Citation Nr: 18148918 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 18-26 816 DATE: November 8, 2018 ORDER Entitlement to service connection for a right testicle disability is denied. Entitlement to service connection for a bladder disability is denied. Entitlement to service connection for balanitis is denied. REMANDED Entitlement to service connection for prostatitis with voiding dysfunction is remanded. FINDINGS OF FACT 1. The Veteran does not have a right testicle disability that is due to disease or injury in service. 2. The Veteran does not have a bladder disability that is due to disease or injury in service. 3. While the Veteran was diagnosed with balanitis in service, the disability was resolved and he does not have a current diagnosis of balanitis or residuals of balanitis. CONCLUSIONS OF LAW 1. The criteria for service connection for a right testicle disability have not been met. 38 U.S.C. § 1101, 1110, 1112, 1116, 5103A, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303 (2018). 2. The criteria for service connection for a bladder disability have not been met. 38 U.S.C. § 1101, 1110, 1112, 1116, 5103A, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303 (2018). 3. The criteria for service connection for balanitis have not been met. 38 U.S.C. § 1101, 1110, 1112, 1116, 5103A, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty with the United States Marine Corps from October 1990 to October 2017. This appeal comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2018 rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina which, inter alia, denied service connection for a bilateral testicle condition, bladder condition, balanitis, prostatitis, and voiding dysfunction. The Veteran filed a timely notice of disagreement and substantive appeal, via a VA Form 9. In the January 2018 rating decision, the RO granted service connection for a left groin injury with left testicle pain; thus, bifurcating the claim for entitlement to service connection for a bilateral testicle condition. The claim for entitlement to service connection for a right testicle disability remains on appeal and is addressed in the decision below. The Board recognizes that the issue on appeal for service connection for prostatitis with voiding dysfunction was characterized by the RO as two separate issues—entitlement to service connection for prostatitis and entitlement to service connection for voiding dysfunction. However, VA treatment records indicate that voiding dysfunction can be a symptom of prostatitis. Therefore, the Board has recharacterized the issue to ensure complete consideration of the claim. See Clemons v. Shinseki, 23 Vet. App. 1, 4-6, 8 (2009). Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from a disease or injury incurred in active military service. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for a right testicle disability The Veteran contends that service connection for a right testicle disability is warranted. Service treatment records (STRs) reflect that the Veteran first complained of testicular pain in November 2012. A March 2013 treatment note reflects that the testes were examined and were abnormal with epidydimal tenderness of the left testicle. The right testicle was noted to sit higher than the left testicle and was not tender. An April 2013 treatment note reflects that the testicular pain was resolved with antibiotics. In December 2016, the Veteran continued to complain of testicular pain. In February 2017, he reported that the pain sometimes radiates to the left testicle. The examiner noted that testicular symptoms were present in the left testicle. The April 2017 separation report of examination noted an abnormal clinical evaluation of the Veteran’s external genitalia and the Veteran, again, reported testicular pain. A June 2017 VA examination report reflects that the examiner found that there was no diagnosis for the right testicle because there was no pathology to render a diagnosis. During the examination, the Veteran reported that that when the condition began in 2012, he had pain in his left side and left testicle. He reported that he went to the doctor and they told him he had a hernia. He stated that they did a surgical repair on it then one year later, it returned and they did a second repair. He reported that in the second surgery, the doctor did a nerve abatement and he felt like it was not done correctly. He reported current pain on the left side of his testicle. No other medical treatment records were submitted showing a current diagnosis or treatment for a right testicular disability. Upon review of the evidence of record, the Board finds that service connection for a right testicle disability is not warranted. The weight of the above evidence reflects that the Veteran has not had a right testicle disability during the pendency of the claim. Moreover, the Veteran only reported left testicular pain and left hernia repairs on his discharge examination which was conducted only a couple of months prior to the June 2017 VA examination. As the evidence does not establish the existence of a right testicle disability following service, entitlement to service connection is not warranted. Palczewski v. Nicholson, 21 Vet. App. 174, 181 (2007) (“Without a current disability, of course, there can be no service connection and, thus, no disability compensation”). In reaching the above guidance, the Board has considered the Veteran’s claim broadly, to encompass any testicular disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009) (a claim should not be limited to the disorder as characterized by the Veteran, but must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim). As noted above, a left hernia disability was identified and diagnosed during service and the Veteran’s current service-connected left testicular pain has been attributed to that condition. For the foregoing reasons, the preponderance of the evidence is against the claim for service connection for a right testicle disability. The benefit of the doubt doctrine is not for application, and entitlement to service connection for a bladder disability is not warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for a bladder condition The Veteran contends that service connection for a bladder condition is warranted. STRS do not reveal complaint of, treatment, or a diagnosis of a bladder disability. A radiology report from December 2007 revealed an unremarkable bladder. An October 2015 computed tomography (CT) scan revealed that the urinary bladder was incompletely distended, however, unremarkable in appearance. A June 2017 VA examination report reflects that the Veteran has never been diagnosed with a condition of the bladder or urethra of the urinary tract. The Veteran reported that in 2012 to 2013 he was in New Orleans, Louisiana and had urinary issues and saw a neurologist where he received a prostate examination. He reported that he continued to have urinary issues and had leaking, dripping, and decreased flow. The examiner concluded that for the Veteran’s claimed condition of bladder (mass), there was no diagnosis because there was no pathology to render a diagnosis. No other medical treatment records were submitted showing a diagnosis or treatment for a bladder disability. Upon review of the evidence of record, the Board finds that service connection for a bladder disability is not warranted. The weight of the above evidence reflects that the Veteran has not had a bladder disability during the pendency of the claim. While a “disability” for the purposes of awarding VA disability benefits is not only a disease or an injury, but also any “other physical or mental defect.” 