Citation Nr: 21001001 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 15-15 766 DATE: January 6, 2021 REMANDED Entitlement to service connection for urinary condition is remanded. Entitlement to service connection for prostate condition, to include cancer is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1969 to March 1972, including service in the Republic of Vietnam from August 1970 to August 1971; the Veteran also served in the United States Air Force from January 1991 to September 1991. The Veteran provided sworn testimony at a hearing before the undersigned in July 2018. The claims for service connection addressed herein were remanded by the Board in April 2019 for further development. The claims have returned for further appellate review.   1. Entitlement to service connection for urinary condition is remanded. 2. Entitlement to service connection for prostate condition, to include cancer is remanded. The Board finds that these claims must be remanded for further development. The Board remanded the claims in April 2019 to obtain VA examinations and opinions. Regarding the Veteran’s claimed prostate condition, the Board specifically directed that the examiner determine whether the Veteran has prostate cancer or a prostate condition, and then opine as to whether any condition is at least as likely as not related to an in-service injury, event, or disease or are aggravated by any of the Veteran’s service-connected conditions. The Veteran was afforded a prostate cancer VA examination in August 2020. The examiner remarked that the Veteran does not have a diagnosis of prostate cancer because there are no findings, signs and or symptoms to support a diagnosis. The examiner then remarked that the Veteran’s prostate was mildly enlarged but had no nodules. She also remarked that the Veteran “does have symptoms” that based on history and examination are likely due to BPH”, but that “it is outside the scope of this DBQ” and as such, no diagnosis was given. The Board notes that an opinion must be obtained to determine whether the Veteran has a prostate condition that is at least as likely as not related to an in-service injury, event, or disease or are aggravated by any of the Veteran’s service-connected conditions. Unfortunately, this requires yet another remand to ensure a fully accurate and descriptive medical opinion is obtained on behalf of the Veteran. See Stegall v. West, 11 Vet. App. 268 (1998). Furthermore, a remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes on the VA a concomitant duty to ensure compliance with the terms of the remand. Id. Regarding the Veteran’s claimed urinary condition, the Board directed that the examiner determine whether the Veteran has a urinary condition that manifests as blood in the urine, and then opine as to whether any condition is at least as likely as not related to an in-service injury, event, or disease or are aggravated by any of the Veteran’s service-connected conditions. The Veteran was afforded a VA examination in August 2020. The examiner remarked that there is no pathology to make a diagnosis regarding the Veteran’s claimed urinary conditions. The examiner opined that the Veteran’s reports of intermittent hematuria could be a symptom of a kidney/urine condition, but there was no pathology to base a diagnosis. The examiner advised the Veteran to consult with a doctor while the condition is “actively happening”, thus acknowledging that further consultation is required to properly assess the Veteran’s claimed condition. The Board notes that an opinion must be obtained to determine whether the Veteran has kidney/urinary conditions with symptoms that manifest as intermittent hematuria that is at least as likely as not related to an in-service injury, event, or disease or are aggravated by any of the Veteran’s service-connected conditions. Unfortunately, this also requires another remand to ensure a fully accurate and descriptive medical opinion is obtained on behalf of the Veteran. See Stegall v. West, 11 Vet. App. 268 (1998). As stated above, a remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes on the VA a concomitant duty to ensure compliance with the terms of the remand. Id. The matters are REMANDED for the following action: 1. Obtain an addendum opinion to determine whether it is at least as likely as not that the Veteran has prostate cancer or a prostate condition and whether the Veteran has a urinary condition claimed as blood in urine. If a physical examination is deemed necessary, schedule an appropriate VA examination (or telehealth interview, review of the record, etc. to respond to the following: If the Veteran has a prostate condition, the examiner must address whether it is at least as likely as not that the condition is related to an in-service injury, event, or disease or are caused or aggravated by any of the Veteran’s service-connected conditions. In answering all questions, please articulate the reasons underpinning your conclusions. That is, (1) identify what facts and information, whether found in the record or outside the record, support your opinion, and (2) explain how that evidence justifies your opinion. A report of the examination should be prepared and associated with the Veteran’s VA claims file. 2. Obtain an addendum opinion to determine the nature and etiology of his reported blood in urine. The determination of whether an in-person examination should be left to the discretion of the examiner. If a physical examination is deemed necessary, schedule an appropriate VA examination (or telehealth interview, review of the record, etc. to respond to the following: If the Veteran has a condition causing blood in urine, the examiner must address whether it is at least as likely as not that the condition is related to an in-service injury, event, or disease or are caused or aggravated by any of the Veteran’s service-connected conditions. In answering all questions, please articulate the reasons underpinning your conclusions. That is, (1) identify what facts and information, whether found in the record or outside the record, support your opinion, and (2) explain how that evidence justifies your opinion. A report of the examination should be prepared and associated with the Veteran’s VA claims file. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Booker 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.