Citation Nr: 20052934 Decision Date: 08/10/20 Archive Date: 08/10/20 DOCKET NO. 18-11 029 DATE: August 10, 2020 REMANDED Entitlement to service connection for prostate cancer is remanded. Entitlement to service connection for erectile dysfunction is remanded. Entitlement to service connection for insomnia is remanded. Entitlement to service connection for a depression is remanded. Entitlement to service connection for abdominal pain is remanded. Entitlement to service connection for anxiety is remanded. Entitlement to service connection for peripheral vascular disease of the left upper extremity is remanded. Entitlement to service connection for a thoracic spine disability is remanded. Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a stomach condition is remanded. Entitlement to service connection for peripheral vascular disease of the left lower extremity is remanded. Entitlement to service connection for peripheral vascular disease of the right lower extremity is remanded. Entitlement to service connection for peripheral vascular disease of the right upper extremity is remanded. Entitlement ot service connection for a bladder disability is remanded. Entitlement ot service connection for a rash is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1974 to March 1975 with additional service on active duty for training and inactive duty training in the Army National Guard. This case comes before the Board of Veterans’ Appeals (Board) in appeal from a February 2015 rating decision of a Department of Veteran Affairs (VA) Regional Office (RO). The Veteran testified at a Board videoconference hearing before the undersigned Veterans Law Judge in March 2020. A transcript of the hearing is of record. 1. Entitlement to service connection for prostate cancer is remanded. 2. Entitlement to service connection for erectile dysfunction is remanded. 3. Entitlement to service connection for insomnia is remanded. 4. Entitlement to service connection for depression is remanded. 5. Entitlement to service connection for abdominal pain is remanded. 6. Entitlement to service connection for anxiety is remanded. 7. Entitlement to service connection for peripheral vascular disease of the left upper extremity is remanded. 8. Entitlement to service connection for a thoracic spine disability is remanded. 9. Entitlement to service connection for diabetes mellitus is remanded. 10. Entitlement to service connection for hypertension is remanded. 11. Entitlement to service connection for a stomach condition is remanded. 12. Entitlement to service connection for peripheral vascular disease of the left lower extremity is remanded. 13. Entitlement to service connection for peripheral vascular disease of the right lower extremity is remanded. 14. Entitlement to service connection for peripheral vascular disease of the right upper extremity is remanded. 15. Entitlement ot service connection for a bladder disability is remanded. 16. Entitlement ot service connection for a rash is remanded. The Veteran has not been afforded an examination regarding any of his claimed disabilities. For the reasons stated below, the Board finds a remand is warranted to afford the Veteran an opportunity for an examination. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006) (VA is obliged to provide an examination where there is insufficient information to decide the claim and there is an indication the current disability may be associated with service). Private treatment records reflect diagnoses of hypertension, diabetes mellitus, peripheral vascular disease, prostate cancer, erectile dysfunction, irritable colon/irritable bowel syndrome, gastroesophageal reflux disease, and pancreatitis. They also show the Veteran’s complaints of bladder pain, back pain, depressed mood and findings of minimal degenerative changes to the thoracic spine. The Veteran stated during the March 2020 Board hearing that he receives treatment for the claimed disabilities at the Florence VA Medical Center as well as Hope Health Medical Center. Service treatment record indicate the Veteran was in a motor vehicle accident during service in September 1975 wherein he was noted to have injured his right knee. The diagnosis reported was contusion right knee. Service treatment records are otherwise negative for any complaints, findings, or treatment for the claimed disabilities. However, the Veteran contends he incurred the claimed disabilities as a result of service. Specifically, he reported that his disabilities were caused by tech school, not eating properly and raw food, stress, heavy lifting and marching with his equipment, ingestion, sleeping in swampy areas, untreated sexually transmitted diseases, and weather conditions during his Basic Combat Training (BCT) at Fort Dix and Advanced Individual Training (AIT) in Fort Polk. The Board notes that the Veteran’s September 1975 motor vehicle accident was determined to be in the line of duty and he was performing duty under 32 U.S.C. § 502 at that time. ACDUTRA is defined as full-time duty in the Armed Forces performed by Reserves for training purposes, and includes full-time duty performed by members of the National Guard of any State under 32 U.S.C. sections 316, 502, 503, 504 or 505. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c). Active military, naval, or air service includes any period of ACDUTRA during which the individual concerned was disabled from a disease or injury incurred or aggravated in the line of duty, and any period of inactive duty for training (INACDUTRA) during which the individual concerned was disabled from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101 (21) and (24); 38 C.F.R. § 3.6 (a). Thus, service connection may be granted for a disability resulting from disease or injury incurred or aggravated while performing ACDUTRA or from an injury incurred or aggravated while performing INACDUTRA. 