Citation Nr: 22046292 Decision Date: 08/16/22 Archive Date: 08/16/22 DOCKET NO. 08-01 951 DATE: August 16, 2022 REMANDED Entitlement to service connection for a right testicular disorder, to include chronic epididymitis with transient hydrocele, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1972 to December 1976. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2007 rating decision of a Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). In a lengthy appellate history, the matter was most recently remanded in March 2022 to obtain an etiology opinion. The Board sincerely regrets the additional delay, but unfortunately the case must be remanded again to ensure substantial compliance with the March 2022 remand instructions. The Veteran testified at a September 2011 Board hearing that immediately after his in-service appendectomy in September 1974 he began experiencing symptoms of pain and swelling in his right testicle that persisted on and off ever since that time. The Board has previously remanded the matter several times to ensure that a VA examiner takes this evidence into account when providing an etiology opinion. Similarly, in the most recent March 2022 remand, the Board expressly directed that "[t]he examiner must specifically acknowledge and address the lay statements of the Veteran that he has experienced problems with his testicles since his September 1974 appendectomy." Yet, in the new June 2022 opinion obtained on remand, the examiner remarked that an April 1975 service treatment record in which the Veteran presented with an indurated, tender, enlarged area in the upper right thigh "is the only in-service complaint in the inguinal area," and there was no other discussion of the Veteran's testimony that he experienced symptoms in service ever since the September 1974 appendectomyin other words, both before and after the April 1975 record. Given this deficiency, the Board must continue to remand the matter in order to ensure that the Veteran's statements are fully considered. Dalton v. Nicholson, 21 Vet. App. 23, 39, 40 (2007); Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the Veteran's right testicular disorder, to include chronic epididymitis with transient hydrocele. The clinician must opine on all of the following: (a) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) any current right testicular disorder, to include chronic epididymitis with transient hydrocele, began in or was incurred during service (regardless of whether it was or was not related to the Veteran's in-service appendectomy)? (b) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) any current right testicular disorder, to include chronic epididymitis with transient hydrocele, is etiologically related to the Veteran's service (regardless of whether it was or was not related to the Veteran's in-service appendectomy)? (c)(i) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's symptoms since the date of his claim (approximately 2006) are due to "chronic pelvic pain syndrome" and/or "chronic prostatitis" (as discussed in the October 7, 2013 C&P opinion)? (c)(ii) If the Veteran has had a diagnosis of "chronic pelvic pain syndrome" and/or "chronic prostatitis," is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the condition began in or was incurred during service (regardless of whether it was or was not related to the Veteran's in-service appendectomy)? (c)(iii) If the Veteran has had a diagnosis of "chronic pelvic pain syndrome" and/or "chronic prostatitis," is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the condition is etiologically related to the Veteran's service (regardless of whether it was or was not related to the Veteran's in-service appendectomy)? In rendering these opinions, the clinician must consider and discuss: (i) The Veteran's statements that he has experienced the same symptoms, on and off, with his right testicle ever since post-surgery of his September 1974 appendectomy; (ii) An April 1975 service treatment note in which the Veteran presented with an indurated, tender, enlarged area in upper right thigh, provisionally diagnosed as lymphangitis (and a consultation report that agreed with lymphangitis); (iii) Another April 1975 treatment record reflecting the Veteran was treated for a mass in his upper leg/groin area, and was assessed with an impression of a possible swollen lymph node; and, (iv) A September 1980 medical examination (four years after separation) at which the Veteran complained of a problem with his testicles. 2. After the above development and any other development deemed necessary is completed, readjudicate the Veteran's claim. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Davis, 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.