Citation Nr: 1019786 Decision Date: 05/27/10 Archive Date: 06/09/10 DOCKET NO. 06-00 943 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Denver, Colorado THE ISSUE Entitlement to service connection for erectile dysfunction, to include as secondary to service-connected urethral stricture. ATTORNEY FOR THE BOARD Helena M. Walker, Associate Counsel INTRODUCTION The Veteran served on active duty from April 1984 to April 2004. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2005 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Denver, Colorado, which denied the benefits sought on appeal. In December 2008, the Board remanded the Veteran's claim for further development-including a VA examination. The VA examination was scheduled and the Veteran indicated that he did not wish to attend the examination. As such, the Board finds that the actions requested in the remand were substantially complied with and the claim is properly before the Board for review. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the Veteran's appeal has been obtained. 2. The Veteran is not currently shown to have erectile dysfunction attributable to service or a service-connected disability. CONCLUSION OF LAW Erectile dysfunction was not caused or worsened by service, nor is it due to a service-connected disability. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. §§ 3.303, 3.310 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSION Before assessing the merits of the appeal, VA's duties under the Veterans Claims Assistance Act of 2000 (VCAA) must be examined. The VCAA provides that VA shall apprise a Veteran of the evidence necessary to substantiate his claim for benefits and that VA shall make reasonable efforts to assist a Veteran in obtaining evidence unless no reasonable possibility exists that such assistance will aid in substantiating the claim. In letters dated in January 2005, July 2005, March 2006, and March 2009, VA notified the Veteran of the information and evidence needed to substantiate and complete his claim for service connection, including what part of that evidence he was to provide and what part VA would attempt to obtain for him. See 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). The letters also generally advised the Veteran to submit any additional information in support of his claim. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). Additional notice of the five elements of a service-connection claim, as is now required by Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006), was provided in the March 2006 notice. As such, the Board finds that VA met its duty to notify the Veteran of his rights and responsibilities under the VCAA. With respect to the timing of the notice, the Board points out that the United States Court of Appeals for Veterans Claims (Court) held in Pelegrini that a VCAA notice, as required by 38 U.S.C.A. § 5103(a), must be provided to a claimant before the initial unfavorable agency of original jurisdiction (AOJ) decision on a claim for VA benefits. In this case, the January 2005 notice was given prior to the appealed AOJ decision, dated October 2005. Under these circumstances, the Board finds that the notification requirements of the VCAA have been satisfied as to both timing and content. The Board also finds that VA has complied with the VCAA's duty to assist by aiding the Veteran in obtaining evidence and by affording him the opportunity to give testimony before an RO hearing officer and/or the Board, even though he declined to do so. VA attempted to schedule the Veteran for a VA examination pursuant to the December 2008 remand. The Veteran indicated to VA personnel that he did not wish to attend the examination, and asked that his claim be transferred to the Board for review. The Veteran did not ask that his VA examination be rescheduled. As such, the Board will proceed on the basis of the evidence currently of record. It appears that all known and available records relevant to the issue here on appeal have been obtained and are associated with the Veteran's claims file. Thus, the Board finds that VA has done everything reasonably possible to notify and assist the Veteran and that no further action is necessary to meet the requirements of the VCAA. The Veteran essentially contends that his claimed erectile dysfunction was caused following his in-service treatment for a urethral stricture. Of note, the Veteran is currently service-connected for his urethral stricture. Service connection for VA compensation purposes will be granted for a disability resulting from disease or personal injury incurred in the line of duty or for aggravation of a preexisting injury in the active military, naval or air service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). There must be competent evidence showing the following: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and a disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247 (1999). Service connection may also be granted for a disability medically shown to be proximately due to or the result of a service-connected disability. See 38 C.F.R. § 3.310(a). Effective October 10, 2006, the regulations also provide for the award of secondary service connection based on aggravation of a nonservice-connected disability by a service-connected disability. See 71 Fed. Reg. 52744-52747 (Sept. 7, 2006) (to be codified at 38 C.F.R. § 3.310(b)). The Veteran's service treatment records (STRs), including his enlistment and separation medical examinations, are devoid of any treatment for, or complaints of, erectile dysfunction. In June 2001, the Veteran was treated for urinary complaints. He was assessed as having dysuria and post-void dribbling with possible mild BPH or prostatitis. In March 2004, the Veteran underwent a cystoscopy with visual internal urethrotomy. He was diagnosed as having a bulbar urethral stricture. Post-service treatment records are devoid of a finding of erectile dysfunction. An August 2004 VA examination reflects the Veteran's reports of "some element of erectile dysfunction" and treatment with Cialis. Also noted was the Veteran's assertion that the Cialis did not benefit him. The Veteran also indicated that because he was not married or did not have a girlfriend, he was not concerned about his sexual function. This examiner did not diagnose erectile dysfunction, nor were any erectile difficulties noted to be due to his service-connected urethral stricture. During a May 2006 VA examination, the Veteran reported being able to have a very slight erection, but insufficient for penetration. He advised that he had experienced this for over one year. He also reported using Cialis with no benefit. This examiner also did not diagnose erectile dysfunction, nor were any erectile difficulties noted to be due to his service-connected urethral stricture. Given the evidence as outlined above, the Board finds that the Veteran is not entitled to service connection for erectile dysfunction. Although the Veteran has twice reported erectile difficulties, there is no current diagnosis of erectile dysfunction. Additionally, the clinical evidence of record is devoid of any finding of erectile dysfunction as due to his service-connected urethral stricture. VA sought a clinical diagnosis and medical opinion regarding the claimed erectile dysfunction in December 2008 when the Board remanded this aspect of his appeal. Again, the Veteran declined to be examined and wished his claims file to be sent to DC. As such, the Board reaches this conclusion based only upon the evidence of record. The Board appreciates the Veteran's assertions regarding his claimed erectile dysfunction being attributable to service, but notes that the Veteran is competent, as a layman, to report that as to which he has personal knowledge-such as having difficulty achieving erections. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). He is not, however, competent to offer a medical diagnosis of erectile dysfunction or a medical opinion as to cause or etiology of the claimed erectile dysfunction as being due to his service-connected urethral stricture, as there is no evidence of record that the Veteran has specialized medical knowledge. See Routen v. Brown, 10 Vet. App. 183, 186 (1997) ("a layperson is generally not capable of opinion on matter requiring medical knowledge"), aff'd sub nom. Routen v. West, 142 F.3d 1434 (Fed. Cir. 1998), cert. denied, 119 S. Ct. 404 (1998); Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Based upon review of the evidence of record, the Board finds that the Veteran is not entitled to service connection for erectile dysfunction as there is no evidence of current disability. Absent a disease or injury incurred during service or as a consequence of a service-connected disability, the basic compensation statutes cannot be satisfied. See Sanchez-Benitez v. Principi, 259 F.3d 1356, 1361 (Fed. Cir. 2001). The Board appreciates the Veteran's contentions, but in the absence of evidence of a present disability, there can be no valid claim. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Therefore, because there is no evidence of erectile dysfunction related to the Veteran's service or a service-connected disability, service connection must be denied. (CONTINUED ON NEXT PAGE) ORDER Service connection for erectile dysfunction is denied. ____________________________________________ James L. March Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs