Citation Nr: 21015114 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 16-19 518A DATE: March 16, 2021 ORDER Service connection for urinary incontinence is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his urinary incontinence began during active service. CONCLUSION OF LAW The criteria for service connection for urinary incontinence are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably on active duty in the United States Marine Corps from February 2007 to September 2013. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Board remanded this matter for further development. In October 2019, the Veteran testified in support of this appeal during a hearing held at the Washington, D.C. central office before the undersigned Acting Veterans Law Judge. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). The Veteran contends that his urinary incontinence began during active service after undergoing hernia repair surgery. For the following reasons, the Board finds that service-connection is warranted. In-service treatment records from January 2013 include a report from the Veteran that he had dribbling after urination since surgery and was assessed to have post micturition dribbling. The Veteran has consistently reported this problem since he left service. The Veteran’s service treatment records also document that in July 2008 he underwent right inguinal hernia repair surgery and was referred for additional surgery in January 2013. Accordingly, the Board finds this to satisfy the first two elements for service connection. Turning to the third element, medical nexus, the evidence consists of a VA examination and a medical article cited by the Veteran’s representative. In June 2020, VA obtained a medical opinion based on a review of the Veteran’s available records. The examiner opined that it was less likely than not that the Veteran’s incontinence was due to service based on the Veteran not having a diagnosis of incontinence but only subjective symptoms. The examiner also noted that there were no complaints of chronic urinary issues after the Veteran’s July 2008 surgery. However, the examiner failed to discuss the Veteran’s January 2013 service treatment records that document him reporting dribbling after surgery, include post-void dribbling as a chronic problem, and assessed him with post micturition dribbling. The Board finds the examiner’s opinion to be based on an incomplete assessment of the facts. As such, the Board finds the opinion to be inadequate and affords it little probative weight. In a September 2019 brief submitted by the Veteran’s representative, the representative cites to a medical article in the Annals of Surgery to support that urinary retention is a known complication of hernia repair surgery. The article stated that in the patients who had complications after surgery, 5.8% were urinary difficulties described as dysfunction or retention. Furthermore, the June 2020 VA examiner noted that “though there have been anecdotal reports of urinary incontinence following inguinal repair surgery, most literature does this [sic] list this as a complication of this surgery.” The Board finds that the medical article cited by the Veteran’s representative and the acknowledgement from the June 2020 VA examiner (that there have been anecdotal reports of urinary incontinence following inguinal repair surgery) to support a finding that the Veteran’s urinary incontinence is related to his in-service hernia surgery. The Board finds the evidence to be in relative equipoise. If the evidence is supportive or is in relative equipoise, then the veteran prevails. See 38 C.F.R. § 3.102. Accordingly, service connection for urinary incontinence is granted. 38 C.F.R. § 3.304. G. JACKSON Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Chandeck, 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.