Citation Nr: 21005872
Decision Date: 02/02/21	Archive Date: 02/02/21

DOCKET NO. 15-29 608
DATE: February 2, 2021

REMANDED

Entitlement to service connection for a prostate disorder is remanded.

REASONS FOR REMAND

The Veteran served on active duty from August 1967 to July 1969. 

The Board most recently remanded the claim in August 2020 for further development. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998).

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2).

The claim must be remanded because the October 2020 VA opinion is inadequate.  The examiner was instructed to identify all prostate disorders diagnosed at any point since September 2014, specifically requesting a determination for prostatitis, but did not do so.

The examiner provided a negative nexus opinion on direct service connection for both prostate cancer and benign prostatic hypertrophy. The examiner also provided a negative nexus opinion as to whether the Veteran’s September 1968 diagnosis of chronic prostatitis and in-service urinary-related complaints caused his current disabilities. Although the examiner considered and commented on the reports cited by the Veteran’s representative, the examiner’s rationale was not was based on the facts specific to the Veteran.

The matters are REMANDED for the following action:

1.  Obtain an addendum opinion from the VA examiner who provided the October 2020 opinion, (or another appropriate provider if the October 2020 examiner is unavailable) to determine the nature and likely etiology of any diagnosed prostate disorder.  Copies of all pertinent records must be made available to the examiner for review. 

Based on review of the record, the examiner should provide an opinion to the following:

(a.) Identify all prostate disorders diagnosed at any point since September 2014, to specifically include prostate cancer and benign prostatic hypertrophy.  The examiner should specifically identify if prostatitis had been diagnosed at any point since September 2014. 

(b.) For each prostate disorder diagnosed, is it at least as likely as not related to an in-service injury, event, or disease, to specifically include his September 1968 diagnosis of chronic prostatitis and his in-service urinary related complaints?  Why or why not?

In answering these questions, the examiner must specifically consider and comment on the following reports cited by the Veteran’s representative:

(i)	The Role of Prostatitis in Prostate Cancer: Meta-Analysis, PLoS One 2013; 8(12), available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877315 / 

(ii)	Correlation Between Prostatitis, Benign Prostatic Hyperplasia and Prostate Cancer: A Systemic Review and Meta-Analysis, J Cancer 11(1) 177-189 (2020), available at https://www.jcancer.org/v11p0177.htm 

In answering these questions, the examiner must specifically consider and comment on the following reports raised by the October 2020 examiner:

(i)	Risk Factors for Prostate Cancer, UpToDate (2020), available at https://www.uptodate.com/contents/risk-factors-for-prostate-cancer 

(ii)	(iv) Epidemiology and Pathophysiology of Benign Prostatic Hyperplasia, UpToDate (2020), available at https://www.uptodate.com/contents/epidemiology-and-pathophysiology-of-benign-prostatic-hyperplasia?source=related_link. 

The examiner must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate.  If an opinion cannot be provided, the examiner should indicate why.

 

M.E. Larkin

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	S.E. Bresler, 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.