Citation Nr: 18148142 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 15-10 924 DATE: November 6, 2018 ORDER Entitlement to service connection for a testicular disorder, characterized as epididymitis, is denied. FINDING OF FACT The Veteran’s testicular disorder, characterized as epididymitis, was not caused by or related to active duty service CONCLUSION OF LAW The criteria for service connection for a testicular disorder, characterized as epididymitis, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Marines from September 1967 to September 1969. The Veteran testified at a video conference hearing in May 2018. A transcript of the hearing has been associated with the claims file. Entitlement to service connection for epididymitis. The Veteran contends that his testicular disorder, characterized as epididymitis, is related to active duty service. Specifically, he stated that he injured himself while moving a cannon. Service connection may be granted for a disability due to disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). To prevail on the issue of service connection, there must be evidence of: a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the disease or injury in service and the present disability. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Based on the evidence of record, the Board determines that service connection is unfortunately not warranted for the testicular disorder, characterized as epididymitis. Initially, the Board notes that the Veteran’s service treatment records (STRs) do not exhibit complaints of or evidence of epididymitis. During his January 1965 entrance examination and September 1969 separation examination, there are also no indications of epididymitis. The Board also observes that the Veteran’s STRs do exhibit a diagnosis of prostatitis in March 1969 and chronic prostatitis is indicated on his September 1969 separation examination. However, the Board notes that, was pointed out by a VA examiner in March 2015, chronic prostatitis is a separate and distinct prostate disorder unrelated to testicular disorders, such as the current claim for epididymitis. Next, it does not appear that he had continuous symptoms, as the first evidence of epididymitis was not clinically shown until May 2011, and forty-two years after discharge from service. The Board recognizes the Veteran's statements regarding his history of continuous symptoms since active duty service. In this regard, while the Veteran is not competent diagnose a disorder such as an epididymis, he is nonetheless competent to testify about the presence of observable symptomatology, which may provide sufficient support for a claim of service connection, if credible, regardless of the lack of contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Here, the Board finds that service connection is not warranted based on the Veteran’s statements alone. Specifically, in private medical records, the Veteran reported that the symptoms of epididymitis began two months prior to a visit in November 2011, and such symptoms had begun only two years prior. As he has made statements that are inconsistent with what he now asserts, such statements of continuous symptoms are unreliable. While the Veteran has stated that he was seen by other doctors in 1994, the records relating to such service could not be obtained. As such, a continuity of symptoms has also not been shown based on the Veteran’s statements. Next, the medical evidence also does not indicate that there is an etiological relationship between his current symptoms and his active duty service. Specifically, in a March 2015 VA examination, the claims file was reviewed and the Veteran was examined in person. The examiner gave the Veteran a diagnosis of a testicular disorder, characterized as epididymitis, but determined that it was less likely than not caused by an in-service injury or illness. The examiner noted that the STRs included previous episodes of prostatitis but that no other male reproductive issue, such as the separate testicular disorder of epididymitis, was evidenced, treated, or diagnosed in the STRs. Therefore, the findings of the VA examiner strongly support the Board’s finding that there is no evidence that the Veteran’s epididymitis was incurred in or aggravated by service. The Board finds that this opinion is of significant probative value. While the Veteran has submitted evidence in support of his claim, not of it rebuts the conclusions of the VA examiner. For example, the Board finds that the records from the Veteran’s private physician are of very little probative value regarding the issue of service connection. The physician does not provide an opinion regarding the etiology of the Veteran’s epididymitis or the potential nexus relationship between the Veteran’s epididymitis and the Veteran’s service. Moreover, there is no clinical evidence regarding scrotal pain until November 2011, which alone is not a bar to service connection. Nonetheless, apart from the Veteran’s testimony, which lacks credibility due to inconsistencies in the record, there is no other evidence to corroborate symptoms of or a diagnosis of epididymitis that is related to service. The Veteran also submitted a November 2012 letter from a friend, who is a retired registered nurse. The friend stated that she had known the Veteran for approximately seven years and that shortly into their friendship she observed that the Veteran felt poorly after performing certain physical activities, such as yardwork. While the Veteran’s friend, as a registered nurse, is competent to testify regarding her medical observations of his symptoms, how his disability impacted his life, and the treatment provided, the friend does not offer any opinions regarding a current diagnosis, the etiology of his current disability, or the nexus relationship of the claimed in-service injury and his present disability. Therefore, the observations of the Veteran’s friend are not probative in supporting the Veteran’s claim that this his current disability, epididymitis, was incurred in or aggravated by service. The friend’s observations merely support his current diagnosis, for which there is no evidence of service-connection. The Board notes the Veteran’s contention in April 2015 that the VA examiner did not conduct a thorough exam. However, the Board finds that the examination and corresponding opinion are adequate for the purposes of the service connection claim adjudicated herein, as they involved a thorough review of the Veteran’s pertinent medical history, as well as an in-person clinical evaluation of the Veteran, and provided an etiological opinion with supporting rationale. See generally Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As such, the Board finds that the VA examination is sufficient and any deficiency is not prejudicial to the Veteran. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015), cert. denied, 137 S. Ct. 33, 196 L. Ed. 2d 25 (2016); see also Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying the exhaustion doctrine to uphold the Court’s determination not to consider a duty to assist argument that the veteran had not raised before the Board). The Board does acknowledge the Veteran’s contentions that his testicular disorder, characterized as epididymitis, was caused by service. While lay evidence may be competent on a variety of matters concerning the nature and cause of disability, etiology of dysfunctions and disorders is a medical determination and generally must be established by medical findings and opinion. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed.Cir.2010) (recognizing that in some cases lay testimony “falls short” in proving an issue that requires expert medical knowledge). In the present case, the Veteran is a lay person without appropriate medical training and expertise, and thus, is not competent to make an etiological conclusion regarding the cause of his testicular disorder, characterized as epididymitis, especially in light of the VA examiner’s conclusions to the contrary.   Thus, while the Veteran may have a diagnosed testicular disorder, characterized as epididymitis, the record contains no evidence of the second and third Shedden elements, that this disability was incurred in or aggravated by service. While the Veteran believes his epididymitis is related to an in-service injury, the Board reiterates that the preponderance of the evidence weighs against the finding of a nexus relationship between the current disability and the claimed in-service injury. Therefore, service connection for the testicular disorder, characterized as epididymitis, is denied. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Page-Nelson, Associate Counsel