Citation Nr: 20021795 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 16-44 892 DATE: March 27, 2020 REMANDED Entitlement to service connection for a sprained right foot is remanded. Entitlement to service connection for a urinary disorder, to include urethritis is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1963 to August 1965. This matter originally came to the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). These issues were denied by the Board in a December 2018 Board decision. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court), which partially vacated the decision pursuant to an August 2019 Joint Motion for Partial Remand. The case returned to the Board for further appellate review. After reviewing the evidence of record, and in light of Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009), the Board has recharacterized the issue of service connection for ureterolithiasis to encompass any urinary disorder, to include urethritis. 1. Entitlement to service connection for a sprained right foot is remanded. The Veteran claimed a right foot disability that he believes is related to service. Service treatment records do not show any complaints of or treatment for a sprained right foot. A June 2014 VA podiatry assessment found the Veteran has limitation of dorsiflexion in his ankles that could constitute evidence of a current disability. Additionally, the Board remains mindful that VA must also consider whether the Veteran has functional impairment with regard to his right foot for which service connection may be granted. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). 2. Entitlement to service connection for urethritis is remanded. The Veteran claimed a urinary disorder that is related to service. Service treatment records show the Veteran was diagnosed with urethritis due to gonococcus in November 1964. Although, post service record shows urinary dysfunction and assessments of urinary frequency, incontinence, nocturia, and incomplete bladder emptying, it is unclear whether the Veteran has a current diagnosis of a urinary disorder. An April 2019 VA examination for male reproductive organ conditions shows the Veteran has a voiding dysfunction. The examiner also stated the etiology of the Veteran's voiding dysfunction was diabetes mellitus type II. The examiner did not provide any opinion. A February 2020 medical opinion from Dr. M.B.S., states that “urethritis is a common sequela of gonorrhea. Gonorrhea causes inflammation of the urethra which results in urethritis. The Veteran contracted gonorrhea in service, which causes irritation, pain and swelling which is the definition of urethritis.” On remand, the examiner should opine as to whether the Veteran has a current urinary disorder, to include urethritis related to his service. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. After the foregoing development is completed Schedule a VA foot examination to determine the nature and etiology of the Veteran's right foot condition. The examiner must review the complete claims file, including this remand. The examiner must address the following, with full supporting rationales: (a.) Identify the Veteran's currently diagnosed right foot disability. (b.) If the Veteran has no current diagnosis, then opine whether his current right foot symptoms have resulted in functional impairment in earning capacity. (c.) Opine whether it is at least as likely as not that any current right foot diagnosis or disability (i.e., functional impairment in earning capacity) is related to the Veteran active service? (d.) Is it at least as likely as not that any current right foot diagnosis or disability (i.e., functional impairment in earning capacity) is proximately due to his service-connected low back condition, sciatic nerve radiculopathy of the lower extremities, or femoral nerve radiculopathy of the lower extremities disabilities? (e.) Is it at least as likely as not that any current right foot diagnosis or disability (i.e., functional impairment in earning capacity) is aggravated beyond its natural progression by his service-connected his service-connected low back condition, sciatic nerve radiculopathy of the lower extremities, or femoral nerve radiculopathy of the lower extremities? 3. Obtain a VA medical opinion from a qualified examiner on the existence and etiology of any current urinary disorder, or residuals thereof. The claims file must be made available to the examiner. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran's service treatment records, post-service medical records, and assertions. A clear explanation for all opinions based on specific facts for the case as well as relevant medical principles is needed. If an examination is deemed necessary, one must be provided. The Veteran is competent to attest to factual matters of which he had first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should identify any urinary disorder, or residuals thereof, that has been present during the current appeal period. In this regard, the examiner must address the Veteran's contentions regarding his symptoms to examiners and other providers during the appeal period. For any identified bladder or prostate disorder, or residuals thereof, the examiner should opine as to the following questions: (a.) Whether it is at least as likely as not (a 50 percent or greater probability) that the current urinary disorder, or any residuals thereof, is related to any event or injury during military service. A rationale for all opinions expressed should be provided in the examination report. If medical literature is relied upon in rendering any opinion(s), the VA examiner should identify and specifically cite each reference material utilized. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Romero-Sanchez, Associate 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.