Citation Nr: 21026614 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 18-45 302 DATE: May 3, 2021 REMANDED Entitlement to a rating in excess of 40 percent for prostate cancer residuals from December 1, 2018 is remanded. REASONS FOR REMAND The Veteran had active duty from June 1966 to March 1974. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2018 decision of a Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in March 2019 and August 2020, when it was remanded for further development. In the August 2020 remand, the Board found that the Veteran's disagreement with the reduced rating for prostate cancer was also a disagreement with the denial of an increased rating for prostate cancer residuals, as the issue of an increased rating for prostate cancer residuals was an inherent part of the Veteran's disagreement with the reduced rating for prostate cancer residuals. 1. Prostate Cancer The Veteran asserts that his service-connected prostate cancer residuals were worse prior to December 1, 2018 than the 40 percent rating which they were assigned. In its August 2020 remand, the Board related that the Veteran indicated that he experienced edema (swelling) in his hands, fingers, legs, and ankles, all of which was accompanied by significant pain. See Board remand, August 3, 2020. Unfortunately, there has not been compliance with the Board's remand directives. The Veteran underwent an examination for prostate cancer residuals in December 2020. See Prostate Cancer Disability Benefits Questionnaire (DBQ), December 15, 2020. Specifically, the examiner failed to address the Veteran's claimed symptoms of edema in his hands, fingers, legs, and ankles, as well as pain. In addition, while the examiner noted residual symptoms such as erectile dysfunction, urinary dysfunction, voiding, and leakage, the examiner failed to address possible renal dysfunction. Compliance with a Board remand directive is neither optional nor discretionary. See Stegall v. West, 11 Vet. App. 268 (1998). As such, another addendum opinion should be obtained on remand. The matter is REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Following the receipt of outstanding records, return the claims file to the December 2020 examiner for an addendum opinion, if available, to address the severity of the Veteran's service connected prostate cancer. A complete and detailed rationale should be given for all opinions and conclusions expressed. The need for further in-person examination is left to the discretion of the examiner. The examiner must address renal dysfunction, if any is present. The examiner must address the Veteran's claimed symptoms of edema in his hands, fingers, legs, and ankles, as well as pain, and indicate whether such symptoms are a residual of the Veteran's prostate cancer. (Continued on the next page) A clear rationale for all opinions must be provided, and a discussion of the facts and medical principles involved would be of considerable assistance. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lech, 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.