38 U.S.C. §§ 101 (24), 106, 1110, 1131. As noted above, the Veteran reported additional treatment through VA and private providers. Upon remand, the AOJ should ensure that any outstanding VA treatment records and identified private treatment records are sought after obtaining any necessary authorizations and associated with the record. The matters are REMANDED for the following actions: 1. After securing the proper authorizations where necessary, make arrangements to obtain all outstanding the records of treatment or examination from Hope Health Medical Center. All information obtained must be made part of the file. If private records are identified, but not obtained, the AOJ must notify the Veteran of (1) the identity of the records sought, (2) the steps taken to obtain them, (3) that the claim will be adjudicated based on the evidence available, and (4) that if the records are later obtained, the claim may be readjudicated. 2. Obtain any outstanding VA treatment records and associate them with the claims file, to include from Florence VA Medical Center. 3. Then, schedule the Veteran for appropriate examination(s) to determine the nature and etiology of his claimed bladder, abdominal, stomach, rash, back, peripheral vascular disorders as well as rash. The entire record must be made available to and reviewed by the clinician. After the record review and examination of the Veteran, the examiner is asked to respond to the following: (a.) Diagnose any bladder, abdominal, stomach, rash, back, and/or peripheral vascular disorders found to be present at any point during the appeal period. (b.) For each bladder, abdominal, stomach, rash, back, and/or peripheral vascular disorder diagnosed, is it at least as likely as not (50 percent or greater probability) that the disability was incurred in or otherwise related to the Veteran’s active service, or caused by the onset of the disease or an injury during any verified active duty or inactive duty for training service, to include the September 1975 automobile accident, stress, heavy lifting and marching with his equipment, sleeping in swampy areas, untreated sexually transmitted diseases, and weather conditions? With regard to any diagnosed arthritis, is it as least as likely as not that such began within one year after discharge from active service? In rendering this opinion, the clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. The examiner should consider and discuss the Veteran’s contentions included in the March 2020 Board hearing and the lay statements of record, his service treatment records, and his VA and any private medical records. If the clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The clinician is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The examiner is also asked to consider the Veteran’s service records noting right knee pain and contusion following the motor vehicle accident in September 1975. A complete rationale for all opinions should be set forth. 4. Schedule a VA examination(s) to address the nature and etiology of the Veteran’s claimed depression, anxiety, and insomnia. The entire record must be made available to and reviewed by the clinician. All indicated studies should be performed. After the foregoing has been completed, please provide an opinion on the following: (a.) Diagnose any acquired psychiatric disorder found to be present at any point during the appeal period, to include depression, anxiety or insomnia. (b.) For each disorder diagnosed, is it at least as likely as not (50 percent or greater probability) that the disability was incurred in or otherwise related to the Veteran’s active service, or caused by the onset of the disease or an injury during any verified active duty or inactive duty for training service? In rendering this opinion, the clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. The examiner should consider and discuss the Veteran’s contentions included in the March 2020 Board hearing and the lay statements of record, his service treatment records, and his VA and private medical records. If the clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The clinician is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The examiner is also asked to consider VA treatment records noting complaints of depression. A complete rationale for all opinions should be set forth. 5. Schedule a VA examination(s) to address the nature and etiology of the Veteran’s diagnosed hypertension, type II diabetes mellitus, prostate cancer, and erectile dysfunction. The entire record must be made available to and reviewed by the clinician. All indicated studies should be performed. The examiner is asked to determine the nature and cause of his type II diabetes mellitus, prostate cancer, erectile dysfunction, and hypertension. The examiner should provide an opinion addressing whether it is at least as likely as not that the Veteran’s type II diabetes mellitus, prostate cancer, erectile dysfunction, and/or hypertension was caused or aggravated by any incident in service, or caused by the onset of the disease or an injury during any verified active duty or inactive duty for training service, to include his food and diet in service, stress, untreated sexually transmitted diseases, and weather conditions. In rendering this opinion, the clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. The examiner should consider and discuss the Veteran’s contentions, the lay statements of record, his service treatment records, and his VA and private medical records. If the clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The clinician is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions.   A complete rationale for all opinions should be set forth. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Williams, 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.