Citation Nr: 21067124 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 17-04 610A DATE: November 3, 2021 REMANDED Entitlement to service connection for a testicle condition is remanded. Entitlement to a rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1968 to May 1970. The matter was previously before the Board in October 2019 at which time it was remanded for development. While the Board regrets the further delay, for the reasons stated below, additional remand is necessary. 1. Entitlement to service connection for a testicle condition is remanded. A remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand orders. Where the remand orders of the Board were not complied with, the Board itself errs in failing to ensure compliance. See Stegall v. West, 11 Vet. App. 268 (1998). This obligation is mandatory, not discretionary. Pursuant to the October 2019 remand directives, the Veteran was afforded a VA examination for male reproductive conditions in January 2021. The Board finds that the VA opinion associated with the January 2021 examination is inadequate. The examiner noted that the causes of orchalgia due to spermatocele and hydrocele were unknown but proceeded to rule out herbicide exposure as a potential cause of the disability without adequate explanation. On remand, an opinion with supporting rationale should be obtained. Similarly, the examiner ruled out the Veteran's service-connected PTSD as a potential cause for his testicle condition without adequate explanation. Additionally, the examiner failed to address whether the Veteran's PTSD aggravated his testicle condition. The Board notes that secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310 (2016). Therefore, the question of "aggravation" is pertinent in order for the Board to properly adjudicate the Veteran's claim. Therefore, an addendum medical opinion is required. 2. Entitlement to a rating in excess of 70 percent for PTSD is remanded. In an October 2021 written argument submitted by his representative, the Veteran asserted that his PTSD disability has increased in severity since the Veteran was last examined by VA. The Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his PTSD disability. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for any medical providers who treated him for PTSD or a testicle condition. Then take all appropriate action to obtain any identified records. 2. After completion of the above, forward the entire claims file, including this remand to the January 2021 VA examiner for an addendum opinion. The examiner should provide an opinion regarding the nature and etiology of the Veteran's testicle condition, which addresses the Veteran's service treatment records, post-service medical records, and lay statements. The Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptoms and their onset. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner must opine whether it is at least as likely as not that any diagnosed testicle condition is (i)related to an in-service injury, event, or disease, specifically including whether it is at least as likely as not related to in-service herbicide agent exposure; (ii) caused by the service-connected PTSD, or; (iii) aggravated by (defined as any increase in disability) the service-connected PTSD. The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. All opinions must be accompanied by a clear rationale. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected PTSD. Copies of all pertinent records must be made available to the examiner for review. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his service-connected PTSD alone. 4. After ensuring completion of the above development, adjudicate the TDIU claim. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Sherman 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.