Citation Nr: 21028585 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 18-50 083 DATE: May 11, 2021 ORDER Entitlement to an evaluation in excess of 60 percent for prostate cancer residuals is denied. FINDING OF FACT The Veteran's prostate cancer is in remission and there has been no local recurrence or metastasis; voiding dysfunction is the predominant residual of his prostate cancer; there is no evidence of renal dysfunction. CONCLUSION OF LAW The criteria for an evaluation in excess of 60 percent for prostate cancer residuals have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.321, 4.3, 4.7, 4.115a, 4.115b, Diagnostic Code 7528 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1964 to November 1967. This matter comes before the Board of Veteran's Appeals (Board) on appeal from a June 2018 decision. The Veteran presented testimony before the Board in February 2020. The matter was recently before the Board in November 2020 and remanded for further development. The Veteran's claims for bilateral eye vision conditions will be the subject of a later decision as the claims are pending development at the RO. The Board notes that some additional medical evidence was added to the claims folder after the March 2021 supplemental statement of the case was issued; however, the evidence was either not pertinent and/or duplicative of evidence already of record. Entitlement to an evaluation in excess of 60 percent for prostate cancer residuals In December 2015, the Veteran was awarded service connection for prostate cancer. The Veteran's prostate cancer was evaluated pursuant to Diagnostic Code 7528. 38 C.F.R. § 4.115b. He was assigned a 100 percent rating for malignant neoplasms of the genitourinary system effective December 11, 2015. He was notified in December 2015 that following cessation of surgical, x-ray, antineoplastic chemotherapy, or other therapeutic procedure, the 100 percent rating shall continue with a mandatory VA examination at the expiration of six months. He was then notified that any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. § 3.105 (e) and if there has been no local reoccurrence or metastasis, the disorder should be rated based on the residuals as voiding dysfunction or renal dysfunction, whichever is predominant. 38 C.F.R. § 4.115b, DC 7528. The mandatory examination took place in April 2017. In May 2017, the RO proposed to reduce the evaluation for prostate cancer from 100 percent disabling to 20 percent disabling based on the April 2017 examination. The Veteran requested a hearing on the proposal, but subsequently filed a claim for an increased evaluation for his voiding dysfunction. A conference in lieu of an informal hearing was held in January 2018. The parties, including the Veteran, agreed that the evidence of record showed residual voiding dysfunction, which had increased in severity since the April 2017 examination. Thus, it was further agreed by the parties that a new examination was warranted, and final determination of the current evaluation would be made once the new examination was received. The examination took place in February 2018 and in June 2018, a 60 percent rating was assigned for voiding dysfunction effective September 1, 2018. During the February 2020 Board hearing, the parties agreed the issue on appeal was entitlement to an evaluation in excess of 60 percent for prostate cancer residuals. The Veteran does not dispute, and the evidence of record shows, that his prostate cancer is in remission and there has been no local recurrence or metastasis. Thus, the Veteran's prostate cancer residuals are to be rated as voiding dysfunction or renal dysfunction, whichever is predominant. The Veteran is currently assigned the maximum 60 percent rating for voiding dysfunction. 38 C.F.R. § 4.115a. In order to get a higher rating for renal dysfunction, an 80 percent rating is warranted for renal dysfunction when it results in 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. 38 C.F.R. § 4.115a. A 100 percent rating is warranted for renal dysfunction regular dialysis or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems, especially cardiovascular. Id. The evidence does not show that the Veteran's prostate cancer residuals have resulted in renal dysfunction. There is no medical evidence of record showing that the Veteran experiences any of these symptoms to a compensable degree, to include VA and private treatment records and reports of VA examination dated in 2017, 2018, 2019, and 2021. Rather, the medical evidence of record is clear that the predominant manifestation of the Veteran's prostate cancer residuals is a voiding dysfunction for which he already receives the maximum rating. As such, the Veteran is not entitled to a higher rating based on renal dysfunction. The Board further notes that the Veteran's erectile dysfunction, associated with prostate cancer, has been service connected since April 28, 2017, rated as zero percent disabling under Diagnostic Codes 7599-7522. The Veteran has received special monthly compensation (SMC) since that date, under 38 U.S.C. § 1114 (k) and 38 C.F.R. § 3.350 (a), on account of loss of use of a creative organ. Accordingly, the Veteran's prostate cancer residuals, manifested predominantly by voiding dysfunction, more nearly approximate the criteria for the currently assigned 60 percent rating under 38 C.F.R. § 4.115b. For the reasons noted above, a rating in excess of 60 percent is not warranted. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. L. Wallin, 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.