Citation Nr: 23019082 Decision Date: 03/28/23 Archive Date: 03/28/23 DOCKET NO. 19-03 474A DATE: March 28, 2023 REMANDED Entitlement to service connection for frequent urinary infections is remanded. Entitlement to service connection for enlarged testicles is remanded. Entitlement to service connection for anemia is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to January 1972 and from June 1976 to May 1980. Evidence affiliated with the claims file indicates that the Veteran also served in the Reserve. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Baltimore, Maryland. 1. Service Connection - Frequent Urinary Infections 2. Service Connection - Enlarged Testicles 3. Service Connection - Anemia First, as noted above, there is evidence in the claims file indicating that the Veteran served in the Reserve outside his periods of active duty service, including service treatment records from between his periods of active duty service and a notice discharging the Veteran from the Ready Reserve in November 1989. Even though the claims file contains service treatment records and service personnel records reflecting the Veteran's performance, assignments, points, and awards, the precise dates of all periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) are not available. On remand, the RO should confirm the Veteran's periods of ACDUTRA and INACDUTRA. The RO should also obtain any and all outstanding Reserve medical records, if available. Second, the Board recognizes that the only post-service medical records available as relate to the Veteran's claims are from VA and most recently dated in October 2018 and received in January 2019. On remand, the Board requests that the RO verify whether the Veteran has seen any non-VA providers for his claimed conditions and obtain his updated VA medical records, as these outstanding records could evidence the presence of current disabilities. Finally, the Board notes that, to date, the Veteran has not been examined to determine the natures and causes of his above-claimed conditions. If the requested medical records indicate the presence of current disabilities, the RO should schedule the Veteran for appropriate examinations and obtain adequate opinions to determine the etiologies of his claimed disabilities. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. The RO should determine the specific dates of when the Veteran served on ACDUTRA and/or INACDUTRA. In this regard a report detailing the Veteran's award of Reserve retirement points will NOT represent compliance with this instruction. Rather, each and every date of active duty, ACDUTRA, and INACDUTRA, must be verified. Then, issue a memorandum for inclusion in the claims file detailing each period of active military service, whether on active duty, ACDUTRA, or INACDUTRA. Any and all outstanding service treatment records from the Veteran's Reserve service should also be obtained and associated with the claims file. 2. The RO should request the Veteran to identify any and all updated and/or outstanding VA and/or private medical records related to his claimed frequent urinary infections, enlarged testicles, and anemia. Appropriate efforts must be made to obtain these records if he has adequately identified them and authorized their release (with respect to any private medical records). He should also be invited to submit these records himself. All actions to obtain the requested records should be documented in the claims file. If they cannot be located or no such records exist, the Veteran and his representative should be so notified in writing. 3. If the obtained medical records indicate the presence of a current disability, the Veteran should be scheduled for an appropriate examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of the Veteran's frequent urinary infections. The entire claims file, including a copy of this remand, must be made available to the examiner, who must note its review. The examiner should opine as to whether it is at least as likely as not that the Veteran's frequent urinary infections manifested during, or are the result of, his active duty service, ACDUTRA, and/or any injuries incurred during INACDUTRA. In formulating his or her opinion(s), the examiner must consider and address the competent medical and lay evidence of record, including but not limited to: (i) The Veteran's service treatment records, including but not limited to a November 1974 Urologic Examination and a December 1974 service treatment record indicating that the Veteran was experiencing dysuria; (ii) The Veteran's service personnel records reflecting the date(s) during which he served on active duty service, ACDUTRA, and/or INACDUTRA; (iii) The Veteran's post-service medical records; and (iv) The Veteran's competent lay statements, including but not limited to those made to his medical providers, his August 2015 Notice of Disagreement (NOD), and his June 2018 Correspondence, regarding his first-hand in-service experiences and the onset and continuity of his symptomatology. If the examiner determines that the Veteran's frequent urinary infections are less likely than not due to his active duty service, ACDUTRA, and/or injuries incurred during INACDUTRA, the examiner should discuss what other factor(s) caused the disorder. In other words, the examiner should ascertain the most likely etiology of the Veteran's frequent urinary infections. A complete rationale must be provided for all opinions and conclusions reached. 4. If the obtained medical records indicate the presence of a current disability, the Veteran should be scheduled for an appropriate examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of the Veteran's enlarged testicles. The entire claims file, including a copy of this remand, must be made available to the examiner, who must note its review. The examiner should opine as to whether it is at least as likely as not that the Veteran's enlarged testicles manifested during, or are the result of, his active duty service, ACDUTRA, and/or any injuries incurred during INACDUTRA. In formulating his or her opinion(s), the examiner must consider and address the competent medical and lay evidence of record, including but not limited to: (i) The Veteran's service treatment records, including but not limited to those diagnosing the Veteran with epididymitis; (ii) The Veteran's service personnel records reflecting the date(s) during which he served on active duty service, ACDUTRA, and/or INACDUTRA; (iii) The Veteran's post-service medical records; and (iv) The Veteran's competent lay statements, including but not limited to those made to his medical providers, his August 2015 NOD, and his June 2018 Correspondence, regarding his first-hand in-service experiences and the onset and continuity of his symptomatology. If the examiner determines that the Veteran's enlarged testicles are less likely than not due to his active duty service, ACDUTRA, and/or injuries incurred during INACDUTRA, the examiner should discuss what other factor(s) caused the disorder. In other words, the examiner should ascertain the most likely etiology of the Veteran's enlarged testicles. A complete rationale must be provided for all opinions and conclusions reached. 5. If the obtained medical records indicate the presence of a current disability, the Veteran should be scheduled for an appropriate examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of the Veteran's anemia. The entire claims file, including a copy of this remand, must be made available to the examiner, who must note its review. The examiner should opine as to whether it is at least as likely as not that the Veteran's anemia manifested during, or is the result of, his active duty service and/or ACDUTRA. In formulating his or her opinion(s), the examiner must consider and address the competent medical and lay evidence of record, including but not limited to: (i) The Veteran's service treatment records; (ii) The Veteran's service personnel records reflecting the date(s) during which he served on active duty service, and/or ACDUTRA; (iii) The Veteran's post-service medical records; and (iv) The Veteran's competent lay statements, including but not limited to those made to his medical providers, his August 2015 NOD, and his June 2018 Correspondence, regarding his first-hand in-service experiences and the onset and continuity of his symptomatology. If the examiner determines that the Veteran's frequent urinary infections are less likely than not due to his active duty service, and/or ACDUTRA, the examiner should discuss what other factor(s) caused the disorder. In other words, the examiner should ascertain the most likely etiology of the Veteran's anemia. A complete rationale must be provided for all opinions and conclusions reached. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Hoffman 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.