Citation Nr: 21004593 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 15-03 680 DATE: January 27, 2021 REMANDED Entitlement to service connection to erectile dysfunction, to include as secondary to his service-connected disabilities is remanded. Entitlement to Special Monthly Compensation (SMC) based on loss of use of a creative organ is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1961 to December 1963. The Veteran’s service connection claims and SMC claim based on loss of use of a creative organ were before the Board in November 2018. The Board denied the claims on the merits. The Veteran timely appealed the claim to the U.S. Court of Appeals for Veterans Claims (CAVC or Court). In a joint motion for partial remand, the Court set aside and remanded the Veteran’s service connection for erectile dysfunction and SMC claims, stating that the Board did not provide sufficient reasons and bases for the decision. The case has been returned to the Board for further development and adjudication of the issues on appeal. 1. Entitlement to service connection to erectile dysfunction, to include as secondary to his service-connected disabilities is remanded. According to the Court’s joint motion for partial remand, the Veteran’s representative asserted that the Veteran’s erectile dysfunction was a result of his service-connected disabilities and/or the medication he is taking for his service-connected disabilities. See August 2015 Notice of Disagreement. The Veteran was afforded VA examinations in January 2014 and March 2014, where the examiners opined that his erectile dysfunction was not caused by his service-connected lumbar spine disability. However, the examiners did not provide an opinion as to the Veteran’s other service-connected disabilities, as well as the medications he takes for his service-connected disabilities. Additionally, according to the January 2014 examiner’s rationale, he stated that “[c]hronic illness [also] contributes to the problem. This veteran has COPD, pulmonary fibrosis, sleep apnea, severe GERD, and rheumatoid arthritis.” According to the Veteran’s rating codesheet, he is service connected for COPD/pulmonary fibrosis and gastritis. Therefore, the Board finds that an additional examination is warranted to provide clarification on the January 2014 opinion, as well as an adequate opinion for his other service-connected disabilities. 2. Entitlement to SMC based on loss of use of a creative organ is remanded. The Board finds that the adjudication of the Veteran’s service connection claim for erectile dysfunction must be completed prior to the adjudication of the Veteran’s SMC claim, as the adjudication of the service connection claim will affect the Veteran’s SMC claim. See Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc) (explaining that claims are inextricably intertwined where the adjudication of one claim could have a significant impact on the adjudication of another claim). The matters are REMANDED for the following action: 1. Obtain an opinion by an appropriate medical examiner to determine the nature and etiology of his erectile dysfunction. The necessity of an in-person examination, with any appropriate testing, is left to the discretion of the examiner. The examiner should opine to the following: Whether it is at least as likely as not (50 percent or greater probability) that his erectile dysfunction is (1) caused by the service-connected disabilities, or (2) aggravated (a medically discernible increase in disability) by the service-connected disabilities. In doing so, the examiner should address the rationale provided by the January 2014 VA examiner noting that the Veteran’s “[c]hronic illness [also] contributes to the problem. This veteran has COPD, pulmonary fibrosis, sleep apnea, severe GERD, and rheumatoid arthritis” in the context that the Veteran is service-connected for COPD/pulmonary fibrosis and gastritis. Whether the Veteran’s erectile dysfunction is at least as likely as not caused by or aggravated by the medication(s) (a medically discernible increase in disability) that he has been prescribed for his service-connected disabilities. (continued on the next page) The examiner must provide a complete rationale for all expressed opinions. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Adeleke, Tomi 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.