Citation Nr: 21041376 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 17-42 460 DATE: July 9, 2021 REMANDED The issue of entitlement to service connection for prostate cancer is remanded. The issue of entitlement to service connection for erectile dysfunction is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1974 to February 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). There was a May 2021 Board hearing before the undersigned Veterans Law Judge (VLJ), and the transcript is of record. 1. The issue of entitlement to service connection for prostate cancer is remanded. VA is obligated to provide an examination when there is competent medical evidence of a disability that may be associated with an in-service event, injury, or disease, but there is insufficient information to decide on the claim. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Although the Veteran in this case attributes his prostate cancer to asbestos exposure while in service, the Board takes note that he was diagnosed with and treated for acute urethritis due to gonococcus while in service. A VA medical opinion is necessary to clarify whether the Veteran's in-service urethritis and gonococcal infection lead to his prostate cancer. 2. The issue of entitlement to service connection for erectile dysfunction is remanded. The Veteran asserts that his erectile dysfunction is secondary to his prostate cancer. See 9/19/2014 VA 21-0820; 5/17/2021 Hearing Transcript. Because the Board is remanding the issue of entitlement to service connection for the Veteran's prostate cancer for an additional medical opinion, a decision on service connection for his erectile dysfunction would be premature. Where a pending claim is inextricably intertwined with a claim currently on appeal, the appropriate remedy is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Forward the claims file, including a copy of this remand to an appropriate clinician to provide a medical opinion regarding the nature and etiology of the Veteran's prostate cancer. The examiner is asked to review the file and then address the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's prostate cancer had its onset in, was caused by, or is otherwise related to service? The examiner should specifically address the Veteran's in-service gonococcal infection and urethritis diagnosis. A complete rationale for the examiner's opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner's lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion. 2. Is it at least as likely as not (50 percent probability or greater) that the Veteran's erectile disfunction had its onset in, was caused by, or is otherwise related to service? The examiner should specifically address the Veteran's in-service gonococcal infection and urethritis diagnosis, and his contention that the provision of saltpeter in service to reduce his sexual appetite may have later caused erectile dysfunction. A complete rationale for the examiner's opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner's lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion S.C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sloley, 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.