Citation Nr: 18159527 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 16-59 924 DATE: December 20, 2018 ORDER Entitlement to service connection for erectile dysfunction is granted. FINDING OF FACT The Veteran was prescribed Viagra in service and was diagnosed with erectile dysfunction within one year of service separation. CONCLUSION OF LAW Resolving all reasonable doubt in the Veteran’s favor, the criteria for service connection for erectile dysfunction are met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1978 to September 1990, from June 2006 to August 2007, and from October 2007 to September 2014. This matter comes to the Board of Veterans’ Appeals (Board) from a November 2015 rating decision which, in pertinent part, denied entitlement to service connection for erectile dysfunction. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 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). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The U.S. Court of Appeals for Veterans Claims (Court) has held that “Congress specifically limits entitlement to service-connected disease or injury to cases where such incidents have resulted in a disability. In the absence of proof of a present disability, there can be no valid claim.” Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); see also Rabideau v. Derwinski, 2 Vet. App. 141, 143-44 (1992). Where the evidence shows a “chronic disease” in service or “continuity of symptoms” after service, the disease shall be presumed to have been incurred in service. For the showing of a “chronic” disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With a chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of “continuity of symptoms” after service is required for service connection. 38 C.F.R. § 3.303(b). Additionally, where a veteran served ninety days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137 (2012); 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Id. Entitlement to service connection for erectile dysfunction. The Veteran contends that service connection is warranted for erectile dysfunction. The Board concludes that the Veteran has a current diagnosis of erectile dysfunction that is related to active service. By way of background, an August 2009 private treatment record reflects that the Veteran reported a history of decreased libido while on blood pressure medication, but that this resolved with the discontinuation of the medication. The Veteran’s service treatment records are silent for complaints of erectile dysfunction. However, a November 2012 service treatment record reflects that the Veteran’s was prescribed Viagra, which was last filled in November 2011, with five of eleven refills remaining. An April 2013 compensation and pension examination report associated with the Veteran’s Physical Evaluation Board proceedings was negative for a reported history of erectile dysfunction. The Veteran separated from service in September 2014. A September 2014 VA treatment progress note to establish care with the VA reflects that the Veteran reported sexual dysfunction. The Veteran was diagnosed with erectile dysfunction and prescribed Viagra. The Veteran was afforded a VA examination in November 2015. The Veteran reported that he began having problems achieving an erection in 2010, and that he was prescribed Viagra, which he found partially effective. The examiner provided a diagnosis of erectile dysfunction with onset in 2014, which was likely age-related given onset. The Board finds the November 2015 VA examiner’s opinion as to etiology less probative, as it is not clear whether the examiner considered the Veteran’s prescription for Viagra in 2011 while in service. The Board finds that erectile dysfunction is a condition susceptible to lay observation. The Veteran is competent to report that he experienced symptoms of erectile dysfunction while in service. Moreover, the symptoms resulted in a diagnosis by a medical professional, at the latest in September 2014, the same month as the Veteran’s separation from service. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Thus, the Board finds the Veteran’s lay statements concerning onset in service competent and credible. The Board finds the evidence is at least in equipoise that the Veteran’s erectile dysfunction was incurred in active service. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Service connection is warranted. 38 C.F.R. § 3.303(a). K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Owen, Associate Counsel