Citation Nr: 21040343 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 17-30 859 DATE: July 3, 2021 REMANDED Entitlement to service connection for prostate disorder, to include as secondary to in-service herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1965 to July 1967, to include service in the Republic of Vietnam from July 1966 to July 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision and was previously before the Board in June 2020 when it was remanded for further development. Of note, following the Board's June 2020 remand, the Veteran was granted service connection for his skin disorder in a December 2020 rating decision, at an initial rating of 50 percent, effective September 23, 2015, the date of his Intent to File submission. Although the appeal period remains pending with regards to this determination, the Veteran has not expressed disagreement with the assigned initial evaluation or effective date of this award, and thus, this issue is no longer in appellate status. Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997). 1. Entitlement to service connection for prostate disorder, to include as secondary to in-service herbicide exposure, is remanded. The Veteran asserts that he has prostate cancer due to his exposure to herbicide agents, while serving in Vietnam. Specifically, that he started having urinary problems during service. See, August 2016 Notice of Disagreement (NOD). Prostate cancer can be presumptively service connected based on herbicide exposure. 38 C.F.R. § 3.309 (e). A veteran who served in the Republic of Vietnam during the Vietnam War shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. 38 U.S.C. § 1116 (f). However, the Veteran has not been diagnosed with prostate cancer throughout the appeal period, which is the basis for the RO's denial of his claim. Notwithstanding this fact, the Board notes that the Veteran's treatment records reflect a February 2018 diagnosis of benign prostatic hyperplasia (enlarged prostate) with lower urinary tract symptoms. As such, although the Veteran's enlarged prostate disability is not among the listed diseases for which service connection may be presumed based on herbicide exposure, service connection may be established upon adequate evidence of actual causation. 38 U.S.C. § 1116(a); 38 C.F.R. § 3.309(e). Further, since 2017, the Veteran's prostate-specific antigen (PSA) reflects an increased elevation (now at 1.25), which may be some indication that he now has cancer. Based on the above, the Board concludes that the threshold to provide the Veteran a VA examination to determine the nature and etiology of his claimed prostate disorder has been met, and as such this matter should be remanded for an examination and opinion so that the Board can make a fully informed decision. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of his claimed prostate disorder. The electronic claims file, to include a copy of this Remand, and his medical treatment records, should be made available to and be reviewed by the examiner. All indicated tests and studies should be performed, and all findings should be clearly set forth in detail. The examiner should than provide the following: a) Identify all diagnoses related to the Veteran's prostate disorder claim. b) Provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any diagnosed prostate disorder, including benign prostatic hyperplasia, had an onset in service or is otherwise related to service, to include the Veteran's conceded exposure to herbicide agents while serving in Vietnam. The examiner is advised that the Veteran is competent to report his medical history, including the onset of symptoms, and such reports must be acknowledged and considered in formulating any opinion. The examiner must include in the medical report, the rationale for any conclusions expressed, to include descriptions of the medical processes involved and citation to relevant medical literature/treatise as necessary. A report containing unsupported or unexplained conclusions will be deemed inadequate. If the examiner cannot respond to an inquiry without resort to speculation, he or she should so state, and further explain why it is not feasible to provide a medical opinion. 2. The RO should then conduct any additional development deemed necessary, and readjudicate the Veteran's claim. If the benefit sought remains denied, furnish to the Veteran an appropriate supplemental statement of the case (SSOC), afford him the appropriate time period to respond, and thereafter, if necessary, return the matter to the Board for further appellate review. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.B. King, 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.