Citation Nr: 20034572 Decision Date: 05/18/20 Archive Date: 05/18/20 DOCKET NO. 16-27 890 DATE: May 18, 2020 REMANDED Entitlement to service connection for residuals of a urethra tumor to include as due to undiagnosed illness is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1988 to March 1989, May 1990 to May 1993, and August 1997 to June 1999. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Veteran submitted a motion to the Board to advance his case on the docket under 38 C.F.R. § 20.900(c) based on financial hardship. Under 38 C.F.R. § 20.900(c), a case may be advanced on the Board’s docket for several reasons, to include as due to serious financial hardship. With respect to financial hardship, the Board does not ordinarily advance a case on the docket unless such hardship is grave in nature at the time the motion is granted, such as if the Veteran is homeless or in the process of foreclosure or eviction proceedings. In the instant case, the Appellant has not shown that his current financial problems are serious enough to warrant that his case be advanced on the docket. Accordingly, the motion to advance the case on the docket is denied. When this case was most recently before the Board in October 2018, the above-noted issue was remanded for additional development. The RO issued a March 2020 supplemental statement of the case which continued the denial for the Veteran’s claimed burns. The case has now been returned to the Board for further appellate review. When VA undertakes to provide an examination or opinion, it must be an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007); see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). Further, a remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). While there is a June 2019 VA examination with a March 2020 addendum in the record for the Veteran’s claimed urethral tumor disabilities, the Board finds them to be inadequate. The Board acknowledges that the June 2019 examiner stated that the Veteran’s claimed disability was at least as likely as not related to his active duty service. However, in the body of the medical opinion the examiner appears to incorrectly be under the impression that the Veteran had a continual period of service from 1988 to 1999; and seems to address the Veteran’s 1995 diagnosis and removal of his urethral tumor as occurring during a period of active service. Additionally, in explaining the rationale behind her opinion the examiner indicates that the Veteran’s diagnoses of weak urinary stream and spraying/spitting of urination could possibly be related to the surgical procedure that removed the urethral tumor, but did not opine whether the Veteran’s tumor, or residuals thereof, were caused or aggravated by his active duty service, to include as due to an undiagnosed illness or the claimed parasite/sand fly bites. In fact, the examiner opined that she cannot verify if the Veteran’s condition was caused by parasites or sandflies. The RO sought a March 2020 addendum to the June 2019 opinion. In this addendum, the examiner records the Veteran’s proper service years, and indicates that his diagnosis and treatment occurred during the “gap between [the Veteran’s] service years.” The examiner indicated there is no service treatment record for the onset of the Veteran’s condition in service and notes a December 2018 urology note which mentions a negative rationale for the relation to sand flies or parasites. However, the examiner here does not offer an etiology opinion at all; not discussing whether the Veteran’s condition is etiologically related to, or aggravated by, his active duty service. The examiner merely indicates that the Veteran’s tumor had an etiology that was not otherwise specified. As such, the VA examiners did not adequately assess whether the Veteran’s claimed disability was related to his active duty service, to include as due to the Veteran’s reports of exposure to parasites and sand fly bites, and the Board finds an additional examination is required to determine the etiology of the Veteran’s disabilities. The matters are REMANDED for the following action: Afford the Veteran a VA examination by an examiner, who has not previously examined the Veteran, with sufficient expertise to address the etiology of the Veteran’s claimed residuals of urethral tumor. All pertinent evidence of record must be made available to and reviewed by the examiner, including a copy of this Remand. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether any diagnosed urethral tumor disability, or residuals thereof, are at least as likely as not (a 50 percent probability or greater) etiologically related to, or aggravated by, his periods of active service, to include as due to the Veteran’s credible report of exposure to parasites and sand flies during service in Southwest Asia. The examiner must provide a complete rationale for all proffered opinions. In this regard, the examiner must discuss and consider the Veteran’s competent lay statements. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete answer as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Gresham 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.