Citation Nr: 18149603 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 17-00 041A DATE: November 9, 2018 REMANDED Entitlement to service connection for a left testicular disability, to include left testicular cancer, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from December 1970 to November 1972. He also served in the Army National Guard of North Carolina from February 1976 to June 1987. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for a left testicular disability. The Veteran seeks to establish service connection for a left testicular disability, to include testicular cancer. He says that he sustained an injury to his groin when he fell off a tank in 1972, while serving in Germany; that a doctor told him that he would probably have later issues associated with the injury; and that he continued to have complications with swelling of his left testicle after service. The Veteran’s service treatment records support his assertion that he was involved in a tank incident in February 1972. According to the records, he suffered blunt trauma to his left lateral thigh and lumbosacral spine when a tank he was in got out of control. On examination, there was evidence of tenderness in the muscles of his left lateral thigh and lumbosacral spine. The clinical impression was probable contusions. There was no documented complaint of or treatment for symptoms specific to the Veteran’s groin area or testicles, however. X-rays of the lumbosacral spine and left femur were unremarkable for fractures. In August 1972, a service department physician noted that the Veteran had a problem with hygiene and recommended a circumcision. Warts were observed on the Veteran’s lower abdomen and testicles in May 1979. Post-service medical records reveal that the Veteran had a left orchiectomy in 2004. The record does not contain a diagnosis of testicular cancer, however. In light of the Veteran’s report that he injured his left testicle in the tank accident during service, his assertions that he has continued to have complications since that time, and evidence of a post-service left orchiectomy, the Board finds that he should be afforded a VA examination for purposes of obtaining an opinion as to the nature and etiology of his condition. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The Veteran has posited, in the alternative, that he may have developed left testicular cancer due to exposure to contaminated water at Camp Lejeune, North Carolina. Although testicular cancer is not a disease presumptively associated with exposure to contaminated water at Camp Lejeune under 38 C.F.R. § 3.309(f), the governing regulations do not preclude the Veteran from establishing service connection with proof of actual causation. Combee v. Brown, 34 F.3d 1039 (1994). Given that the Veteran’s dates of service at Camp Lejeune have not been verified, the Board finds that further development of that matter should be undertaken as well. This matter is REMANDED for the following action: 1. Conduct appropriate development to ascertain the Veteran’s dates of service at Camp LeJeune. 2. Identify and obtain any outstanding, pertinent VA and/or private treatment records and associate them with the claims file. 3. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any left testicular disability. The claims file must be made available to, and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran has a left testicular disability that had its onset in, or is otherwise attributable to, service, to include an in-service groin injury and/or exposure to contaminated water while stationed at Camp Lejeune. A complete rationale for all opinions expressed must be provided. If the examiner cannot provide an opinion without resort to speculation, he or she must provide an explanation as why that is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of the need for additional information, or whether he or she has exhausted the limits of current medical knowledge in providing an answer to a particular question. 4. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Ware, Associate Counsel