Citation Nr: 21006684 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 16-55 520 DATE: February 4, 2021 ORDER Service connection for the Veteran’s urinary disability, as currently diagnosed, is granted. FINDING OF FACT It is at least as likely as not that the Veteran’s current urinary disability was either incurred in service or is secondary to a service-connected disability. CONCLUSION OF LAW The criteria for service connection for the Veteran’s urinary disability, as currently diagnosed, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303(a), 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1976 to April 1996. This matter comes before the Board of Veterans’ Appeals (Board) from a March 2015 rating decision. The Veteran testified at a Board videoconference hearing in September 2019. In January 2020, the Board remanded the Veteran’s appeal for additional development. At that time, the Veteran’s appeal included the issue of service connection for diabetes mellitus type 2. Service connection for this disability has since been established. That issue is therefore no longer on appellate status. *** The Veteran seeks service connection for a urological disability, described as frequent urination. 12/29/2014, Statement in Support of Claim. At his Board hearing, he asserted that this disability manifested in service and that it is secondary to medications for his service-connected hypertension. He also suggested that it is secondary to his service-connected lumbar spine disability. In August 2015, a VA examiner noted that, in 1986, the Veteran was diagnosed with hypertension and was treated with hydrochlorothiazide, which he took for one to two years; the examiner indicated that use of this medication resulted in increased frequency of urination. 08/13/2015, C&P Exam. Notwithstanding, in a separate opinion addressing the etiology of the Veteran’s diabetes, the same VA examiner indicated that frequency of urination is a symptom of diabetes. Thereafter, in June 2016, the August 2015 VA examiner further opined that Veteran’s claimed urinary disability was less likely than not etiologically related to his hypertension medications. The examiner noted that, after hydrochlorothiazide was discontinued, the Veteran was treated with verapamil, hydralazine, and clonidine, none of which are diuretics, like hydrochlorothiazide, and therefore not the cause of the Veteran’s voiding dysfunction. 08/17/2016, C&P Exam. Based on the above, the Board, in January 2020, remanded this matter for additional development, to include a new VA examination. The Veteran underwent a VA examination in February 2020. The examination report shows a diagnosis of overactive bladder syndrome. The Veteran reported that this disability began in 1986. He described his symptoms as constant thirstiness, excessive visits to the bathroom, and dribbling urination.   The February 2020 VA examiner opined that the Veteran’s urinary disability is less likely than not related to service or secondary to a service-connected disability. Regarding direct service connection, the examiner acknowledged the Veteran’s history of symptoms in service. Specifically, the examiner noted that the Veteran was started on hydrochlorothiazide around 1986 for one or two years, during which he experienced frequent urination. The examiner, however, noted that the Veteran’s separation examination was negative for genitourinary symptoms. Based on the latter, the examiner opined that the Veteran’s urinary disability was less likely than not incurred in service. Regarding secondary service connection, the examiner opined that the Veteran’s urinary disability is less likely than not related to his service-connected hypertension, diabetes, or lumbar spine disability. The opinion regarding hypertension focused on the fact that the Veteran’s separation examination was negative for urinary symptoms, suggesting that the Veteran’s in-service symptoms due to hypertension medication had resolved following discontinuation of the medication. Regarding diabetes, the examiner noted that the Veteran’s diabetes had been diagnosed in 2012 and that diabetes causes polyuria but not frequency. Regarding the lumbar spine disability, the examiner noted that a 2019 VA examination had been negative for radiculopathy or IVDS. Rather, the examiner opined that the Veteran’s urinary frequency is more likely than not related to radiation treatment for his prostate cancer (not service-connected). Regarding the aggravation prong of secondary service connection, the examiner indicated that medical records did not show significant polyuria, urinary frequency, or urgency; therefore, a baseline could not be established without resorting to mere speculation. The Board finds that service connection for the Veteran’s urinary disability, as currently diagnosed, is warranted. As noted above, the evidence of record establishes that the Veteran first experienced urinary frequency in service following medication treatment for his hypertension. The Veteran has also indicated that he has experienced a urinary disability since service. Additionally, the evidence is in relative equipoise as to whether the Veteran’s urinary disability is secondary to his service-connected diabetes. While the most recent VA examiner opined that the Veteran’s urinary disability is less likely than not related to his diabetes, an August 2015 VA examiner concluded otherwise, suggesting that the urinary frequency is related to the diabetes. Based on this evidence, and resolving doubt in favor of the Veteran, it is at least as likely as not that the Veteran’s urinary disability was either incurred in service or is secondary to a service-connected disability. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. López 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.