Citation Nr: 21031145 Decision Date: 05/20/21 Archive Date: 05/20/21 DOCKET NO. 19-36 752 DATE: May 20, 2021 REMANDED Service connection for a prostate condition. REASONS FOR REMAND The Veteran served on active duty from February 1961 to June 1964. The case is on appeal from a March 2018 rating decision. In November 2020, the Veteran testified at a Board hearing. The claim was last before the Board in November 2020. At that time, the Board reopened the claim of service connection for a prostate condition and remanded the same for further development. The Board notes that the issues of service connection for a kidney condition, bladder condition, retinal condition, upper right diabetic peripheral neuropathy, and upper left diabetic peripheral neuropathy have also been perfected for an appeal. However, these issues will be adjudicated separately at a later date, when in order. Service connection for a prostate condition. The Board finds there was not substantial compliance with the Board's November 2020 remand directives where the Board directed the RO to obtain a VA medical examination and opinion. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Upon remand, a VA examination was provided in April 2021. The examiner opined that the Veteran's prostate condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale the examiner provided "there is no evidence of prostate condition during service" and that his prostate conditions include benign prostatic hyperplasia (BPH), which has not been connected to Agent Orange exposure. In the rationale, the examiner failed to consider evidence of record provided in the Board's November 2020 remand, namely a February 1964 service treatment record (STR) providing the Veteran noticed tender swelling of the groin. Additionally, the examiner mentioned the Veteran's 2013 prostate cancer diagnosis is "considered due to elevated PSA" without providing a medical opinion or any additional rationale. The Board also finds the April 2021 examination medical opinion inadequate, as it relied on a mere absence of evidence in service to provide a negative opinion. Dalton v. Nicholson, 21 Vet. App. 23 (2007). Accordingly, remand is warranted at this time such that a proper medical opinion may be obtained, and, if necessary, a VA examination, based on full consideration of the Veteran's documented in-service and post-service medical history and all lay assertions, and supported by a complete, clearly stated rationale, to resolve the claim. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or to obtain a VA opinion, it must ensure that the examination or opinion is adequate). In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain outstanding VA treatment records dated since February 2021. 2. After completing the records development indicated above, schedule the Veteran for an examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional to determine the nature and etiology of his prostate condition(s). The entire claims file should be reviewed by the examiner. Thereafter, the examiner is to: (a.) Identify all prostate disorders present, including benign prostatic hyperplasia and whether the Veteran has prostate cancer. If prostate cancer is not diagnosed, explain why this is so, including commenting on any elevated PSA levels. (b.) State whether it is at least as likely as not (a 50 percent or greater probability) that any identified prostate condition had its onset during service or is otherwise related to service, to include as due to herbicide agent exposure, such as Agent Orange. Consideration should be given to a February 1964 STR noting in-service tender swelling of the right groin, slowly enlarging and service personnel records (SPRs) showing he served between 1961 and 1964 on the USS Providence, a ship associated with service in Vietnam and exposure to herbicide agents. A complete rationale should be provided for any opinion reached. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.