Citation Nr: 21063883 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 15-06 705 DATE: October 18, 2021 REMANDED Entitlement to service connection for a prostate disorder, to include benign prostatic hypertrophy (BPH) is remanded. REASONS FOR REMAND The Veteran had active service from July 1987 to November 1987 and from November 1990 to April 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO or AOJ). The Veteran seeks service connection for a prostate disorder (diagnosed as BPH) that he asserts is the result of exposure to various toxins in service. He cites to his service in the Southwest Theater of Operations, exposure to burning of human waste and smoke from burning oil rigs, and the experimental drugs he was given in active service. See February 2015 VA Form 9. Alternatively, he relates his prostate disorder to his service-connected posttraumatic stress disorder (PTSD) and/or erectile dysfunction. Unfortunately, remand is warranted for additional medical inquiry into the service connection claim for a prostate disorder, to include BPH. See Stegall v. West, 11 Vet. App. 268, 271 (1998). This case was previously before the Board in March 2021 when it was remanded for additional development to include obtaining a new VA medical opinion. A VA medical opinion was obtained in July 2021. The examiner was asked to address the Veteran's aforementioned contentions regarding his inservice exposures and PTSD. The examiner did not address this question. Instead, the examiner only commented that there was no in-service evaluation, diagnosis, or treatment of BPH and stated, "symptoms are subjective only." Such was a repetition of the opinions that have been provided in May 2012, September 2019, and November 2020, which have been found to be substantively inadequate. Thus, as the remand instructions were not fully complied with, a remand is again warranted to obtain an opinion as to whether the Veteran experiences a prostate disorder that is related to his active service and/or service-connected PTSD and/or erectile dysfunction. See Stegall v. West, 11 Vet. App. 268 (1998). The Board notes that the AOJ attempted to assist the Veteran in retrieving his private treatment records. See Correspondence dated March 2021 and April 2021. The Veteran did not return the enclosed VA Form 21-4142, Release of Information Form or the VA Form 21-4142a, General Release for Medical Provider Information. As the matter is being remanded, the Veteran should be afforded another opportunity to provide the information and releases necessary to obtain any outstanding private treatment records. In Remanding this matter again, the Veteran is reminded that "it is the veteran's 'general evidentiary burden' to establish all elements of his claim." Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). VA "is required to reject a disability claim if the claimant fails to put forth sufficient evidence showing that he suffered an injury or incurred a disease during service." Holton v. Shinseki, 557 F.3d 1362, 1370 (Fed. Cir. 2009). Although VA has a duty to assist, this duty is not "a one-way street." Wood v. Derwinski, 1 Vet. App. 190, 191 (1991). The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative, if any, and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A (b) (2) and 38 C.F.R. § 3.159 (e). 2. Following the receipt of outstanding records, provide the Veteran's claims file to a qualified clinician to determine the etiology of the Veteran's prostate disorder, to include BPH. The entire claims file and a copy of this Remand must be made available to the clinician for review. A new examination is only required if deemed necessary by the clinician. The examiner must provide opinions as to the following: (a) whether it is at least likely as not that the Veteran's prostate disorder, to include BPH is at least as likely as not related to an in-service injury, event, or disease. The examiner must address the Veteran's lay statements regarding the onset and continuity of symptomatology since onset and/or since separation from service. The examiner must address whether the Veteran's prostate disorder is related to his Southwest Asia service and environmental exposures during such service, including smoke from burning oil fields and the burning of human waste, and/or experimental drugs that he was given in service. (b) whether it is at least likely as not that the Veteran's prostate disorder, to include BPH is proximately due to the service-connected PTSD and/or erectile dysfunction or medications used to treat the same. (c) whether it is at least likely as not that the Veteran's prostate disorder, to include BPH underwent any incremental increase in disability, regardless of its permanence, due to the service-connected PTSD and/or erectile dysfunction or medications used to treat the same. The term "incremental increase in disability" means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any "incremental increase in disability" need not be permanent. A complete rationale for all opinions must be provided. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and he/she must provide the reasons why an opinion would require speculation. The examiner must indicate whether there is any further need for information or testing necessary to make a determination. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith, Associate 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.