13-00 024, 13-00 024

Veteran served on active duty 1980–1983 and was service-connected for pseudofolliculitis barbae with an initial 10% rating effective October 30, 2008.
Board previously denied a rating in excess of 10%; the Veteran appealed to the Court of Appeals for Veterans Claims.
The Court granted a Joint Motion for Remand (Oct. 2016) directing further development because the Board failed to address whether doxycycline (an oral antibiotic used by the Veteran) is a systemic therapy "like or similar to" corticosteroids or other immunosuppressives.
The record shows doxycycline was used during the relevant appeal period; the last VA skin exam in the file was from August 2012.
Veteran and representative have asserted symptoms worsened since 2012; the Board ordered a new VA skin examination and a medical opinion on whether doxycycline (and any other oral meds used) is "like or similar to" corticosteroids/immunosuppressants, and directed collection of VA treatment records from February 2014 onward.
The Board remanded the claim for additional development (new exam/opinion and outstanding treatment records) and instructed readjudication; no final merits decision was made.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the Veteran is entitled to an initial rating in excess of 10% for pseudofolliculitis barbae (including whether doxycycline qualifies as systemic therapy "like or similar to" corticosteroids/immunosuppressives)	Veteran: doxycycline was used during the appeal period and may qualify as systemic therapy warranting higher rating; symptoms have worsened since last exam	VA/Board: prior record/exam did not establish rating >10%; adequacy of prior exam/opinion on systemic-therapy question unresolved	Remanded: obtain outstanding records, new VA skin exam, and medical opinion on whether doxycycline/other oral meds are "like or similar to" corticosteroids/immunosuppressives; then readjudicate rating issue

Forcier v. Nicholson, 19 Vet. App. 414 (Vet. App. 2006) (Board must follow clear, specific Court instructions)
Floyd v. Brown, 9 Vet. App. 88 (Vet. App. 1996) (VA duty to provide a thorough, contemporaneous medical exam)
Weggenmann v. Brown, 5 Vet. App. 281 (Vet. App. 1993) (entitlement to new exam where condition may have worsened)
Snuffer v. Gober, 10 Vet. App. 400 (Vet. App. 1997) (new exam warranted if deterioration alleged)
Caffrey v. Brown, 6 Vet. App. 377 (Vet. App. 1994) (same principle on need for new exam)
Barr v. Nicholson, 21 Vet. App. 303 (Vet. App. 2007) (VA must ensure examinations/opinions are adequate)
Warren v. McDonald, 28 Vet. App. 194 (Vet. App. 2016) (compensation available for systemic therapies "like or similar to" corticosteroids/immunosuppressives)
Murphy v. Derwinski, 1 Vet. App. 78 (Vet. App. 1990) (duty to obtain relevant VA and private records)
Bell v. Derwinski, 2 Vet. App. 611 (Vet. App. 1992) (same duty to obtain outstanding records)
Kutscherousky v. West, 12 Vet. App. 369 (Vet. App. 1999) (veteran may submit additional evidence on remand)