Citation Nr: 18156976 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-58 423 DATE: December 11, 2018 ORDER Service connection for erectile dysfunction secondary to a service connected heart condition is denied. FINDING OF FACT The Veteran’s erectile dysfunction is neither proximately due to nor aggravated beyond its natural progression by his service-connected ischemic heart disorder and is not otherwise related to an in-service injury, event, or disease. CONCLUSION OF LAW The criteria for service connection for erectile dysfunction are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably from November 1964 to November 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for the Veteran’s erectile dysfunction. The Veteran contends that his erectile dysfunction is secondary to his ischemic heart disorder (IHD). The Veteran states in his September 2016 VA examination that he has suffered from erectile dysfunction for three to four years, and that he has trouble obtaining an erection and maintaining an erection. His medical records indicate that he was prescribed Viagra in January 2014 to assist getting an erection. The Veteran contends in his September 2016 VA examination that the Viagra is ineffective and he still has trouble obtaining an erection that allows penetration. The Veteran contends that the medication used to treat his IHD is the cause of his erectile dysfunction. The question for the Board is whether the Veteran has a current disability that is proximately due to or the result of, or was aggravated beyond its natural progress by service-connected disability. The Board concludes that the Veteran has a current diagnosis of erectile dysfunction. The September 2016 C&P Examination indicates a 2014 diagnosis of erectile dysfunction, and references the prescribed Viagra to treat the disability. However, the preponderance of the evidence is against finding that the Veteran’s erectile dysfunction is proximately due to or the result of, or aggravated beyond its natural progression by service-connected IHD. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). The September 2016 VA examiner opined that the Veteran’s erectile dysfunction is instead more likely due to the Veteran’s age, alcohol use, tobacco use, and an enlarged prostate, and was less likely than not due to the Veterans medication for IHD. The rationale was that the Veteran was diagnosed with IHD in 2001, and began treatment using the same medication he uses now at the time of the IHD diagnosis. The Veteran did not complain of erectile dysfunction until nearly 13 years after treatment for IHD began. He was not diagnosed with erectile dysfunction until 2014. While the Veteran believes his erectile dysfunction is proximately due to or the result of the service-connected disability, he is not competent to provide a nexus opinion about his claim. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the September 2016 VA examination than it does to the Veteran’s contentions regarding the cause of his disability. Service connection may also be granted on a direct basis, but the preponderance of the evidence is also against finding that the Veteran’s erectile dysfunction is related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). A review of the service treatment records indicated there was no complaint, diagnosis, or injury in service related to erectile dysfunction. Consequently, the Board denies the Veteran’s claim for service connection for erectile dysfunction secondary to his service connected IHD because the VA examiner concludes that the erectile dysfunction is less likely than not due to, or aggravated by, the IHD medicine and there is no competent evidence in support of service connection. M. H. Hawley Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Drew Kelly, Associate Counsel