Stephens v. Principi

3 Vet. App. 513, 1992 U.S. Vet. App. LEXIS 378, 1992 WL 353769
CourtUnited States Court of Appeals for Veterans Claims
DecidedDecember 3, 1992
DocketNo. 91-87
StatusPublished
Cited by2 cases

This text of 3 Vet. App. 513 (Stephens v. Principi) is published on Counsel Stack Legal Research, covering United States Court of Appeals for Veterans Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stephens v. Principi, 3 Vet. App. 513, 1992 U.S. Vet. App. LEXIS 378, 1992 WL 353769 (Cal. 1992).

Opinions

IVERS, Associate Judge, filed the opinion of the Court. FARLEY, Associate Judge, filed a concurring opinion. STEINBERG, Associate Judge, also filed a concurring opinion.

IVERS, Associate Judge:

Wilbur B. Stephens appeals from a December 7, 1990, Board of Veterans’ Appeals (BVA or Board) decision which denied his claim for service connection for chronic skin disability, including psoriasis, and for arthritis, including psoriatic arthritis. The Court has jurisdiction of the case under 38 U.S.C. § 7252(a) (formerly § 4052(a)). The Court holds that the Board’s determination that the evidence most recently submitted by the veteran was not “new and material” was correct. 38 U.S.C. § 5108 (formerly § 3008). However, because the Board did not provide adequate reasons or bases regarding the issue of error in previous adjudications of this claim, we vacate the BVA decision and remand the case for readjudi-cation consistent with this opinion.

I. FACTS

The veteran served in the United States Navy from June 1942 to April 1946 and from September 1950 to November 1950. Wilbur B. Stephens, BVA 90-46095, at 4 (Dec. 7, 1990); R. at 5, 63. In January 1946, Mr. Stephens broke his right wrist. R. at 3, 7, 55. On February 5, 1946, Mr. Stephens reported to sick bay complaining of a cough, an itchy rash on his chest and abdomen, and dizziness. R. at 26. The doctor commented that no Koplik spots were noted; Koplik spots are “small bluish white dots surrounded by a reddish zone that appear on the mucous membrane of the cheeks and lips before the appearance of the skin eruption in a case of measles.” Webster’s Medical Desk Dictionary 368 (1986). The doctor also noted: “Suggestion of blanching rash on abdomen[; otherwise negative.” R. at 26. Mr. Stephens was found fit for duty two days later. R. at 26. His separation examination report dated April 17, 1946, provides no evidence of a skin condition but it does note “[frequent pains and stiffness in r[igh]t wrist.” R. at 1-2, 28-29.

The veteran was service connected for traumatic arthritis of the right wrist at 10% from April 19,1946. R. at 72. A report of physical examination, date-stamped received by the Veterans’ Administration (now Department of Veterans Affairs) (VA) Regional Office (RO) on June 24, 1948, reveals that the veteran was suffering from “[ejczematous lesions of both external ears” and that they were “scaly with red irritated area deep.” R. at 8.

The veteran was treated in a VA hospital in 1964 and 1966 for pruritus ani. R. at 70. Pruritus is “localized or generalized itching due to irritation of sensory nerve endings from organic or psychogenic causes”; prur-itus ani is “pruritus of the anal region.” Webster’s Medical Desk Dictionary 583. [515]*515The hospital summary of record from 1966 states, inter alia, the following:

Examination at time of admission was not remarkable except for edematous and lichenified areas around the perianal and scrotal regions. He was admitted to the dermatology service with diagnosis of neurodermatitis involving the perianal and scrotal areas.... The pruritus ani was treated with steroid cream with fairly good results.

R. at 70. Upon examination by the VA in November 1967, the examiner reported that “[h]e has no evidence of any disease of the skin and its appendages. His skin is dry, warm, clear and intact.” R. at 74. The examiner also noted that “[e]ar canals are dry, clear and free. The ear drums are intact and are of good color and luster and anatomical landmarks.” Id.

The veteran made his first claim for service connection of a skin disorder in 1978 when he requested that the VA amend his claim, which was apparently for an increase in the disability rating for his service-connected arthritis of the right wrist, “to include an additional disability for a skin disease.” R. at 82. On a VA Form 10-10m, Medical Certificate and History, dated January 17, 1978, a doctor wrote, “Several y[ea]r [history] psoriasis, seen in past by Dr. Tansen and other pri[vate] dermatologists. Wants more cream for areas — now uses Synalen on ear. Extensive patches knees, elbows, pre-sacral area, thighs, of excoriation and silver scales.” R. at 76. An RO rating board issued a rating decision dated April 24, 1978, denying service connection for a skin condition and stating that

[t]he service records show a normal enlistment examination and a normal discharge examination. On [February 5, 1946], the veteran had a rash on his stomach which was treated. There is no further mention of a skin problem in the service. Outpatient reports from [January 1, 1978], to [March 13, 1978], show treatment for a skin problem diagnosed as psoriasis.

R. at 84.

The veteran filed a Notice of Disagreement (NOD) with the rating decision on April 30, 1979. R. at 85. In support of his claim, Mr. Stephens submitted a letter from Dr. Charles Davis, a private dermatologist, who stated, inter alia, that

[i]t is important that many years ago he describes scaliness limited to the ears and scalp, which, at that time, was thought to be seborrhea, but in retrospect probably represents early stages of psoriasis. Frequently, when psoriasis begins it can present a scaliness and flakiness of the scalp and ears and can run a rather intermittent course for years before the more typical lesions of psoriasis develop on the body. This, apparently, is Mr. Stephens^] case, as now he has extensive psoriasis and has continued to have problems with scalp involvement.
R. at 88.

In May 1979, the veteran underwent a VA physical examination in which the examining physician, Dr. Lynn Thompson, reported, inter alia, as follows:

The patient states that his skin pathology began in 1943 and the start of the condition was in the external ear canal and in the ear lobe itself. The dermatitis then extended to his arms, back, buttocks and his lower extremities and has developed into a generalized psoriasis. Associated with the increase of the psoriasis the veteran has developed arthritic type pains in the shoulders, neck, and in the back which has gradually gotten worse.... This examiner has reviewed the records in the C-Folder and there is evidence that he was treated for some form of dermatitis of the ears while on active duty.
R. at 91, 94 (emphasis added). In addition, the examiner noted the following:
[T]his examiner is inclined to believe that the psoriasis of this veteran had its inception as a dermatitis of the ears which gradually extended into a generalized manifestion [sic]. The prominence of psoriasis arthritis is known to exist in approximately 35% of all patient’s [sic] having this dermatological manifestation and it would be reasonable to assume [516]*516that there is a probable relationship between the dermatological condition and the generalized arthritis.

R. at 93 (emphasis added). A VA dermatologist confirmed the diagnosis of psoriasis and noted that “[t]he patient has had this problem since 1948, and he has not been doctoring it very well.” R. at 98.

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Cite This Page — Counsel Stack

Bluebook (online)
3 Vet. App. 513, 1992 U.S. Vet. App. LEXIS 378, 1992 WL 353769, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stephens-v-principi-cavc-1992.