ was completed by FNP E. H., and Dr. C. R.  The providers indicated the Veteran was not examined in person, and the findings were based on a tele-health video appointment.  The Veteran reported an onset of symptoms during service and reported his symptoms have worsened over time.  He reported taking prednisolone orally on a constant/near constant basis.  He reported taking Dupixent, a biologic, injection for less than 6 weeks in the prior 12 months.  He reported taking triamcinolone orally for 6 weeks or more but not constant, over the past 12 months.  He had not had any treatments or procedures other than systemic or topical medications in the past 12 months.  His eczema covered greater than 40 percent of his total body area, and exposed area.  His eczema is located on all fingers, front and back of his neck, chest, arms, back and legs, appearing as red and bumpy skin.  His condition limits his ability to be productive. 

In June 2024 the Veteran underwent a VA examination.  He had symptoms of itchiness and scabs in arms, neck, legs, and thighs.  Treatment included over-the-counter topical hydrocortisone.  He reported that the itchiness becomes so uncomfortable it can disrupt his sleep.  He utilizes topical hydrocortisone on a constant/near constant basis.  The examiner indicated he has not had any treatment or procedure other than systemic or topical medications in the past 12 months.  The examiner indicated there was no exposed body area, and the condition is quiescent.  The examiner indicated there is no objective evidence of eczema, which is not unusual since the condition is triggered by exposure allergen. 

In reducing the assigned rating from 30 percent to 0 percent, the AOJ relied on the June 2024 VA examination and discounted the June 2024 private evaluation.  The June 2024 VA examination was the last VA examination on record prior to the reduction. Hohol v. Derwinski, 2 Vet. App. 169 (1992).

However, the Board finds that the lay evidence of record did not reflect "an improvement in the Veteran's ability to function under the ordinary conditions of life and work." Brown v. Brown, 5 Vet. App. 413, 420-421 (1993); Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991); Faust v. West, 13 Vet. App. 342 (2000). Specifically, there is a private DBQ of record wherein the Veteran reported treatment with steroids and biologics, and the examiner noted an active episode of eczema covering 40 percent of the body. 

Additionally, in comparing the medical evidence of record from the time of the June 2022 treatment record, to the time of examination in June 2024, the Veteran has claimed a worsening of symptoms, and both June 2024 examinations indicate continued treatment for eczema.  Thus, as compared to the June 2022 treatment records, the Veteran's overall disability picture had not improved appreciably. Cf. Dofflemyer v. Derwinski, 2 Vet. App. 277, 281-82 (1992).

Accordingly, when resolving reasonable doubt in favor of the Veteran, the Board concludes that the reduction in rating from 30 percent to 0 percent for the Veteran's eczema, effective March 1, 2025, was improper
 time of the June 2022 treatment record, to the time of examination in June 2024, the Veteran has claimed a worsening of symptoms, and both June 2024 examinations indicate continued treatment for eczema.  Thus, as compared to the June 2022 treatment records, the Veteran's overall disability picture had not improved appreciably. Cf. Dofflemyer v. Derwinski, 2 Vet. App. 277, 281-82 (1992).

Accordingly, when resolving reasonable doubt in favor of the Veteran, the Board concludes that the reduction in rating from 30 percent to 0 percent for the Veteran's eczema, effective March 1, 2025, was improper, and the 30 percent rating is therefore restored. 38 U.S.C. § 5107(b); Lynch, 21 F.4th 776. 

REASONS FOR REMAND

1. Entitlement to an increased evaluation greater than 30 percent for eczema. 

The Veteran has claimed an increase in his evaluation for eczema. 

In the June 2024 private DBQ, the Veteran reported an onset of symptoms during service and reported his symptoms have worsened over time.  He reported taking prednisolone orally on a constant/near constant basis.  He reported taking Dupixent, a biologic, injection for less than 6 weeks in the prior 12 months.  He reported taking triamcinolone orally for 6 weeks or more but not constant, over the past 12 months.  He had not had any treatments or procedures other than systemic or topical medications in the past 12 months.  His eczema covered greater than 40 percent of his total body area, and exposed area.  His eczema is located on all fingers, front and back of his neck, chest, arms, back, and legs, appearing as red and bumpy skin.  His condition limits his ability to be productive. 

At the June 2024 VA examination, the Veteran was noted to have symptoms of itchiness and scabs in arms, neck, legs and thighs.  He reported the itchiness becomes so uncomfortable that it can disrupt his sleep.  He utilizes topical hydrocortisone on a constant/near constant basis.  The examiner indicated he has not had any treatment or procedure other than systemic or topical medications in the past 12 months.  The examiner indicated there was no exposed body area, and the condition is quiescent.  The examiner indicated there is no objective evidence of eczema, which is not unusual since the condition is triggered by exposure allergen. 

In light of the private June 2024 examination finding the Veteran to have 40 percent exposed area, and the use of steroids and biologics, and the June 2024 VA examiner's finding that the Veteran solely requires over the counter topical medication, the failure to obtain an opinion that takes into account the private opinion and thus reconciling the conflicting findings is a pre-decisional duty to assist error requiring remand. 

The matters are REMANDED for the following action:

1. Obtain an addendum opinion to the June 2024 examination.  If another in-person examination is necessary, one should be provided.    The examiner must review the claims file.

The examiner is asked to provide a response to the following:

(a)	Please identify the Veteran's eczema symptoms, in an attempt to reconcile the findings of the private June 2024 findings, and June 2024 VA examination findings.  The examiner is asked to note the June 2024 findings of the total exposed area, and use of steroids and biologics. 

The examiner is asked to provide a detailed rationale for any opinions provided.

 

 

 

H.M. WALKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Skiouris, Elena

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.