Citation Nr: 20028070 Decision Date: 04/22/20 Archive Date: 04/22/20 DOCKET NO. 19-27 592 DATE: April 22, 2020 REMANDED Entitlement to service connection for erectile dysfunction is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1989 to December 1993. This matter comes before the Board from a December 2018 rating decision. The matter was most recent remanded by the Board in July 2019 for the issuance of a Statement of the Case (SOC). An SOC was issued in September 2019. The Board finds there is substantial compliance with the July 2019 remand directives. The issues of service connection for a sleep disorder, neck disorder, headaches, fibromyalgia, and chronic fatigue syndrome were also remanded in July 2019. The ordered development has yet to be completed in its entirety. Accordingly, those issues will be adjudicated in a future decision. 1. Entitlement to service connection for erectile dysfunction is remanded. The Veteran was afforded a VA examination in December 2018. The examiner opined that the Veteran’s diagnosed ED was less likely than not related to his service. Such was based on the finding that there was no indication of erectile issues in service or in the following years, and that to ascribe service correlation would amount to speculation. This opinion is inadequate. The Veteran was seen twice in service for painful erection. He was referred for a psychological evaluation to determine whether there was a psychological explanation for the pain. These complaints were not discussed, to include whether there was a relationship between these complaints and the Veteran’s current ED. There was also no discussion as to whether the Veteran’s diagnosed ED could be secondarily related to his now service connected depressive disorder. Additionally, there is an October 2018 medical note which indicates the Veteran’s ED could be related to his service-connected peripheral neuropathy of the lower extremities, to include the medication the Veteran takes for this condition. No VA examiner has opined as the whether the Veteran’s ED could be secondary to these conditions. Another VA examination is warranted to determine the etiology of the Veteran’s erectile dysfunction, to include whether it is related to the notations of painful erection in-service, and whether it is secondarily related to a service connected disability, to include the Veteran’s deprssive disorder and/or peripheral neuropathy. Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran’s diagnosed erectile dysfunction. After reviewing the claims file and examining the Veteran, the examiner should address the following: (a.) Opine whether it is at least as likely as not that the Veteran’s erectile dysfunction had its onset in service or is related to active service. The clinical significance, if any, of the Veteran’s in-service complaints of erectile pain must be addressed. (b.) Opine as to whether it is at least likely as not that the Veteran’s erectile dysfunction was proximately due to a service connected disability, to include his service-connected depressive disorder or peripheral neuropathy of the lower extremities. Consideration must be given to the medications used to treat those disabilities. (c.) Opine as to whether it is at least likely as not that the Veteran’s erectile dysfunction was aggravated by a service connected disability, to include his service-connected depressive disorder or peripheral neuropathy of the lower extremities. Consideration must be given to the medications used to treat those disabilities. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Rekowski The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.