Citation Nr: 21068357 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 16-62 723 DATE: November 10, 2021 REMANDED A rating higher than 40 percent for prostate cancer, status post radical retropubic prostatectomy. A compensable rating for erectile dysfunction. A total disability rating based on individual unemployability (TDIU). REASONS FOR REMAND The Veteran served on active duty from February 1967 to January 1971. The case is on appeal from a January 2014 rating decision. In July 2021, the Veteran testified at a Board hearing. The record was held open for 60 days for the submission of additional evidence, which was received in August 2021. 1. A rating higher than 40 percent for prostate cancer, status post radical retropubic prostatectomy. 2. A compensable rating for erectile dysfunction. The Veteran maintains that higher ratings are warranted for prostate cancer residuals and erectile dysfunction, noting a possible recurrence of prostate cancer, and that the head of his penis is always wet due to a penile prosthesis for erectile dysfunction. See July 2021 Board hearing testimony. In that respect, VA treatment records in January 2020 reflect that the Veteran had pelvic floor therapy in preparation for radiation therapy due to a gradually increasing prostate specific antigen (PSA). In addition, an August 2021 Disability Benefits Questionnaire (DBQ) reflects that a penile prosthesis was in place, noting a July 2021 referral to the VA Medical Center (VAMC) in Milwaukee, Wisconsin, for salvage external radiation beam therapy based on a PSA of .321. Although no active disease was noted to have been found, remand is warranted to obtain the treatment records. In addition, as there is an indication of worsening, VA examination is warranted. See Snuffer v. Gober, 10 Vet. App. 400 (1997) (noting that a Veteran is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination). A TDIU. The Veteran maintains that a TDIU is warranted based on service-connected residuals of prostate cancer, along wiith service-connected diabetes and peripheral neuropathy of the bialteral upper and lower extremties. See July 2021 Board hearing testimony. Because a decision on the higher rating claims being remanded could significantly impact a decision on the issue of a TDIU, the issues are inextricably intertwined, and thus, the TDIU claim must also be remanded. See Harris v. Derwinski, 1 Vet. App. 180 (1991). On remand, the RO will have an opportunity to consider the additional evidence associated with the claims file since the February 2017 supplemental statement of the case (SSOC). The matters are REMANDED for the following action: 1. Obtain outstanding VA treatment records since January 13, 2020, to include from the Milwaukee VAMC and the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois. 2. After completion of the above, schedule the Veteran for an examination by an appropriate clinician to assess the severity of the service-connected prostate cancer, status post radical retropubic prostatectomy, and erectile dysfunction. The examiner should attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups, including the effect on any occupational functioning. An opinion should also be provided as to whether the Veteran's erectile dysfunction includes penis deformity, i.e., a distortion of the penis, either internal or external. In considering the evidence, the clinician should address the Veteran's statements, to include that the head of his penis is always wet due to the penile prosthesis. Rationale for all opinions expressed should be provided. If the reviewing clinician is unable to provide the requested opinions without resort to speculation, it must be so stated, and he or she must provide the reasons why an opinion would require speculation. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.