38 U.S.C. § 1701 (1); Allen v. Brown, 7 Vet. App. 439, 444-45 (1995) (applying definition of disability in section 1701(1) to statutes describing “eligibility for disability compensation for service connected disabilities”), here the evidence does not reflect any complaint or notation of physical defect of the Veteran’s bladder. To the contrary, imaging reports in service reflect that although the urinary bladder was incompletely distended it was unremarkable in appearance and no diagnosis was ever noted. As the Veteran has not had a bladder disability, entitlement to service connection is not warranted. Palczewski v. Nicholson, 21 Vet. App. 174, 181 (2007) (“Without a current disability, of course, there can be no service connection and, thus, no disability compensation”). In reaching the above guidance, the Board has considered the Veteran’s claim broadly, to encompass any bladder disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009) (a claim should not be limited to the disorder as characterized by the Veteran, but must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim). The Court also held in Clemons, however, that “[i]t is generally the province of medical professionals to diagnose or label a mental condition, not the claimant.” Id. at 6. Thus, while the Veteran is competent to describe the symptoms he experiences, and the Board has considered these statements, he is not competent to opine as to whether those symptoms are due to a bladder disability. The Veteran’s statements in this regard are therefore not competent. For the foregoing reasons, the preponderance of the evidence is against the claim for service connection for a bladder disability. The benefit of the doubt doctrine is not for application, and entitlement to service connection for a bladder disability is not warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. 3. Entitlement to service connection for balanitis STRs first document a diagnosis of balanitis in 2012. In April 2012, the Veteran was treated with Lotrisone cream and he was directed to take it for 10 days. A diagnosis of balanitis was continually reported from 2013 to 2016. The April 2017 separation report of examination noted an abnormal clinical evaluation of the Veteran’s external genitalia; however, the Veteran did not complain of balanitis at separation and the examiner did not note a diagnosis of balanitis at the time of separation. A June 2017 VA examination report reflects that there is no diagnosis of balanitis because there was no pathology to render a diagnosis. During the examination, the Veteran did not report any complaints of balanitis. No other medical treatment records were submitted showing a diagnosis or treatment for a balanitis. Upon review of the evidence of record, the Board finds that service connection for balanitis is not warranted. The weight of the above evidence reflects that the Veteran has not had a current diagnosis of balanitis during the pendency of the claim. While a “disability” for the purposes of awarding VA disability benefits is not only a disease or an injury, but also any “other physical or mental defect.” 38 U.S.C. § 1701 (1); Allen v. Brown, 7 Vet. App. 439, 444-45 (1995) (applying definition of disability in section 1701(1) to statutes describing “eligibility for disability compensation for service connected disabilities”), here the evidence does not reflect any complaint or notation of balanitis. Balanitis was last noted in December 2016. During the April 2017 separation medical examination, the Veteran did not list balanitis as a complaint and the examiner did not note it as a current diagnosis. Moreover, the Veteran specifically denied having a skin disease on his separation examination’s report of medical history. Following the April 2017 separation examination, the Veteran underwent an additional VA examination in June 2017 where the examiner found no pathology of balanitis. Additionally, the Veteran did not report or complain of balanitis during this examination. As the Veteran does not have a current diagnosis of balanitis, entitlement to service connection is not warranted. Palczewski v. Nicholson, 21 Vet. App. 174, 181 (2007) (“Without a current disability, of course, there can be no service connection and, thus, no disability compensation”). For the foregoing reasons, the preponderance of the evidence is against the claim for service connection for balanitis. The benefit of the doubt doctrine is not for application, and entitlement to service connection for balanitis is not warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for prostatitis with voiding dysfunction is remanded. The Board finds that further action on the remaining claim on appeal is warranted. The Veteran contends that he has a diagnosis of prostatitis with voiding dysfunction. STRs reflect a diagnosis of prostatitis, and the Veteran reported frequent and/or painful urination on his April 2017 Report of Medical History. The separation examination also suggests that the Veteran was prescribed Flomax, but that it did not work. At a June 2017 VA examination, the Veteran reported that he also had problems with urination including leaking, dripping, and decreased flow. The examiner noted a diagnosis of status post prostatitis. The examiner reported that the Veteran did not have a history of chronic prostatitis, but noted that the Veteran’s prostate was not examined. The examiner indicated that the Veteran’s prostate was not examined per his request, but it is not clear how the examiner found no diagnosis if the Veteran’s prostate was not examined, given that such was reported on the Veteran’s discharge examination which was conducted only two months prior. It is therefore unclear whether the Veteran has a current diagnosis of prostatitis and/or a voiding dysfunction. In his May 2018 substantive appeal, the Veteran reported that he did not remember refusing an examination of his prostate and would like an examination. Thus, an examination of the prostate is warranted to determine whether he has a current diagnosis of prostatitis and/or voiding dysfunction, and if so, whether it is related to his active military service. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any prostate disability and/or voiding dysfunction including, but not limited to frequent and/or painful urination. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including his in-service diagnosis and treatment for prostatitis. A complete rationale should accompany any opinion provided L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Laroche, Natalie