Citation Nr: 21066321 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 15-14 566 DATE: October 29, 2021 REMANDED Entitlement to service connection for urinary frequency, to include as secondary to service-connected hypertension, is remanded. REASONS FOR REMAND The Veterans served on active duty from August 1977 to February 1986. This matter is before the Board of Veterans' Appeals (Board) on appeal from a September 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in August 2018. A transcript of the hearing is of record. This matter was previously before the Board in March 2019, March 2020, November 2020, and May 2021 when it was remanded for further development. Entitlement to service connection for urinary frequency is remanded. Although the additional delay is regrettable, the Board finds further development is required before a decision can be made on the Veteran's claim. In accordance with the May 2021 Board remand, a medical opinion addressing the etiology of the Veteran's urinary frequency was obtained. In the June 2021 opinion, a VA examiner opined that it was less likely as not the Veteran's urinary frequency was related to his active service. In support of the opinion, the examiner noted that the Veteran's symptoms were consistent with BPH and were not consistent with diuretic-induced frequency as frequency due to diuretics is dose-related and generally passes after the initial response to the medication dose. The examiner also noted that the Veteran's separation examination was negative for frequency or other urinary dysfunction complaints and that there was no evidence of urinary frequency for a span of over 20 years, which also suggests BPH is the likely cause of the Veteran's symptoms. Lastly, the examiner explained that the likely cause of the Veteran's in-service symptoms would have been a sexually transmitted disease (STD) or urinary tract infection (UTI). The Board, however, finds the opinion inadequate. In this regard, the Board notes that the examiner incorrectly noted that the Veteran's separation examination did not include any complaints of urinary dysfunction. Additionally, although the examiner suggests the Veteran's in-service symptoms of urinary frequency were likely due to a STD or UTI, the examiner did not identify any service treatment record which reflects a diagnosis of an STD or UTI and also has not provided any other evidence in support of the contention. Therefore, the Board finds remand for a new medical opinion is required. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records, including records for the period from July 2021 to the present. Any negative search response should be noted in the record. 2. After obtaining any additional records, obtain an addendum opinion from a VA examiner addressing the etiology of the Veteran's urinary frequency. The electronic claims file must be made available to the medical professional for review in connection with the request for an opinion. An examination should only be scheduled if the examiner deems one is necessary for providing the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to provide an opinion on the following: Irrespective of the January 2020 VA examination report containing no diagnosis of a bladder or urethra condition, is it at least as likely as not (a 50 percent or greater probability) the Veteran's urinary frequency was caused by or is otherwise related to the Veteran's active service? In providing the requested opinion, the examiner should address (i) the Veteran's in-service reports of urinary symptoms and diagnosis of nonspecific urethritis as noted in January and July 1984 service treatment records and (ii) the Veteran's report of frequent/painful urination during his separation examination. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.