Citation Nr: 21031139 Decision Date: 05/20/21 Archive Date: 05/20/21 DOCKET NO. 17-01 005 DATE: May 20, 2021 REMANDED Entitlement to service connection for a right inguinal hernia, to include residuals of 2002 right hernia repair surgery, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from November 1986 to November 1989 and from March 1990 to June 1994, with subsequent service in the U.S. Naval Reserve. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) declining to reopen a previously denied claim of service connection for residuals of a right inguinal hernia, and which was itself a reconsideration of a December 2013 rating decision. In June 2008, additional service department records were associated with the file, regarding the Veteran's service in the Naval reserve through January 2003. Under 38 C.F.R. § 3.156(c), at any time after VA issues a decision on a claim, if VA receives or associates with the claims file relevant official service department records that existed and had not been associated with the claims file when VA first decided the claim, VA will reconsider the claim. This includes service records that were forwarded by the Department of Defense or the service department to VA any time after VA's original request for service records. 38 C.F.R. § 3.156 (c)(ii). Such records were associated with the claims file in 2008. The Veteran's claim for service connection for residuals of a right-sided inguinal hernia repair was first denied in an October 2002 rating decision on the basis that there was no evidence that the condition began in or was caused by service; service treatment records (STRs) from the Veteran's active duty periods were considered in this decision. The Veteran did not initiate an appeal from this decision, and it became final. Subsequently, in June 2008, additional service department records, including STRs from the Veteran's period of Reserve service, were received and associated with the claims file. The Board notes that the RO has not, at any time, indicated these new records were considered as part of any decision. However, remand for initial consideration is not necessary in light of the favorable finding made here. The service records received in June 2008 are relevant to a question in dispute here, namely the question of a hernia disability related to service. The records tend to prove or disprove the presence of a disability on a duty status. As relevant service department records were associated with the file after the October 2002 rating decision, reconsideration (not reopening) under 38 C.F.R. § 3.156(c) is appropriate, and the issue has been recharacterized to reflect consideration of the merits. Remand of Right-Side Inguinal Hernia and Residuals The Veteran contends that he incurred a right sided inguinal hernia during active duty service. As is noted above, reconsideration of the entirety of the evidence of record is required in connection with the recharacterized claim. The Veteran's entrance examination in October 1986 did not document hernias, nor did his October 1989 separation examination. Service treatment records show that the Veteran was referred to a surgical clinic due to a left inguinal hernia that was noted during a routine exam in September 1990. An October 1990 examination performed by a surgeon documented bilateral inguinal hernias, but concluded that the left inguinal hernia was more symptomatic than the right. Surgical repair of the Veteran's left inguinal hernia was scheduled and performed. In August 1991, the Veteran expressed concerns that his left hernia had recurred. A physical examination showed no bulge or obvious deformity in the Veteran's right or left groin, and no bulge was felt on strain and cough. In October 1991, a treatment note indicates that the Veteran had sought treatment for right groin pain on three different occasions. Physical examination documented no obvious right groin bulge, but the clinician was able to palpate a bulge in the right groin when the Veteran coughed. The Veteran was referred to the surgical clinic to rule out a right inguinal hernia versus ligament laxity. At the surgical consult the next day, the clinician observed no definite hernia present but noted mild laxity of the inguinal canal floor. The Veteran was allowed to return to full duty. Approximately 10 days later, in October 1991, the Veteran again sought treatment for right groin pain. Physical examination did not find a direct or indirect right inguinal hernia. The Veteran was directed to return to the surgical clinic for additional treatment and he was prescribed scrotal support and pain medication. The next day, the Veteran was seen at the surgery clinic for follow up of right groin pain. The clinician assessed his condition as musculoskeletal pain and placed him on light duty for four weeks. An emergency department record from February 1992 mentions that the Veteran complained of right lower quadrant pain, but other records from that February 1992 visit indicate that he was seeking treatment for left sided lower quadrant pain. The Veteran's May 1994 separation examination documented no hernias, and the Veteran subjectively denied having hernias. These active duty STRs appear to support a finding that a right inguinal hernia injury occurred during active duty, prior to 1994. The claim, though, includes the residuals of a February 2002 surgery, and it is unclear if any portion of that disability is related to the in-service diagnosis. Service treatment records from the Veteran's service in the U.S. Naval Reserve show that he repeatedly denied injuries or illnesses related to his reserve service, but his surgery for a right inguinal hernia in February 2002, related to a civilian work injury, was documented. No VA examination has been afforded the Veteran with regard to the right inguinal hernia and the current claim. However, as there is evidence of a current disability, potential injury in service, and potential link between the two, an examination is required. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Schedule a VA hernia examination. The claims folder must be reviewed in connection with the examination. The examiner must identify all residuals of the Veteran's 2002 right inguinal hernia repair surgery, and the current status of the Veteran's right inguinal hernia. The examiner is directed to the diagnosis of an asymptomatic right inguinal hernia on active duty, discussed above. The examiner must opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran's right sided inguinal hernia which required surgical repair in 2002 was caused or aggravated by service. The examiner must consider and discuss the service treatment records showing that the Veteran was diagnosed with a right inguinal hernia in October 1990, as well as his repeated complaints of right groin pain. Did the presence of such condition cause or contribute to the severity of the February 2002 injury? A full and complete rationale for any opinion expressed is required. 2. Then, readjudicate the claims on appeal. If any benefit sought remains denied, issue an appropriate supplemental statement of the case and return the appeal to the Board if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Megan-Brady Viccellio 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.