Citation Nr: 20004494 Decision Date: 01/23/20 Archive Date: 01/21/20 DOCKET NO. 14-10 480 DATE: January 23, 2020 REMANDED Entitlement to service connection for a testicular disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from February 1969 to January 1973, including service in Thailand. The Board sincerely thanks the Veteran for his service to our country. This matter comes before the Board of Veterans’ Appeals (Board) from March 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. Historically, the Veteran’s claim for service connection for testicular torsion was denied in an unappealed May 1973 RO rating decision because the Veteran’s separation examination revealed no residuals/complaints of the testicle(s). This claim was previously before the Board in February 2017, when the Veteran testified before the undersigned Veterans Law Judge in a videoconference hearing. A transcript of the hearing is associated with the record. In January 2018, the Board reopened the issue of entitlement to a testicular disability and remanded the claim for RO consideration.   1. Entitlement to service connection for a testicular disability is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a testicular disability because no VA examiner has opined as to whether the Veteran’s asserted in-service injury could cause a testicular disability or whether the Veteran’s resulting symptoms, in service and during the instant appeal, were at least as likely as not the residuals of testicular torsion. Where there is competent evidence of a current disability or persistent or recurrent symptoms of a disability, evidence establishing that an event, injury, or disease occurred in service, and an indication that the disability or persistent symptoms of a disability may be associated with service or another service-connected disability, but there is insufficient competent medical evidence to make a decision on the claim, the Veteran must be afforded a VA examination. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). In this case, the Veteran contends that he underwent an operation for testicular torsion around April 1969 at Lackland Air Force Base. See May 2012 VA Form 21-526, March 2014 Correspondence. The Service Treatment Records (STRs) are negative for testicular torsion complaints, surgery for such, or hospitalization for such. However, the Board notes that in the past, in-patient records may have been stored independently from, and not filed with, individual STRs (but instead filed by year and place of treatment). The RO attempted to obtain records for in-patient services at Lackland Air Force Base for the Veteran for March and April 1969. A search of Lackland Air Force Base hospital records for 1969 was conducted, but no records were located. However, the Board finds probative that on the Veteran’s December 1972 Report of Medical History, he checked “yes” in response to the question “[h]ave you had, or have you been advised to have, any operation?” Next to the question, he explained that he had his tonsils and adenoids removed at age 6, and that he had a testicular torsion operation performed at Lackland Air Force Base when he was 22. The Veteran has asserted that after his testicular torsion surgery, he continued to experience pain throughout his military service, and that he still experiences testicular pain today. The Veteran’s lay statements are bolstered by two statements submitted by his current and former spouses, respectively, which state that the Veteran experiences pain during sex and testicular sensitivity. His ex-wife stated that prior to the operation he had during Basic Training, she and the Veteran had a healthy sexual relationship. She further stated that they were unable to regain their physical relationship after the operation due to the extreme pain the Veteran experiences during intercourse. Based on the above, there is sufficient information of record to show recurrent symptoms, an event in service, and a potential nexus between the two. However, the Board cannot make a determination absent evaluation of the Veteran’s contentions by a medical professional. Thus, a remand is necessary to obtain a new examination. The matters are REMANDED for the following action: 1. Please associate updated VA and non-VA medical treatment records with the record on appeal. 2. After the record has been determined to be complete, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of the Veteran’s claimed testicular disability. Based upon a review of the entirety of the claims file, the history presented by the Veteran, and the examination results, the clinician is requested to provide an opinion which addresses the following: (a.) Please identify, by diagnosis or by functional impairment, the Veteran’s current testicular disability; and (b.) Is it at least as likely as not (i.e., at least a 50 percent probability) that the Veteran’s testicular disability began in or is otherwise etiologically related to the Veteran’s military service, including testicular torsion surgery in service? The examiner should accept for purposes of the opinion that the Veteran underwent a procedure to treat testicular torsion while in service. The clinician should consider and discuss as necessary the Veteran’s statements that he underwent a testicular torsion operation, was hospitalized for one week thereafter, was provided pain medication for the following six months, and has continued to experience testicular pain since that time. Any opinion expressed by the VA examiner should be accompanied by a complete rationale. If the VA examiner is unable to offer an opinion without resorting to speculation, an explanation should be provided as to why an opinion cannot be rendered. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board O. Halpern 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.