## Facts

- Newman Akles incurred mumps during active duty, resulting in complete atrophy of his left testicle.
- VA granted service connection for the condition but assigned a noncompensable (0%) rating.
- Akles later sought to reopen/increase the rating based on increased pain, but he submitted no new clinical evidence documenting greater severity.
- VA denied the request without obtaining a current medical examination, citing insufficient clinical evidence.
- The record implicated potential entitlement to special monthly compensation (SMC) for loss or loss of use of a creative organ, but VA did not inform Akles of SMC or adjudicate it.
- The Board of Veterans’ Appeals affirmed, also without ordering an examination and without addressing SMC.
- Akles appealed to the United States Court of Veterans Appeals.

## Issues

1. Whether the Board must consider and adjudicate entitlement to SMC when that benefit is reasonably raised by the record, even if the veteran did not expressly claim it or cite the governing provision.
2. Whether the Board violated the duty to assist by denying for lack of clinical support without obtaining a medical examination to develop the record.

## Decision

- The court held the Board erred by failing to consider and adjudicate SMC when the record reasonably raised entitlement to that benefit.
- The court held the Board also erred by failing to adequately develop the claim, including by not obtaining a medical examination, while relying on an asserted lack of clinical evidence.
- The court vacated the Board’s decision in relevant part and remanded for further proceedings consistent with its opinion.

## Legal Principles

- VA must adjudicate benefits and theories of entitlement reasonably raised by a liberal reading of the record, even if the veteran does not identify the precise legal label or regulatory citation.
- The Board may not disregard a potential benefit supported by the facts simply because it was not explicitly claimed.
- The duty to assist requires VA to help develop evidence necessary to decide a claim; when severity is at issue and the record is inadequate, this can require providing a medical examination.
- Denying a claim for lack of clinical evidence while declining to develop the record can constitute legal error warranting remand.

## Conclusion

The court required VA to consider SMC and other benefits reasonably raised by the evidence and to fulfill the duty to assist by developing an adequate record, including obtaining examinations when needed, before denying claims for insufficient medical support.


Akles v. Derwinski, 1 Vet. App. 118 (1991)