Citation Nr: 21001376 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 18-00 244 DATE: January 7, 2021 ORDER Service connection for erectile dysfunction (ED) as due to inguinal hernia surgery is granted. A 10 percent rating for a painful inguinal hernia surgical scar is granted. REMANDED A compensable rating for bilateral hearing loss is remanded. A compensable rating for right inguinal hernia repair is remanded. A compensable rating for an umbilical hernia is remanded. FINDINGS OF FACT 1. The preponderance of the evidence establishes that the Veteran’s ED is related to his service connected hernia surgical repair. 2. The Veteran’s inguinal hernia repair scar is painful. CONCLUSIONS OF LAW 1. The criteria for service connection for ED are met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.3.09, 3.310. 2. The criteria for a separate 10 percent rating for a painful right inguinal surgical scar are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.20, 4.27, 4.118, Diagnostic Code (DC) 7804. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1979 to September 1983. In November 2020, the Veteran testified before the undersigned Veterans’ Law Judge. A copy of the transcript is associated with the record. Service Connection Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. ED The Veteran has sought service connection for ED as a result of his in-service hernia surgery. The Veteran is service connected for his hernia surgery and residuals. In his November 2020 hearing, and other statements of record, the Veteran has stated that his ED began in service after his hernia surgery. Private medical records and a January 2016 VA examination confirm the Veteran has been diagnosed with ED. Though the VA examiner was unable to provide an opinion beyond speculation as to the etiology of the Veteran’s ED, a March 2016 private medical opinion from the Veteran’s treating provider stated that it was more likely than not that the Veteran’s ED was related to his in-service hernia surgical procedure. As such, the evidence of record supports a finding that the Veteran’s ED was proximately due to a service connected condition. Thus, service connection for ED is granted. Increased Rating Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3. Hernia Scar The Veteran is service connected for scars related to his service connected hernia surgeries and residuals thereof. A January 2016 VA examination found the Veteran had three scars related to laparoscopic umbilical hernia procedure and one scar related to his inguinal hernia surgery. The Veteran has specifically stated that he was not appealing the 20 percent rating associated with his 3 laparoscopic surgical scars but was appealing the non-compensable rating assigned to his inguinal hernia procedure scar pursuant to DC 7805. In his VA examination and his November 2020 hearing, the Veteran stated that all of his hernia scars were painful. DC 7804, which addresses scars which are unstable or painful, specifically provides for a 10 percent rating for one painful scar. Thus, the Veteran’s inguinal hernia procedure scar warrants a 10 percent rating under DC 7804. The Board has considered if higher ratings are applicable. However, higher ratings available under DCs 7800 or 7801 are not warranted as the scar does not affect the Veteran’s head, face, or neck and has not been shown to have underlying soft tissue damage. REASONS FOR REMAND Bilateral Hearing Loss Right Inguinal Hernia Umbilical Hernia The Veteran stated in his November 2020 hearing testimony that his bilateral hearing loss and hernia residuals have increased in severity since his last VA examinations in 2016 and 2017, respectively. As such, new VA examinations are warranted. The matters are REMANDED for the following action: 1. Schedule a VA audiometric examination to determine the current severity of the Veteran’s bilateral hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms. To the extent possible, the examiner should identify any symptoms and functional impairments due to bilateral hearing loss alone and discuss the effect of the Veteran's hearing loss on any occupational functioning and activities of daily living. The examiner must also describe the effect of the Veteran’s hearing loss on his occupational functioning and daily activities. 2. Schedule a VA examination to determine the current severity of the Veteran’s service-connected right inguinal and umbilical hernias. All necessary tests should be performed, and the results reported. All symptomatology associated with the hernias, including use of a truss or belt, should be reported. The examiner is asked to address the residual symptomology and service connected conditions associated with the Veteran’s hernias, including that of his right hip, right groin, and abdomen. If separate examinations are necessary for evaluation of these conditions, such examinations should be scheduled and conducted accordingly. In addition to objective test results, the examiner should fully describe the functional effects caused by the Veteran’s hernia, including the effect of his hernia on his occupational and daily functioning. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Parrish, Counsel 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.