Citation Nr: 21076842 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-12 862 DATE: December 28, 2021 REMANDED Service connection for a digestive condition is remanded. Service connection for a prostate disability is remanded. Service connection for bladder incontinence is remanded. Service connection for a renal disability is remanded. Service connection for glucose fasting impairment is remanded. Service connection for a hernia condition is remanded. Service connection for peripheral vascular disease is remanded. Service connection for glaucoma is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from November 1951 to November 1953. This matter comes before the Board of Veterans' Appeals (Board) on appeal from April 2014 and December 2015 rating decisions. The Veteran had previously requested a hearing in connection with his appeal, but withdrew that request in correspondence dated October 2021. Digestive Condition Private treatment records from July and August 2013 show diagnoses of hiatal hernia, polyp, diverticulosis, and internal hemorrhoids. The Veteran's separation examination from November 1953 noted a dilated left ring. A medical opinion is necessary to determine whether there is a link, if any, between the current diagnoses and the in-service finding. Prostate Disability Private treatment records from April 2010 show a diagnosis of benign prostate hypertrophy. The Veteran's service treatment records from November 1952 note treatment for a urinary tract infection, such as prostatitis. A medical opinion is necessary to determine whether there is a link, if any, between the current diagnoses and the in-service finding. Bladder Incontinence The Veteran was afforded a VA examination in August 2015. The examiner noted a history of urinary calculi and a diagnosis of urinary incontinence. The Veteran's service treatment records from November 1952 note treatment for a urinary tract infection, such as non-specific urethritis. Shortly after service, in September 1956, the Veteran was treated for urinary/urethral stricture. A medical opinion is necessary to determine whether there is a link, if any, between the current diagnosis and the in-service finding. The Veteran also had service at Camp Lejeune. Notably, while bladder or urinary incontinence is not among those conditions presumed to be associated with exposure to the contaminated water at Camp Lejeune, bladder cancer is a presumptive condition. On remand, the opinion should also address whether current incontinence is related to the Veteran's exposure. Renal Disability VA treatment records from May 2016 show the Veteran has been diagnosed with bilateral renal cysts. Notably, while renal cysts is not among those conditions presumed to be associated with exposure to the contaminated water at Camp Lejeune, kidney cancer is a presumptive condition. A medical opinion is necessary to address whether current cysts are related to the Veteran's exposure. Peripheral Vascular Disease, Glaucoma, Glucose Fasting Impairment, Hernia Condition The VA treatment records currently associated with the claims file are only dated through April 2017. Updated VA records should be obtained on remand, and the Veteran should be afforded the opportunity to submit any additional private treatment records relevant to his claims. Adjudication of the remaining claims is deferred pending receipt of any updated records. The Board notes that glucose fasting impairment is a laboratory finding, not a disability for which service connection can be granted. However, additional records obtained on remand may show a ratable disability, such as diabetes. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his claimed digestive disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is any current digestive disability at least as likely as not related to service, including a dilated left ring noted in November 1953? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran's description of his/her in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his/her current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? 2. Schedule the Veteran for a VA examination for his claimed prostate disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is any current prostate disability at least as likely as not related to service, including a urinary tract infection and possible prostatitis noted in November 1952? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran's description of his/her in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his/her current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's urinary incontinence is at least as likely as not related to service, including a November 1952 urinary tract infection. The examiner should also note the Veteran was treated for urinary/urethral stricture in 1956. The examiner should also address whether the Veteran's urinary incontinence is at least as likely as not related to his exposure to contaminated water at Camp Lejeune. 4. Obtain a medical opinion from an appropriate clinician regarding whether the Veteran's bilateral renal cysts are at least as likely as not related to service, including his exposure to contaminated water at Camp Lejeune. Shamil Patel Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jorge Barroso, 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.