Citation Nr: 21064012 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 16-18 242 DATE: October 18, 2021 ORDER Entitlement to service connection for a prostate disorder, characterized as benign prostrate hypertrophy and prostatitis, is granted. FINDING OF FACT The evidence is in at least relative equipoise regarding a nexus between the Veteran's prostate condition and his service. CONCLUSION OF LAW The criteria for service connection for a prostate disorder, characterized as benign prostrate hypertrophy and prostatitis, have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1985 to November 2005. This appeal to the Board of Veteran's Appeals (Board) arose from an October 2013 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In October 2018, June 2020, and March 2021, the Board remanded this appeal for further evidentiary development. Service connection for a prostate disorder The Veteran seeks service connection for a prostate disorder that believes onset during his active duty. The evidence of the record establishes that he has current diagnoses of benign prostate hypertrophy and prostatitis. A veteran is granted service connection where evidence shows that an injury or disease that results in a current disability was incurred during service or was aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To be entitled to service connection, the evidence must support (1) a current disability; (2) an in-service injury or event; and (3) a nexus between the current disability and the in-service injury or event. 38 C.F.R. § 3.303(a). Regarding an in-service injury or event, the Veteran asserts that he experienced urinary difficulties around 2005 but did not seek treatment. He reported being told to hold his urine for prolonged periods of time. Review of his service treatment records shows that, in March 1998, he was seen for hematuria, or blood in his urine. See August 2014 Service Treatment Records. Regarding whether there is a nexus between the Veteran's current benign prostate hypertrophy and prostatitis and his active duty, an August 2019 examiner opined that it was less likely than not that the Veteran's prostate condition was due to his service. The examiner explained that the Veteran's 2005 separation examination was silent for any prostate conditions. The examiner continued that post-service treatment records from a private provider identified complaints of, as well as evaluation and treatment for, acute prostatitis and benign prostate hypertrophy (BPH) beginning in October 2009, which was four years after the Veteran's service. The examiner explained that in-service, and post-service, medical records were absent of any complaints of, or evaluation (including diagnosis) and treatment for, a prostate condition during or immediately after service. In another opinion provided in August 2020, the examiner stated that the Veteran's prostate problems began in 2009 and that there were no lay statements supporting the Veteran's assertions of prostate issues during his military service. The examiner acknowledged the Veteran's own lay statements that these symptoms started in military service, but was unsure sure if VA would allow this assertion to be enough data to support a positive connection. An April 2021 VA examiner also provided a negative nexus opinion. This examiner agreed that the onset of symptoms occurred in 2009 (based on the records). The examiner also noted that the Veteran was treated for hematuria and urinary complaints in 2009. In all of the medical opinions obtained, the Veteran's lay statements were not thoroughly considered or addressed when rendering the opinions. Additionally, the opinions do not address the March 1998 in-service record regarding hematuria. Further, post-service treatment records reflect the Veteran's complaints of, and treatment for, benign prostate hypertrophy, hematuria, and prostatitis. When providing the assessment for BPH (or an enlarged prostate), hematuria has consistently been noted as well. See May and September 2013 Private Medical Treatment Records. After a thorough consideration of the evidence, the Board finds that the evidence is at least in relative equipoise as to whether the Veteran's prostate condition was incurred during his service. The Veteran is competent to report experiencing urinary difficulties. He was assessed to have hematuria during service in 1998, and hematuria has been present when assessing his current prostate condition. Significant time has been used to develop the evidentiary record in this matter in order to resolve the uncertainties. Although these symptoms from service cannot with medical certainty be attributed to the Veteran's current condition, when thoroughly considering his accounts of his symptoms during and after service, as well as his diagnosed benign prostate hypertrophy and prostatitis based on similar symptoms, the evidence raises a reasonable doubt as to the initial onset of his prostate condition. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Resolving all reasonable doubt in favor of the Veteran, the Board finds that his prostate disorder (CONTINUED ON NEXT PAGE) is related to his active duty. Accordingly, the Board determines that the criteria for service connection have been met and that service connection for a prostate disorder is warranted. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Middleton, 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.