Citation Nr: 20050107 Decision Date: 07/28/20 Archive Date: 07/28/20 DOCKET NO. 19-15 371 DATE: July 28, 2020 ORDER A 40 percent rating for prostate cancer residuals is granted. REMANDED A rating in excess of 40 percent for prostate cancer residuals is remanded. FINDING OF FACT The Veteran’s prostate cancer residuals result in voiding dysfunction requiring wearing of absorbent materials which must be changes 2 to 4 times a day. CONCLUSION OF LAW The criteria for a 40 percent rating for prostate cancer residuals have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.105, 3.344, 4.115a, 4.115b, Diagnostic Code (DC) 7528. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Army from August 1966 to May 1968. The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge in July 2020. A 40 percent rating for prostate cancer residuals The Veteran seeks a higher rating for his residuals of prostate cancer. His prostate cancer residuals have been rated under 38 C.F.R. § 4.115b, DC 7528, at 100 percent from August 8, 2013, and 10 percent from August 1, 2016. DC 7528, which pertains to malignant neoplasms of the genitourinary system, provides: following the cessation of surgery, chemotherapy, or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months and any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. § 3.105(e). The rating criteria also provide that if there has been no local reoccurrence or metastasis, then a Veteran’s cancer is rated based on residuals as voiding dysfunction or renal dysfunction, whichever is the predominant disability. 38 C.F.R. § 4.115b, DC 7528. The criteria for rating voiding dysfunction requires the condition to be rated as urine leakage, frequency, or obstructed voiding. With regard to urine leakage, the regulation provides that requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day warrants a rating of 60 percent; requiring the wearing of absorbent materials which must be changed 2 to 4 times per day warrants a rating of 40 percent; and requiring the wearing of absorbent materials that must be changed less than 2 times per day warrants a 20 percent rating. See 38 C.F.R. § 4.115b. Here, the evidence, including the Veteran’s sworn testimony, reflects that he changes his garments twice a day. The Board finds that the evidence supports a 40 percent rating for voiding dysfunction on the basis of urinary incontinence. In his July 2016 Notice of Disagreement, the Veteran reported that he awakened more than two times per night due to voiding and experienced a higher frequency of daytime voiding. Medical treatment records from 2017 noted reduced urinary stream, urgency and nocturia. During the July 2020 Board hearing, the Veteran provided competent, credible testimony that he found it hard to urinate at all due to his prostate cancer residuals and felt the need to urinate 8-9 times per day. He wakes up three times throughout the night due to voiding, and changes garments twice per day due to voiding dysfunction. The Veteran’s remarks were indicative of the fact that his urinary incontinence has required wearing of absorbent materials that must be changed at least two times daily. After resolving any doubt in the Veteran’s favor, the Board finds that a 40 percent rating is warranted as the Veteran’s voiding dysfunction requires wearing of absorbent materials that must be changed two to four times daily. REASONS FOR REMAND A rating in excess of 40 percent for prostate cancer residuals The Veteran failed to report to the VA examination scheduled in March 2019. At the July 2020 Board hearing, the Veteran testified he was willing to report for a new VA examination. Accordingly, the Board finds that the examination reports of record are insufficient to adjudicate the claim. On remand, the Veteran should be provided another VA examination to determine the current nature and severity of his prostate cancer. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records pertaining to the Veteran’s prostate cancer and associate them with the record. 2. Schedule the Veteran for an examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate clinician to determine the current nature and severity of all manifestations associated with his service-connected prostate cancer. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Zarar Ahmed, Attorney Advisor 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.