Citation Nr: 21063815 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 17-61 734 DATE: October 18, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent prior to June 1, 2021 for prostate cancer, to include whether the reduction in disability rating was proper is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from August 1965 to August 1969, to include service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. 1. Entitlement to a disability rating in excess of 10 percent prior to June 1, 2021 for prostate cancer, to include whether the reduction in disability rating was proper is remanded. The Veteran contends that the reduction in rating form 100 percent to 10 percent for residuals off prostate cancer was inappropriate. In support, the Veteran notes that he genitourinary residuals of his prostate cancer, to include erectile dysfunction, as well as hypertension. The Veteran was afforded a VA prostate examination in August 2021. The Board notes that the examiner indicated the Veteran does not have a voiding dysfunction, urinary frequency, or obstructed voiding, and further stated that the Veteran does not have erectile dysfunction. The Board notes that in his notice of disagreement (NOD) and appeal to the Board, the Veteran has asserted experiencing fecal urgency, urinary urgency and leaking, weakened stream, and erectile dysfunction, for which he is service connected. Here, the Board finds that the examination is inconsistent with the evidence of record and, as such, is inadequate for rating purposes. See, Barr v. Nicholson, 21 Vet. App. 303 (2007) (explaining that once VA provides an examination, it must ensure that it is an adequate one). In addition, in Morgan v. Wilkie, 31 Vet. App. 162 (2019), the Court held, "VA has powerful, ready-made schedular rating tools with which it can better adjudicate claims that include symptoms and effects not contemplated by an applicable diagnostic code." Morgan, 31 Vet. App. at 167. Indeed, the Court stated doing so was necessary to ensure a veteran is appropriately compensated before resorting to § 3.321(b)'s extraschedular provisions. In doing so, the Court held this included secondary service connection. Id; see also, Bailey v. Wilkie, 33 Vet. App. 188, 203 (2021); Long v. Wilkie, 33 Vet. App. 167, 174 (2020) (en banc). As noted above, the Veteran has asserted voiding urgency and frequency issues. In his appeal to the Board, the Veteran asserted that these issues cause challenges when travelling and further asserted that his medication used to control these symptoms has an affect on his blood pressure. As such, VA must investigate whether service connection is warranted for the Veteran's hypertension. See Bailey. In light of the lay evidence, the Board finds that further information is necessary to properly rate, on a schedular basis, all of the manifestations of the Veteran's service-connected prostate cancer and residuals thereof. As such, on remand, a medical opinion should be obtained to determine any symptoms or secondary disabilities the Veteran may have and whether they are proximately due to his prostate cancer. Morgan; Bailey; Long. Finally, in a September 2021 rating decision, the RO assigned a 100 percent disability rating to the Veteran's prostate cancer due to active malignancy, effective June 1, 2021, which was the date of receipt of an intent to file. The Board notes that there is no evidence of record indicating when the Veteran's prostate cancer returned to active malignancy. See Swain v. McDonald, 27 Vet. App. 219, 224 (2015) (holding that the effective date for an increased rating is predicated on when the increase in the disability can be ascertained). The matters are REMANDED for the following action: 1. Obtain any outstanding private treatment records as well as the Veteran's VA treatment records for the period from August 2015 to the present. 2. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge the impact of the manifestations of his prostate cancer. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected prostate cancer. The examiner must specifically identify all manifestations of the Veteran's prostate cancer and its treatment. In doing so, the examiner state whether it is possible to determine the date the Veteran's prostate cancer recurred. The examiner must also opine as to whether it is at least as likely as not that any such manifestation or impairment is due to the Veteran's prostate cancer or its treatment. In doing so, the examiner must opine as to whether it is at least as likely as not that the Veteran's hypertension was caused by his prostate cancer. The examiner must also opine as to whether the Veteran's hypertension was aggravated by his prostate cancer. The examiner must also opine as to whether it is at least a as likely as not that the Veteran's hypertension is related to or had its onset in service, to include as secondary to Agent Orange. In responding to this inquiry, the examiner must acknowledge and discuss the recent study showing that the NAS just hypertension to the "sufficient" category from "limited or suggestive," indicating that "there is enough epidemiologic evidence to conclude that there is a positive association" between hypertension and herbicide exposure. See Vietnam Veterans and Agent Orange Exposure New Report | National Academies (Nov. 15, 2018). STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Keeley, Brian 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.