Citation Nr: 21029429 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 12-17 134 DATE: May 13, 2021 REMANDED Service connection for urinary incontinence, to include as secondary to a service-connected back disability and/or erectile dysfunction, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from September 1971 to September 1973. He also served on active duty from October 2006 to February 2008, to include service in support of Operation Enduring Freedom. The Veteran also had periods of active duty for training and inactive duty for training during his service in the Army National Guard. The matter is on appeal before the Board from a July 2010 rating decision. The Board previously remanded the issue for further development in June 2017 and May 2019. The Veteran's representative in their April 2021 post-remand brief, contends that the October 2020 VA addendum medical opinion is inadequate. Specifically, he argued that the VA examiner failed to provide any analysis or rationale in the secondary service connection opinion. Rather, it is alleged that the opinion consisted of only data and conclusions. In the October 2020 VA addendum medical opinion, as to secondary service connection, the examiner found that the Veteran's claimed urinary incontinence was less likely than not (less than 50 percent probability) proximately due to, the result of, caused by, nor aggravated beyond its natural progression by any of the Veteran's service-connected disabilities, to include the Veteran's service-connected back disability, major depressive disorder, gastroesophageal disease (GERD), bilateral lower extremity radiculopathies, and erectile dysfunction. The examiner cited medical literature and rationalized that the medical literature does not show that the Veteran's claimed urinary incontinence is caused or aggravated beyond its natural progression by any of the Veteran's service-connected disabilities. As the Veteran's representative pointed out, the VA examiner failed to provide an appropriate analysis or rationale in the opinion pertaining to secondary service connection. The secondary service connection opinion consists solely of citations and a conclusion. Additionally, the "beyond the natural progression of the disability" language is not consistent with VA regulations which define aggravation in the context of secondary service connection as making the disability worse. As such, a remand is warranted to obtain a VA addendum medical opinion. The matters are REMANDED for the following action: Obtain an addendum opinion to address whether the Veteran's urinary incontinence is secondary to his service connected disabilities. If a physical examination is necessary to answer the Board's questions, one should be scheduled. The examiner should answer the following question: Is it at least as likely as not (50 percent or greater probability) that any disability manifesting in urinary incontinence has been caused or aggravated (made worse) by any of the Veteran's service-connected disabilities, which currently include major depressive disorder, degenerative herniated disk L4-L5 and L5-S1, gastroesophageal disease (GERD), left and right lower extremity radiculopathy, and erectile dysfunction? Why or why not? If aggravation is found, the examiner should identify the baseline level of severity of the urinary incontinence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the urinary incontinence. If such cannot be done, then it should be explained why. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Lutgens-Staley, 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.