Citation Nr: 21026794 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 16-24 642 DATE: May 4, 2021 ORDER Entitlement to a compensable rating for calculus, left ureter, for the time period prior to March 11, 2020, and a 20 percent rating thereafter is dismissed as moot. REMANDED Entitlement to service connection for prostate hypertrophy is remanded. FINDING OF FACT The grant of a 100 percent rating for transitional cell carcinoma (claimed as bladder cancer) with calculus, left ureter, status post, ureteral lithotomy (previously calculus, left ureter, PO, symptomatic) renders the issue of entitlement to a compensable rating for calculus, left ureter, for the time period prior to March 11, 2020, and a 20 percent rating thereafter moot CONCLUSION OF LAW The issue of entitlement to a compensable rating for calculus, left ureter, for the time period prior to March 11, 2020, and a 20 percent rating thereafter is moot. 38 U.S.C. § 7104; 38 C.F.R. § 20.101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1966 to September 1968. This appeal comes before the Board of Veterans' Appeals (Board) from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), in Waco, Texas (hereinafter Agency of Original Jurisdiction (AOJ)). In May 2018, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In December 2018, the Board remanded the appeal to the AOJ for further development. Specifically, the Board directed the AOJ to obtain additional treatment records, to obtain an addendum opinion regarding the Veteran's sleep apnea claim, and to schedule the Veteran for VA examinations. In January 2021, the Board once again remanded the appeal to the AOJ to complete the adjudication of the proposed severance of the award of service connection for prostate cancer and award an initial rating and effective date of award for residuals of bladder cancer. 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). 1. Entitlement to a compensable rating for calculus, left ureter, for the time period prior to March 11, 2020, and a 20 percent rating thereafter In February 2021, the AOJ combined the claims of calculus, left ureter, and transitional cell carcinoma (claimed as bladder cancer) as to avoid pyramiding. 38 C.F.R. § 4.14. Upon combining the claims, the AOJ granted service connection for transitional cell carcinoma (claimed as bladder cancer) with calculus, left ureter, status post, ureteral lithotomy (previously calculus, left ureter, PO, symptomatic) with an evaluation of 100 percent effective July 13, 2012. The effective date of July 13, 2012 was established from the date of the VA received the claim. 38 C.F.R. § 3.400 Therefore, the claim for entitlement to a compensable rating for calculus, left ureter, for the time period prior to March 11, 2020, and a 20 percent rating thereafter is dismissed as moot. REASONS FOR REMAND 1. Entitlement to service connection for prostate hypertrophy is remanded. The Veteran seeks entitlement to service connection for prostate hypertrophy, to include as secondary to service-connected prostate cancer. However, the Veteran's entitlement to service connection for prostate cancer was severed effective March 1, 2021 in accordance with 38 C.F.R. § 3.105 (d). In February 2021, the Veteran was granted service connection for transitional cell carcinoma (claimed as bladder cancer) with calculus, left ureter, status post, ureteral lithotomy. Prior to the AOJ's February 2021 severance of service connection for prostate cancer, the Veteran was provided a positive nexus opinion regarding secondary service connection for prostate hypertrophy. The May 2020 VA medical opinion determined "[i]t is more likely than not that the Veteran's prostate cancer and associated treatment did aggravate his prostatic hypertrophy beyond its natural progression. The aggravation would be cause by the additional inflammation cause by the prostate cancer/treatments." This finding includes the Veteran's bladder periodic infusion therapies, which was prescribed to treat the Veteran's bladder cancer, but listed as treatment for prostate cancer in his medical records. Therefore, the Board requires medical opinion as to whether the Veteran's prostate hypertrophy is caused or aggravated by his service-connected transitional cell carcinoma (claimed as bladder cancer) with calculus, left ureter, status post, ureteral lithotomy. And to determine whether the Veteran's erectile disfunction is related to his service-connected disability. The matters are REMANDED for the following action: 1. Undertake appropriate development to obtain any outstanding records pertinent to the claims on appeal, to include updated VA treatment records. 2. Afford the Veteran a VA genitourinary examination to determine the nature and etiology of his claimed prostate hypertrophy. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The claims file must be reviewed by the examiner. Following review of the claims file, the examiner should respond to the following questions regarding service connection for the Veteran's claimed prostate hypertrophy: The examiner is asked to opine whether it is at least as likely as not that the Veteran's prostate hypertrophy is (1) proximately due to his service-connected transitional cell carcinoma (claimed as bladder cancer) with calculus, left ureter, status post, ureteral lithotomy, or (2) aggravated (a medical discernible increase in disability) beyond its natural progression by such disabilities, including any medical treatment procedure, therapy and/or medications for service-connected transitional cell carcinoma with calculus, left ureter, status post, ureteral lithotomy renal calculi and/or prostate cancer. Please explain why or why not. After completing the development above and after completing any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue of entitlement to service connection for prostate hypertrophy, to include as secondary to service-connected transitional cell carcinoma with calculus, left ureter, status post, ureteral lithotomy. should be readjudicated based on the entirety of the evidence. 3. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Patrick C. Brady, Attorney Advisor 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.