BVA9503689 DOCKET NO. 93-14 066 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUES 1. Entitlement to an increased (compensable) evaluation for status postoperative left spermatocelectomy. 2. Entitlement to service connection for hemorrhoids. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD S. L. Kennedy, Counsel REMAND The veteran served on active duty from December 1953 to October 1955. This appeal arises from a November 1991 rating decision of the Department of Veterans Affairs (VA), San Juan, Puerto Rico, Regional Office (RO). In that decision, service connection for status postoperative spermatocelectomy was granted, and a noncompensable evaluation assigned, and service connection for hemorrhoids was denied. In connection with the current claim, the veteran appeared and presented testimony before a hearing officer at the RO in October 1992. At that time, it was noted that the veteran had been afforded a VA genitourinary examination in December 1990. It was asserted that the veteran had developed a disability of the right testicle secondary to his service-connected disability of the left testicle, and it was noted that the VA examiner in his report indicated that the veteran had a history of a left spermatocelectomy and a right hydrocelectomy. The veteran also claimed that he had become impotent as secondary to these disabilities. Although the veteran's representative stated that a VA Form 21-4138 (Statement in Support of Claim) would be forthcoming on the additional issues, the Board has determined that the veteran has clearly raised the issues of secondary service connection for a disability of the right testicle and entitlement to special monthly compensation based on the loss of use of a creative organ, both of which could potentially result in an increased evaluation in this case. Thus, the Board has determined that those issues are inextricably intertwined with the increased rating issue on appeal. Harris v. Derwinski, 1 Vet.App. 180 (1991). On remand, the RO should address those issues. The VA has a duty to assist a claimant in the development of facts pertinent to his or her claim under 38 C.F.R. § 3.103(a) (1993). The U. S. Court of Veterans Appeals has held that fulfillment of the VA's duty to assist the veteran includes providing him with a thorough and contemporaneous medical examination. Littke v. Derwinski, 1 Vet.App. 90, 92 (1990). The Board has reviewed the report of the December 1990 examination, and although the report does contain a reported medical history regarding disability relating to each testicle, the objective findings and diagnosis clearly relate only to the left testicle. The origin of the information regarding the nonservice-connected right testicle is unclear from the record. However, the Board has reviewed the report of this examination, and finds it to be inadequate for rating purposes in light of the veteran's most recent complaints of functional pain and impotence associated with his service-connected disability of the left testicle and in light of his secondary service-connection claim. Additionally, the Board notes that the RO also evaluated the veteran's service- connected status postoperative spermatocelectomy under the provisions of Diagnostic Code 7804 of the VA Schedule for Rating Disabilities; however, the VA examiner made no specific findings relating to the presence of a tender and painful scar. The RO should ensure that the veteran is afforded a complete VA genitourinary examination. Fulfillment of the duty to assist the appellant includes the procurement and consideration of any relevant VA or other medical records. Ferraro v. Derwinski, 1 Vet.App. 326 (1991). In additional written argument submitted to the Board and dated in March 1994, the veteran's accredited representative in this case noted that although the record contains several references to medical treatment provided to the veteran for pain associated with the service-connected disability at issue, those records have not been associated with the appellate record. The Board notes that the veteran in his initial claim application and at his personal hearing held at the RO in October 1992 made reference to treatment of his service-connected disability both at a VA medical facility and at a private medical facility. The RO should ensure that all pertinent VA and private medical records are associated with the record on appeal. In view of the foregoing, and in order to fully and fairly adjudicate the veteran's claim, the case is REMANDED to the RO for the following action: 1. The veteran should identify all sources of medical treatment, both private and VA, received for both the service-connected left testicle and the nonservice-connected right testicle and furnish signed authorizations for release to the VA of private medical records in connection with each non-VA medical source he identifies. Copies of the medical records from all sources he identifies (not already in the claims folder) should then be requested. All records obtained should be added to the claims folder. 2. The veteran should be afforded a VA genitourinary examination to determine the nature and extent of the veteran's service- connected status postoperative left spermatocelectomy and to determine the etiology of any disability of the right testicle. All pertinent complaints or symptoms having a medical cause should be covered by a definite diagnosis. The examinations should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. All indicated diagnostic tests and procedures should be accomplished. The report should summarize all significant positive findings. All disability should be evaluated in relation to its history, with emphasis upon the limitation of activity, to include employability, and any functional loss due to pain, imposed by the disorder in light of the whole recorded history. The examiner should describe in detail symptomatology related to any postoperative scar of the left testicle. All symptomatology related to any nonservice-connected disability should be discussed, and the examiner is requested to express a medical opinion as to the degree of probability that a disability of the right testicle is proximately due to the veteran's service-connected disability of the left testicle. The examiner should describe in detail any loss of use of the creative organ. The claims folder should be made available to the examiner prior to the examination. 3. Thereafter, the RO should readjudicate the veteran's claim of entitlement to an increased evaluation for status postoperative left spermatocelectomy and adjudicate the claims of entitlement to secondary service connection for a disability of the right testicle and claim of entitlement to special monthly compensation on account of loss of use of a creative organ. The RO should then issue a supplemental statement of the case which addresses all issues for which a notice of disagreement has been received. The supplemental statement of the case should include a summary of additional evidence, pertinent laws and regulations, and the reasons for the decision. The veteran and his representative should be afforded the applicable time to respond. The case should then be returned to the Board for further appellate review. The purpose of this REMAND is to obtain additional evidence and ensure that the veteran is afforded all due process of law. A decision on the issue of service connection for hemorrhoids is deferred pending completion of the additional development requested pursuant to this REMAND. The Board intimates no opinion, either factual or legal, as to the ultimate conclusion warranted in this case. CHARLES E. HOGEBOOM 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. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This action has been taken in accordance with the Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).