Citation Nr: 18143193 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 15-03 053 DATE: October 18, 2018 ORDER The appeals seeking entitlement to service connection for plantar wart, right foot and service connection for a right shoulder disability are dismissed. REMANDED Entitlement to service connection for erectile dysfunction, to include as secondary to a service connected disability, is remanded. Entitlement to service connection for diverticulosis is remanded. Entitlement to service connection for epididymitis is remanded. Entitlement to service connection for a hernia is remanded Entitlement to service connection for a left knee disability, to include as secondary to service connected right knee disability, is remanded. FINDING OF FACT In May 2018 written correspondence and on the record at the May 2018 Board hearing, prior to the promulgation of a decision in the appeal in the matter, the Veteran stated he wished to withdraw the appeal seeking entitlement to service connection for plantar wart, right foot and service connection for a right shoulder disability. CONCLUSION OF LAW The criteria for withdrawal of an appeal are met as to the appeal seeking entitlement to service connection for plantar wart, right foot and service connection for a right shoulder disability. The Board has no further jurisdiction in these matters. 38 U.S.C. §§ 7104, 7105(b)(2), (d)(5); 38 C.F.R. § 20.204. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1977 to October 1985. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a February 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In May 2018, the Veteran testified at a video conference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. At the hearing, the Veteran was granted a 90-day abeyance period for the submission of additional evidence to support his claims. The Veteran did not submit additional evidence during this time period. A. Withdrawn Claims The Board has jurisdiction in any matter which under 38 U.S.C. § 511(a) is subject to a decision by the Secretary. 38 U.S.C. § 7104. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105(b)(5). An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the Veteran or by his authorized representative, and must be in writing or on the record at a hearing. 38 C.F.R. § 20.204. In a May 2018 written statement, the Veteran, through his representative stated, he wished to withdraw his appeal as to the issues seeking entitlement to service connection for plantar wart, right foot and a right shoulder disability. At a May 2018 Board hearing, the Veteran also stated that he wished to withdraw his appeal as to these issues. There remain no allegations of errors in fact or law for appellate consideration regarding these issues. Accordingly, the Board does not have jurisdiction to consider an appeal in these matters, and the appeal in these matters must be dismissed. REASONS FOR REMAND Entitlement to service connection for erectile dysfunction, diverticulosis, epididymitis, a hernia, and a left knee disability are remanded. Once VA has provided a VA examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place. Barr v. Nicholson, 21 Vet. App. 303 (2007). A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). In February 2013, the Veteran underwent a VA examination for erectile dysfunction, diverticulosis, epididymitis, hernia, and a left knee disability. The examiner provided a negative opinion regarding a nexus between erectile dysfunction, diverticulosis, and epididymitis to the Veteran’s service. Regarding the hernia, the examiner noted the Veteran did not have a diagnosed condition. Regarding the left knee, the examiner did not provide an etiology opinion. The Board finds the February 2013 VA examination to be inadequate. Regarding the opinion for erectile dysfunction, diverticulosis, and epididymitis, the examiner based the negative opinion on the basis that the Veteran’s service treatment records (STRs) were silent for these conditions. The Board finds this examination to be inadequate because the examiner failed to properly consider the lay evidence of record. See Buchanan v. Nicholson, 451 F.3d 1331, 1335-37 (Fed. Cir. 2006). Moreover, the examiner failed to explain why the absence of medical evidence during service would negate a nexus of the Veteran’s disabilities to his service. Rather, the examiner provided a conclusory opinion without any supporting rationale. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As to the hernia, the examiner’s premise that the Veteran does not have a diagnosed disability is not supported by the evidence. For example, a June 2014 VA treatment note indicates the Veteran suffered from a right ventral hernia for the past two years. Additionally, hernia is listed as an active problem in his VA treatment records. As such, the Board finds this opinion to be inadequate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value). Regarding the left knee, the examiner diagnosed the Veteran with degenerative joint disease but failed to provide an etiology opinion. As such, the Board finds the VA examination to be inadequate. The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file VA treatment records from October 2015 to the present. 2. After completing the development in 1), schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any erectile dysfunction and epididymitis. The examiner is asked to provide an opinion on the following questions: (a.) Is it at least likely as not that the Veteran’s erectile dysfunction and epididymitis were caused by his service, including any rectal bleeding and/or passing blood in the stool? (b.) Is it at least as likely as not that the Veteran’s erectile dysfunction was caused by any of the Veteran’s service-connected disabilities, including any medications used to treat the service-connected disabilities? (c.) Is it at least as likely as not that the Veteran’s erectile dysfunction, was aggravated (that is, any increase in severity beyond the natural progression of the condition) by any of the Veteran’s service-connected disabilities, including any medications used to treat the service-connected disabilities? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. After completing the development in 1), schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any diverticulosis and any hernia. The examiner must opine whether it is at least as likely as not that the Veteran’s diverticulosis and hernia are related to an in-service injury, event, or disease. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 4. After completing the development in 1), schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any left knee disability. The examiner is asked to provide an opinion on the following questions: (a.) Is it at least likely as not that the Veteran’s left knee disability was caused by his service, including carrying equipment that weighed a minimum of 35 pounds and/or participating in exercises (such as running)? (b.) Is it at least as likely as not that the Veteran’s left knee disability, was caused by the Veteran’s service-connected right knee disability? (c.) Is it at least as likely as not that the Veteran’s left knee disability was aggravated (that is, any increase in severity beyond the natural progression of the condition) by the Veteran’s service-connected right knee disability? (d.) If an arthritic condition of the left knee is diagnosed, the examiner should offer an opinion on whether it is at least as likely as not that the Veteran had any arthritic condition of the left knee within a year of his discharge from service? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Patel, Associate Counsel