Citation Nr: A21020164 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 190725-16356 DATE: December 17, 2021 REMANDED Entitlement to service connection for urethral stricture is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from December 1982 to September 1986. The rating decision on appeal was issued in July 2019 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the July 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. Entitlement to service connection for urethral stricture is remanded. The Veteran seeks service connection for urethral stricture. The issue of entitlement to service connection for urethral stricture is remanded to correct a duty to assist error that occurred prior to the July 2019 rating decision on appeal. The Veteran has not been afforded a VA examination for this claim. In determining whether the duty to assist requires that a VA medical examination be provided, or medical opinion obtained with respect to a veteran's claim for benefits, four factors are for consideration: (1) competent evidence of a current disability or recurrent symptoms; (2) establishment of an in-service event, injury, or disease; (3) indication that the current disability may be associated with an in-service event; and (4) sufficient competent medical evidence to decide the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81-85 (2006). Here, the Veteran has been diagnosed with a bulbar urethral stricture in April 2018. His treating urologist has provided a letter to VA stating that the Veteran reported to her that he hit his genitalia very hard during a training activity during his military service, although he did not seek medical treatment. The urologist wrote that although bulbar urethral strictures are very common, trauma can be the cause of the condition about fifteen percent of the time. Thus, in her opinion, it is very possible that the Veteran's problem resulted from his in-service injury. See June 2019 Correspondence. The Veteran has provided additional lay statements explaining that he injured his scrotum and urethra during an obstacle course event in basic training, though he did not realize the extent of the injury at the time. His later problems were caused by scar tissue from that injury. See April and May 2019 VA Forms 21-526EZ, Fully Developed Claim (Compensation). The evidence described above was available to the AOJ at the time of the July 2019 rating decision. The Board finds that this evidence is sufficient to meet the McLendon factors, as evidence has been presented of a current condition, an in-service event, and indication that the condition may be the result of service. Remand is therefore necessary to correct the duty to assist error of not affording the Veteran a VA examination, as required by McLendon. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the nature and etiology of his urethral stricture condition. The examiner should indicate review of the complete claim file, including the Veteran's lay statements, the letter provided by the Veteran's urologist in June 2019 and other private medical urology records. See June 2019 Correspondence (addressing trauma as a cause of the Veteran's disability). The examiner should provide an opinion addressing: (a.) Is it at least as likely as not (probability of approximately 50 percent) that the Veteran's urethral stricture condition was incurred in, caused by, or otherwise related to military service? (Continued on the next page) A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are require), or the examiner (does not have the knowledge or training). Garrett Morales Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Hermsdorfer, 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.