Actinic Keratosis

[PNC]

I wanted to pass along to my brothers and sisters in arms that there is hope, light and yes, even success at the end of the tunnel.  History: I served almost 20 years, with 11 years in the Marine Corps and 9 years, 5 months in the Navy.  My primary duties in both branches were administrative in nature.  My final discharge was in 1989.  In 2010 I was diagnosed by a VA Hospital Physician with Actinic Keratosis.  Basically pre-cancerous and cancerous skin lesions due to the over-exposure to the harmful rays of the sun.  I was seen off and on at the VA for removal of lesions through mostly freezing; cryo-surgery.  After actual surgical removal of a lesion in 2015 I filed a claim for service connection.  This was initially disapproved because the VA Physician who examined me at C&P (who was not a dermatologist) decided that because I had not reported to sickbay with a major sunburn and any time while in service and that my administrative specialties had me indoors, that over exposure to the sun was not likely.  Bottom line:  After filing a NOD which was disapproved, and then filing an appeal to that decision I was recently approved for service connection for Actinic Keratosis (Skin Cancer).  Things that I wish to pass on:

1.  I did this all myself without the aid of a lawyer or other representative.  I felt that those people just would add another link in the already heavy chain of VA paperwork.  Granted, not everyone could do this.  But, being an administrative specialist, basically for the government, I understood the process, and just worked the system and was very patient.

2.  My time in service was 1969-1989.  Over-exposure to the sun was not taken seriously, and who ever heard of sun block?  Not me and I am sure millions of others.  It may only be a myth, but when your drill instructor tells you that if you report to sickbay with a sunburn, you might be charged with damaging government property.  How many of  you remember that?

3.  Yes, my administrative specialty kept me indoors for 6-8 hours per day.  But what about the rest of the time.  PT, command formations and functions.  How about liberty and leave?  All time out of doors and all the time on active duty and subject to 24/7 recall.

4.  I believe there were several things that won my appeal for me:  a.)  Finally having a C&P Exam outside of the VA by the new claims contractor QTC who knew what Actinic Keratosis was, measured the scars caused by the removal of lesions, and knew that this skin condition may not manifest itself in skin lesions until years even decades after over exposure.  That the effects of over exposure are cumulative and that one really bad sunburn is not the root cause for the disease.  b.) My argument was based on the fact that while I was an administrator, I was still a Marine and Sailor who was outside for a major portion of every day.  That almost 14 years my service was in geographical locations close to the equator.  And that having entering the service at 17 and leaving at 37 years of age; 70% of my life at the time I filed my initial claim had been spent in the active military.  c.)  And, while the current military recognizes the need for sun screen and skin protection (I provided evidence of current Naval Medicine Regulations), they certainly did not while I was on active duty. 

So, take heart if you have filed for service connection for Actinic Keratosis.  There is hope.  If you are seeing a VA Dermatologist, get copies of treatments and surgeries.  See a civilian Dermatologist if you can.  Explain your years in the sun and over exposure.  Ask for a letter stating their medical opinion on the cumulative effects and the length of time it takes to appear as lesions and cancers.  Use  your memory and records to document your duty assignments and their geographical location.  The closer to the equator the more dangerous the sun's rays are.  If you have pictures of outdoor activity shirtless, in shorts, etc.,  send them along as evidence in your claim and/or appeal.  Be patient and persistent.  The VA knows that there are millions of us out here that most likely could claim the same thing.  To me, a non-combat veteran, I liken it to the denials for Agent Orange.  Many of us unknowingly were exposed in the performance of our duties.   Mike H. SSgt/USMC and PNC/USN, 1969-1989 Semper Fi