BVA9502515 DOCKET NO. 92-08 454 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUES 1. Entitlement to service connection for residuals of surgery to remove the left testicle. 2. Entitlement to service connection for a disorder of the right testicle. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL Appellant and his spouse ATTORNEY FOR THE BOARD Michael P. Vander Meer, Associate Counsel INTRODUCTION The veteran served on active duty from June 8 to June 27, 1960, and from January 1963 to September 1963. This appeal arises from an April 1991 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina. This case was last before the Board of Veterans' Appeals (Board) in November 1993, at which time it was remanded for further development. A rating decision entered in May 1994 continued to deny the benefit sought on appeal, and a Supplemental Statement of the Case was issued the same months. The appeal was returned to and redocketed at the Board in September 1994. The case is now ready for appellate review. When this case was last before the Board in November 1993, the benefit sought by the veteran was framed in the single issue of entitlement to service connection for a disorder of the testes, including the residuals of surgery to remove the left testicle. However, in light of one of the dispositions reached in the decision below, the Board is of the opinion that the single issue listed for appeal when this case was last before the Board is more appropriately restated as the two issues listed on the title page of this decision. CONTENTIONS OF APPELLANT ON APPEAL The veteran acknowledges that he experienced an infection in his left testicle, with resultant atrophy, approximately one year preceding his entrance into his first period of service, but contends that, in any event, he was struck in the groin with a rifle butt in basic training during his second period of service, for which he received initial treatment at a medical facility at Fort Jackson, South Carolina. He states that he was thereafter transferred to Fort Sam Houston, Texas, during which period soreness involving his left testicle persisted and in response to which such testicle was surgically removed. He contends that service connection for residuals of such surgery is, therefore, warranted. Regarding his right testicle, he denies experiencing any problems involving such testicle prior to service, but states that, as a result of the rifle butt incident referred to above, he experienced pain in such testicle following his transfer to Fort Sam Houston, Texas. He states that pain in his right testicle persisted after the surgical removal of the left. He asserts that he currently experiences severe pain in his right testicle and contends, in essence, that he has current disability of the right testicle which is of service origin. DECISION OF THE BOARD In accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), following review and consideration of all evidence and material of record in the veteran's claims file, and for the following reasons and bases, it is the decision of the Board that the evidence is at least in equipoise and thus, with resolution of reasonable doubt in the veteran's favor, supports service connection for residuals of surgery to remove the left testicle; and that the preponderance of the evidence is against the veteran's appeal for service connection for a disorder of the right testicle. FINDINGS OF FACT 1. The veteran's left testicle was surgically removed, in response to suspected torsion involving such testicle, during peacetime service. 2. Any torsion or trauma to the right testicle in service did not result in a chronic disorder. CONCLUSIONS OF LAW 1. Residuals of surgery to remove the left testicle were incurred during peacetime service. 38 U.S.C.A. §§ 1131, 5107 (West 1991). 2. A chronic disorder of the right testicle was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5107 (West 1991); 38 C.F.R. § 3.303(b) (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board finds that the veteran's claims are well grounded within the meaning of 38 U.S.C.A. § 5107(a). That is, the Board finds that each claim is plausible. The Board is also satisfied that all relevant facts, with respect to either claim, have been properly developed, and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a). I. Residuals of Surgery to Remove the Left Testicle Under the law, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by peacetime service. 38 U.S.C.A. § 1131. The veteran contends that, notwithstanding that he experienced an infection involving his left testicle prior to his first period of service, he thereafter, during his second period of service, underwent the surgical removal of his left testicle in the aftermath of what he asserts was trauma to the testicle occasioned by being struck in the groin with a rifle butt during basic training. In this regard, when examined for service entrance purposes in May 1960, prior to his first period of service, the veteran was noted to have left testicular atrophy of 1 1/2 years' duration for which the cause was unknown. When examined for Medical Board purposes in June 1960, several weeks after entering service, the veteran indicated that he had experienced an episode of infection in the left testicle approximately one year earlier which had resulted in a small painful testis. Pursuant to diagnoses including, pertinently, atrophy of the left testis, the veteran was medically discharged from service in late June 1960. When the veteran was medically examined for service entrance purposes, preceding his second period of service, in September 1962, it was noted that the left testicle problem that had occasioned his previous discharge from service was no longer troublesome. In February 1963, the veteran complained of a painful left testicle. On a urology consult conducted in May 1963, he was noted to have an atrophic left testicle, and the examiner indicated that the veteran had probably sustained torsion involving such testicle on at least two occasions. Thereafter, although any surgical