Citation Nr: 21003748 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 14-03 318 DATE: January 22, 2021 ORDER Service connection for persistent urinary infection is denied. Service connection for hematuria is denied. REMANDED Service connection for a right knee condition is remanded. Service connection for a left knee condition is remanded. Service connection for severe groin pain is remanded A total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had persistent urinary tract infections at any time during or approximate to the pendency of the claim. 2. The preponderance of the evidence of record is against finding that the Veteran has had a disability resulting from hematuria at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for service connection for persistent urinary tract infection are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 2. The criteria for service connection for hematuria are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1997 to July 2001. The Board remanded the issues on appeal for additional development in October 2017, as well as claims for service connection for bilateral hip disabilities, an acquired psychiatric disorder, and bilateral foot conditions. In an August 2018 rating decision, the Agency or Original Jurisdiction (AOJ) granted service connection for bilateral hip disabilities, schizophrenia, bilateral hallux valgus, and bilateral hammer toes. In a January 2020 rating decision, the AOJ granted service connection for bilateral pes planus. As these claims have been granted, they are no longer on appeal. Service Connection for Persistent Urinary Tract Infection and Hematuria The Veteran contends he is entitled to service connection for persistent urinary tract infections and hematuria, asserting the conditions are linked to his bilateral hip disability. See July 2010 Veteran Statement; September 2011 Veteran Statement. The Veteran also provided a statement made by his father dated in August 2011 in support of his claim. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have persistent urinary tract infections or a disability resulting from hematuria and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The November 2017 VA examiner determined the Veteran had no current diagnosis related to his bladder or urethra. The Veteran denied any current symptoms and an examination showed no objective findings of any urinary tract condition. The Veteran reported he had experienced an infection and hematuria when he was in the hospital for hip surgery in 2010. He stated his symptoms resolved in a few days and denied a history of recurrent or persistent urinary tract infection, hematuria, or urinary retention. The examiner noted treatment for an acute infection and hematuria in 2010, for which the Veteran was treated with antibiotics, that resolved with no residuals. As noted by the VA examiner, a July 2010 private treatment record shows the Veteran reported blood in his urine with onset one day prior, but his symptoms had resolved at the time of treatment. The examining physician gave the Veteran a diagnosis of “hematuria (resolved).” Further, despite consistent treatment beginning in February 2008, VA treatment records do not contain a diagnosis of urinary tract infection and no other record of treatment or complaint for hematuria. While the Veteran suffered from one instance of hematuria in July 2010, his symptoms resolved without residuals and no current diagnosis of hematuria, or any other urinary tract or bladder condition, has been made, nor has any residual disability resulting from the single instance of hematuria been identified or diagnosed. While the Veteran and his father believe the Veteran has persistent urinary tract infection or hematuria, they have not been shown to have the training, education, or experience necessary to provide a competent medical diagnosis. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. Upon careful review and weighing of the evidence, with reasoning as detailed above, the Board finds that the preponderance of the evidence is against the claim for service connection for persistent urinary tract infection or hematuria and the benefit of the doubt doctrine is not for application. See generally Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). The appeal must therefore be denied. REASONS FOR REMAND 1. Service Connection for Bilateral Knee Conditions The Veteran asserts his bilateral knee conditions are related to his service-connected bilateral hip disabilities. See December 2009 VA Form 21-526. While the November 2017 VA examiner diagnosed bilateral degenerative arthritis and opined that the Veteran’s diagnoses were not related to service, the examiner gave no opinion as to whether the claimed conditions were secondary to his service-connected hip disabilities. 2. Service Connection for Groin Pain The Veteran asserts he experiences severe groin pain, which he contends is due either to inflammation cause by osteoarthritis, a muscle injury resulting from his bilateral hip replacement, or inflammation due to an allergy to the metal components of his hip prosthesis. See September 2011 Veteran Statement. The Veteran was afforded a VA examination in November 2017, but the examination only addressed whether the Veteran had a hernia condition, which the Veteran has never asserted. 3. TDIU Finally, because a decision on the remanded issues could significantly impact a decision on the issue of entitlement to TDIU, the issues are inextricably intertwined. A remand of the claim for TDIU is required. The matters are REMANDED for the following action: 1. Obtain an additional opinion from an appropriate clinician regarding whether the Veteran’s right and/or left knee disabilities are at least as likely as not proximately due to or aggravated by his service-connected bilateral hip disabilities. 2. Schedule the Veteran for a VA examination for his claimed groin pain disability, which he asserts is a muscle injury. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran’s condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinions below. The examiner is asked to provide a response to the following: Is any diagnosed condition at least as likely as not proximately due to the Veteran’s right or left hip disabilities? Is any diagnosed condition at least as likely as not aggravated by his right or left hip disabilities? In offering either opinion, the examiner must address the Veteran’s assertion that his claimed groin disability is due either to inflammation cause by osteoarthritis, a muscle injury resulting from his bilateral hip replacement, or inflammation due to an allergy to the metal components of his hip prosthesis. 3. Then readjudicate the claims. If any benefit sought is not granted, the Veteran and his representative should be furnished an SSOC and given the requisite opportunity to respond before the case is returned to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Mine 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.