Citation Nr: 18148678 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 14-10 735A DATE: November 8, 2018 ORDER Entitlement to service connection for erectile dysfunction, as secondary to post-traumatic stress disorder and/or diabetes mellitus type 2, is denied. FINDING OF FACT The preponderance of evidence is against finding that the Veteran’s erectile dysfunction was not, caused or aggravated by, the Veteran’s service connected post-traumatic stress disorder (PTSD), or diabetes mellitus type 2 (diabetes). CONCLUSION OF LAW The criteria for service connection for erectile dysfunction, as secondary to post-traumatic stress disorder and diabetes mellitus type 2, are not met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1967 to May 1969. The Veteran appeals a December 2011 rating decision from the Department of Veteran Affairs (VA) Regional Office (RO) in Louisville, Kentucky. This case comes back to the Board from a September 2015 Board remand order. The September 2015 remand order requested the RO schedule an examination for the Veteran’s erectile dysfunction. The Veteran underwent the new VA examination in November 2015, and a supplemental statement of the case was issued in March 2016. The Veteran did not request a Board hearing in his March 2014 VA Form 9. The Veteran’s representative submitted an appellate brief in April 2015 and October 2018. Service Connection The Veteran asserts that his erectile dysfunction was caused, or aggravated by the Veteran’s service connected PTSD, and/or diabetes. Service connection is warranted where the evidence of record establishes that a particular injury or disease results in a present disability that incurred in the line of duty during active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Secondary service connection requires: (1) a service connected disability; (2) a nonservice connected disability; and (3) evidence that the nonservice connected disability is either (a) proximately due to or the result of the service-connected disability or (b) aggravated (increased in severity) by the service-connected disability. See 38 C.F.R. § 3.310. Entitlement to service connection for erectile dysfunction, as secondary to post-traumatic stress disorder and diabetes mellitus type 2 The Veteran was currently diagnosed with erectile dysfunction in the November 2015 VA examination. The Veteran has been service connected for PTSD and diabetes. As such, the Veteran’s claim turns on whether the Veteran’s erectile dysfunction is caused or aggravated by either the Veteran’s PTSD or diabetes. The Veteran’s service treatment records do not show symptoms of erectile dysfunction. Rather, the service treatment records show treatments for a tonsillectomy, bronchitis, elbow and feet pain, hernia, and a cold. The evidence of records shows the Veteran began treatment for erectile dysfunction since April 2007. However, in a May VA 2004 medical note the Veteran stated that he was not sexually active, and thus he did not know if he had erectile dysfunction. Additionally, the evidence of record shows that the Veteran underwent the same, or a similar treatment for erectile dysfunction since April 2007. The Veteran underwent a VA examination in November 2015. The VA examiner noted that the Veteran was first diagnosed with erectile dysfunction in 2007. But, the VA examiner stated that because the Veteran stated that he was not sexually active in 2004, the Veteran’s erectile dysfunction could have started as far back as 2004. Regarding PTSD, the VA examiner stated that the Veteran’s PTSD was diagnosed around 1980. Thus, the VA examiner opined that had PTSD caused the Veteran’s erectile dysfunction, the Veteran’s erectile dysfunction would have begun earlier than 2004-2007. Next, the VA examiner opined that she could not find PTSD aggravated the Veteran’s erectile dysfunction. The VA examiner based this opinion on the presence in the Veteran of other risk factors of erectile dysfunction such as, smoking, weight, hypertension, and dyslipidemia. Regarding the relationship between diabetes and erectile dysfunction, the VA examiner opined that the Veteran’s diabetes did not cause or aggravate the Veteran’s erectile dysfunction. First, the VA examiner observed that the Veteran’s diabetes was not diagnosed until 2013, a few years after the Veteran’s erectile dysfunction was diagnosed (2007). As such, the Veteran’s diabetes did not cause the Veteran’s erectile dysfunction. Next, the VA examiner reported that the Veteran’s diabetes was under decent control, and that the Veteran was undergoing the same treatment for erectile dysfunction shortly after the time that the diabetes was diagnosed. Therefore, the Veteran’s erectile dysfunction was not aggravated by the Veteran’s diabetes. The Board finds the VA medical examiner’s opinion probative. It is based on the evidence of record, and medically logical in its reasoning. For example, the VA examiner pointed out, from the VA medical records, several other risk factors of erectile dysfunction present that could be aggravating the disability. Further, the evidence of record shows the Veteran undergoing the same treatment for erectile dysfunction after his diabetes diagnosis. The Board acknowledges the Veteran’s representative argues that the VA examiner is not competent. The Veteran’s representative attacks competency on the grounds that the VA examiner is not a “demonstrated expert” in PTSD or psychiatric medicine, and is not a urologist. Even when the claimant challenges a VA examination or opinion, the Board may assume the competency of the VA medical examiner as long as, under 38 C.F.R. § 3.159(a)(1), the examiner is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. See Cox v. Nicholson, 20 Vet. App. 563 (2007). Here, the examiner's competency is challenged based solely on not being a psychologist, psychiatrist, or urologist. No additional evidence or compelling argument has been submitted to indicate that the VA examiner is not otherwise qualified to offer diagnoses and nexus opinions pursuant to 38 C.F.R. § 3.159(a)(1). Accordingly, the Board finds that the VA examiner is competent and the examination is adequate for adjudication purposes. The Board does not deny that the Veteran has a problem with erectile dysfunction. But only that the evidence of record does not show that the erectile dysfunction was caused or aggravated by PTSD or diabetes. Based on the above, the Board finds that service connection for the Veteran’s erectile dysfunction, as secondary to PTSD or diabetes, is not warranted. John Crowley Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Timothy A. Campbell, Associate Counsel