report that may have been prepared is not of record, the report of the veteran's September 1963 service separation examination reflects that he underwent the surgical excision of his left testicle due to torsion in June 1963. Most recently, the veteran's left testicle was noted to be missing when he was examined in the course of VA outpatient treatment in February 1991; when seen the following month, the veteran was noted to be status post left orchiectomy secondary to traumas experienced in the past. In considering this aspect of the veteran's appeal, the Board finds it significant that, notwithstanding the absence of any reference in the veteran's service medical records to the rifle butt incident to which he attributes the necessity of his June 1963 inservice surgery to remove his left testicle, the veteran was noted when examined the previous month to have sustained probable torsion to such testicle. On assessing such consideration in conjunction with the notation on his September 1963 service separation examination documenting the June 1963 surgical removal of his left testicle, the absence of which was confirmed in the course of VA outpatient treatment in February 1991, and when consideration is given to the reasonable doubt doctrine, the Board is of the opinion that service connection for residuals of surgery to remove the left testicle is in order. Accordingly, service connection for such disability is granted. 38 U.S.C.A. §§ 1131, 5107. II. Disorder of Right Testicle As noted above, under the law, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by peacetime service. However, continuity of symptomatology is required where a condition noted during service is not, in fact, shown to be chronic. 38 C.F.R. § 3.303(b). The veteran contends that he has current disability of the right testicle which is traceable to trauma sustained to such testicle in the inservice rifle butt incident referred to above. In this regard, when examined for Medical Board purposes in June 1960 during the veteran's first period of service, he complained of pain in the right testicle on any exertion. On examination, the right testis was slightly enlarged and the right epididymis was tender. The pertinent diagnoses were chronic right-sided epididymitis, with painful right testis secondary thereto. In February 1963, during his second period of service, the veteran complained of a painful right testicle which had increased in size without prior injury. On a May 1963 urology consult, the right testicle was normal, though the examiner suspected prior torsion, which had de-torsed spontaneously, involving such testicle. In August 1963, subsequent to the surgical removal of the veteran's left testicle, pain in the right testicle was noted to have persisted and the impression was right testicle neuralgia. On a mental hygiene consult in August 1963, it was noted that repeated examinations had failed to reveal any organic cause for the veteran's complaint of right testicular pain, and his testicular neuralgia was thought to be an exaggerated response to minimal pain. When the veteran was examined for service separation purposes in September 1963, no abnormality involving the right testicle was noted. Subsequent to service, when examined in the course of VA outpatient treatment in February 1991, at which time the veteran related that he had last experienced pain in the right testicle in 1978 when he was diagnosed as having epididymitis, his right testis was tender to palpation; the assessment was epididymitis. The assessment in March 1991, at which time the veteran complained of intermittent right testis swelling and pain when lifting or straining, was recurrent epididymitis. In considering the veteran's claim for service connection for a disorder of the right testicle, the Board is aware that, notwithstanding the absence of any reference in service medical records to the inservice rifle butt incident to the groin to which the veteran attributes his current right testicle disorder, presumably right-sided epididymitis, service medical evidence dated in May 1963 does reflect the suspicion of prior torsion to such testicle. However, following its review of the record, the Board is nevertheless of the opinion that service connection for a disorder of the right testicle is not warranted. In reaching the foregoing conclusion, the Board must emphasize that, despite the June 1960 Medical Board diagnosis of chronic right-sided epididymitis and the August 1963 assessment of right testicle neuralgia, there is no evidence of record documenting any treatment for a right testicle condition in the duration between the veteran's periods of service or, most significantly, in the immediate post service years following his final period of service, as would otherwise be indicative of a chronic condition of service origin. See 38 C.F.R. § 3.303(b). Rather, it appears that the veteran experienced no right testicle problem, based on the history he related to the VA outpatient examiner in February 1991, until 1978, when he was reportedly diagnosed as having epididymitis, with which condition he was diagnosed on VA outpatient treatment in 1991. Given the multiple year duration between the veteran's inservice right testicle problems and the apparently initial assessment in the late 1970's of any right testicle condition, the Board is of the opinion that any right testicular torsion or trauma experienced by the veteran in service did not result in a chronic disorder involving such testicle. In light of the foregoing consideration, and in the absence of any medical opinion relating the veteran's current right-sided epididymitis to service, the Board concludes that the preponderance of the evidence is against the veteran's appeal for service connection for a disorder of the right testicle. 38 U.S.C.A. §§ 1131, 5107(b); 38 C.F.R. § 3.303(b). ORDER Service connection for residuals of surgery to remove the left testicle is granted. Service connection for a disorder of the right testicle is denied. ROBERT E. SULLIVAN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.