Citation Nr: 21008937 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 18-31 431 DATE: February 18, 2021 REMANDED Whether the rating reduction from 100 to 60 percent for prostate cancer residuals is proper for the period September 1, 2016 to April 25, 2019, is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from July 1963 to July 1967. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2016 rating decision of the Chicago, Illinois, Department of Veterans Affairs (VA) Regional Office (RO). In June 2019 a Video Conference Board hearing was held before the undersigned. Whether the rating reduction from 100 to 60 percent for prostate cancer residuals is proper for the period September 1, 2016 to April 25, 2019, is remanded. The Veteran’s prostate cancer residuals are evaluated under Diagnostic Code 7527. Under DC 7527 a 60 percent evaluation is assigned whenever there is a requirement for use of an appliance or the wearing of absorbent materials which much must be changed more than four time per day. A higher evaluation of 80 percent is not warranted unless the record shows poor renal function with persistent edema and albuminuria with BUN 40 to 80 mg% or creatinine 4 to 8 mg%, or generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion. A 100 percent evaluation is assigned based on active malignancy. His 100 percent evaluation was reduced effective September 1, 2016, to a 60 percent evaluation. At the Board hearing he reported that as recently in May 2019 he had a diagnosis of active cancer. His representative argued additionally that levels of PSA 4+ are indicative of active cancer, and that the Veteran has had active cancer throughout the period on appeal. A March 2017 urology clinic note indicates the Veteran’s PSA was low and stable. He was using 3 to 4 pads per day, and had no dysuria or hematuria. A June 2018 VAMC treatment record noted the Veteran had peristent urinary incontinence after prostate cancer treatment but no urinary symptoms at present, and he was taking over the counter medication for his prostate. A July 2018 lab entry notes “prostate cancer- PSA low and stable.” A November 2018 treatment record the Veteran had prostate cancer status-post brachytherapy. It is not evident if the Veteran’s prostate cancer was in active status during this period. In June 2019 the Board remanded the appeal for an examination and opinion as to whether the Veteran had active cancer from September 2016 through present. An opinion was rendered in November 2019, wherein the examiner found that the Veteran was diagnosed with prostate cancer in 2013. The examiner stated in April 2019 the Veteran’s PSA was 2.92, and was sent to Radiation/oncology department. In September 2019, he was started on Eligard, and has active prostate cancer. In an October 2020 addendum opinion, the examiner again stated the Veteran was diagnosed with prostate cancer in 2013, with a PSA of 5.0, and then in 2014 care was transferred to Hines. The examiner stated that in April 2019 the Veteran had rising PSA. He was assessed as having micrometastatic prostate adenocarcinoma with rising PSA. The RO determined the Veteran to have active prostate cancer as of April 2019, and granted a 100 percent evaluation from April 25, 2019. The Veteran maintains that he should be in receipt of the 100 percent evaluation and asserts there is evidence of active cancer for the period from September 2016 through April 2019. It remains unclear from the record whether the Veteran had prostate cancer for the period from September 1, 2016, to April 2019. An opinion is needed to address whether he had active cancer during that period. The matters are REMANDED for the following action: 1. Obtain a VA medical opinion addressing the history of the Veteran’s prostate cancer. The examiner is asked to identify: Whether the Veteran had active cancer from the period September 2016 to April 2019. The examiner is asked to review the Veteran’s PSA levels for the period September 2016 to April 2019 and opine whether his symptoms during that time are consistent with active malignancy. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Skiouris, 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.