Citation Nr: 19149591 Decision Date: 06/25/19 Archive Date: 06/25/19 DOCKET NO. 18-32 867 DATE: June 25, 2019 ORDER Entitlement to service connection for a prostate condition is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s benign prostate hyperplasia began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a prostate condition are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1994 to April 2000. Entitlement to service connection for a prostate condition The Veteran contends that he developed a prostate condition during active duty service. As will be discussed in more detail below, the Board concludes that the probative evidence of record weighs against a finding that the Veteran’s diagnosed benign prostate hyperplasia (BPH) was incurred during service or developed as a result of active duty service. The Board therefore denies the claim for service connection. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110. In addition, certain chronic diseases may be presumed to have been incurred during service if the disorder becomes manifest to a compensable degree within one year of separation from active duty. 38 C.F.R. §§ 3.307, 3.309. Service connection may also be granted for any disease diagnosed after discharge, when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Here, the service treatment records do not contain any evidence of treatment, diagnosis or findings consistent with a chronic prostate condition, to include BPH. The condition was not shown in service or within one year following discharge from service. The Veteran reports that he received treatment during active duty for complaints of frequent and painful urination. He recalled being told by medical providers that his prostate was enlarged. Service treatment records show that in June 1996, the Veteran requested refills for medication to treat symptoms of painful urination, which he stated began one week ago. He was assessed with urethritis. In July 1996, he presented for a follow-up appointment for complaints of dysuria and pain in his penis. Post-service medical records include a December 2012 private treatment record which noted the Veteran’s prostate was normal upon examination. VA treatment records show he was taking medication for urinary urgency. See, e.g., May 2016 primary care note. Both VA and private treatment records show the Veteran has been diagnosed with BPH. In May 2018, a VA examiner reviewed the claims folder and concluded that it was less likely than not that the Veteran’s BPH was incurred in or caused by the claimed in-service injury, event or illness. In support of this conclusion, the examiner acknowledged that service treatment records documented painful urination with a diagnosis of urethritis and subsequent records noting the possibility he was diagnosed with prostatitis. The examiner stated that commonly accepted risk factors for BPH include age, diabetes, obesity and a diet high in saturated fat. However, there were no well-established studies linking prostatitis or urethritis with the subsequent development of prostatism or BPH. The Board finds that the May 2018 VA examiner’s opinion is afforded significant probative weight. The conclusion was supported by a well-reasoned rationale that considered both the medical evidence of record and the Veteran’s statements. Monzingo v. Shinseki, 26 Vet. App. 97, 105 (2012). Notably, there is no contradictory medical opinion in the claims file. The Board acknowledges the Veteran’s belief that his BPH is related to his active duty service. He is competent to provide testimony concerning factual matters of which he has first-hand knowledge (i.e., experiencing symptoms either in service or after service). See, e.g., Barr v. Nicholson, 21 Vet. App. 303 (2007). However, as a layperson without the appropriate medical training and expertise, the Veteran is simply not competent to provide the etiology opinion under the facts of this case. The onset and etiology of BPH are complex questions, and the Veteran has not been shown to possess the medical training and expertise required to provide such an opinion. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). (Continued on the next page)   As the preponderance of the evidence weighs against the Veteran’s claim, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C.A §5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.