Citation Nr: 18141019 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 16-27 437 DATE: October 9, 2018 ORDER Entitlement to service connection for right testicle orchiectomy, to include as secondary to service-connected left testicle spermatocelectomy, is denied. FINDING OF FACT The Veteran’s right testicle orchiectomy is neither proximately due to nor aggravated beyond its natural progression by his service-connected left testicle disability, and is not otherwise related to an in-service injury, event, or disease. CONCLUSION OF LAW The criteria for service connection for a right testicle disorder are not met. 38 U.S.C. §§ 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310(a) (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from January 1979 to September 1989. In April 2017, the Veteran and J.R. testified before the undersigned Veterans Law Judge in a Travel Board Hearing. A transcript of the hearing is of record. Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Entitlement to Service Connection for a Right Testicle Disorder The Veteran contends that a September 2013 right testicle orchiectomy is due to his service-connected left testicle disability. The Veteran is service connected for the residuals of a December 1980 spermatocelectomy to remove spermatoceles from his left testicle, with a non-compensable evaluation effective from November 12, 2013. The first two elements of secondary service connection are satisfied here. September 2009 VA treatment records document the Veteran’s complaint of testicular/scrotal pain, and a May 2010 ultrasound identified cysts consistent with spermatoceles on the right testicle. In September 2013, the Veteran’s right testicle was removed. He is also service connected for the removal of spermatoceles from his left testicle in December 1980 during active service. See Allen v. Brown, 7 Vet. App. 439, 447–48 (1995); 38 C.F.R. § 3.310. Thus, question for the Board is whether the Veteran’s right testicle orchiectomy is proximately due to or the result of, or is aggravated beyond its natural progress by, the Veteran’s service-connected December 1980 spermatocelectomy and residual scar. The preponderance of the evidence weighs against finding that the Veteran’s right testicle orchiectomy is proximately due to or the result of—or aggravated beyond its natural progression by—the Veteran’s service-connected removal of spermatoceles from his left testicle and residual scar. An August 2014 VA examination report includes the examiner’s opinion that the Veteran’s right testicle orchiectomy was less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service-connected residuals from a December 1980 disability. The examiner reasoned that the Veteran’s right testicle was removed due to pain, and there was no association between the development of right testicle spermatoceles and the Veteran’s December 1980 spermatocelectomy of the left testicle. The examiner’s opinion is probative. It is based on a physical examination, review of the Veteran’s claim file, and the medical expertise of the physician who conducted the examination. The examiner also provided an opinion supported by rationales. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board also notes the Veteran indicated during his personal hearing that no physician had ever attributed his right testicle spermatoceles to the in-service incurrence of spermatoceles on the Veteran’s left testicle. That said, as he has had no medical training, the Veteran lacks competence to render an opinion that there is a relationship between his service connected left testicle disability and the surgical removal of the right testicle, which occurred over 20 years after service. In light of the foregoing, the Veteran is not entitled to secondary service connection for right testicle orchiectomy due to his service-connected residuals of a left testicle spermatocelectomy. Service connection may also be granted on a direct basis, but the preponderance of the evidence is also against finding that the Veteran’s September 2013 orchiectomy is related to an in-service injury, event, or disease. 38 U.S.C. §§ 1131; 38 C.F.R. § 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). The Veteran’s service treatment records are silent for any complaints of right testicular or scrotal pain during active service. The Veteran testified in April 2017 that he experienced pain during active service without seeking medical attention. According to the Veteran, his experience as a soldier and member of the Airborne taught him to keep complaints of pain or discomfort to himself. The Veteran’s post-treatment records do not accord with his testimony. VA treatments records dating back to February 1990 are silent for complaints of right testicular or scrotal pain until September 2009, when the Veteran complained of pain for the prior two weeks that he attributed it to moving heavy boxes. December 2009 VA treatment records report that the Veteran first experienced right testicular pain “two months ago,” and a December 2009 ultrasound examination did not identify any abnormalities in the Veteran’s right testicle. Approximately six months later in May 2010, an ultrasound examination of the Veteran’s right testicle identified two small cystic structures that were most consistent with spermatoceles. The VA treatment records documenting the onset of right testicular pain in 2009 and the identification of spermatoceles in May 2010 are more probative than the Veteran’s April 2017 testimony that right testicular pain started during active service. See Buchanan v. Nicholson, 451 F.3d 1331, 1336–37 (Fed. Cir. 2006) (noting a lack of contemporaneous medical evidence can be considered and weighed against a Veteran’s lay statements). While the Veteran is competent to describe his pain and the history of treatment that he has received, he is not competent to provide an opinion regarding the etiology of the spermatoceles on his right testicle. This issue is also medically complex, as it requires specialized medical knowledge that the Veteran does not possess based the record before the Board. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 & n.4 (Fed. Cir. 2007). Because the weight of the evidence is against the Veteran’s claim, the benefit-of-the-doubt doctrine does not apply. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Service connection for a right testicle orchiectomy must be denied. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Douglas M. Humphrey, Associate Counsel