Citation Nr: 18154035
Decision Date: 11/29/18	Archive Date: 11/28/18

DOCKET NO. 16-37 067
DATE:	November 29, 2018
REMANDED
The claim for entitlement to a higher rating for residuals of prostate cancer rated as 100 percent disabling prior to September 1, 2015, and 20 percent thereafter, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 1968 to September 1969.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in White River Junction, Vermont (Agency of Original Jurisdiction (AOJ)).
The Veteran seeks a higher disability rating for his prostate cancer residuals. Historically, the Veteran had been rated as 100 percent disabled beginning on March 28, 2013.  An August 2014 examination showed that the Veteran had ended external radiotherapy for prostate cancer over six months prior to the August 2014 VA examination, and he exhibited no local reoccurrence or metastasis at time of his VA examination.  After receiving proper due process notice, his 100 percent rating was reduced, as mandated by Diagnostic Code 7528, to a 20 percent rating based upon urinary symptoms.
In recent statements submitted to VA, the Veteran reported a worsening of his symptoms of prostate cancer residuals, including urinary frequency and erectile dysfunction.  Notably, he has been awarded special monthly compensation for erectile dysfunction. 
To ensure that the record reflects the current severity of his disabilities, a contemporaneous examination is warranted.  See Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide the Veteran with a thorough and contemporaneous medical examination) and Caffrey v. Brown, 6 Vet. App. 377, 381 (1994) (an examination too remote for rating purposes cannot be considered “contemporaneous”).  In light of the Veteran’s statements, his current complaints, and treatment records, the Board finds that a more recent VA examination is warranted.
The matter is REMANDED for the following action:
1. Associate with the claims folder any outstanding VA treatment records that pertain to the Veteran’s prostate cancer residuals, and obtain all relevant private treatment records including complete records from UMass Memorial Medical Center/Dr. Jesse Aronowitz.
2. Schedule the Veteran for a VA genitourinary examination to determine the current severity of his service connected prostate cancer residuals.  Access to the electronic claims file must be made available to the examiner. 
In accordance with the latest worksheets for rating genitourinary disabilities, the examiner is to provide a detailed review of the Veteran’s pertinent medical history, current complaints and the nature and extent of his disabilities. 
The VA examiner should specifically describe the severity of any associated voiding dysfunction, urinary frequency, obstructed voiding, and any renal dysfunction associated with the Veteran’s prostate cancer residuals. 
The examiner should also evaluate and discuss the severity of all complications of the Veteran’s service-connected erectile dysfunction, including whether there is any internal or external deformity.
A complete, well-reasoned rationale must be provided for all opinions offered.  The examiner must reconcile any opinion with the Veteran’s lay statements.
3. Thereafter, the AOJ should consider all of the evidence of record and readjudicate the increased ratings claim on appeal.  If the benefits sought are not granted, issue a Supplemental Statement of the Case (SSOC) and allow the Veteran and his representative an opportunity to respond.
 
T. MAINELLI
Veterans Law Judge
Board of Veterans’ Appeals

ATTORNEY FOR THE BOARD	N. Rasool