Citation Nr: 21067056 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 13-20 251 DATE: November 3, 2021 REMANDED Entitlement to a disability rating in excess of 20 percent for diabetes mellitus, type II with erectile dysfunction, is remanded. Entitlement to a disability rating in excess of 10 percent for left upper extremity, diabetic neuropathy, is remanded. Entitlement to a disability rating in excess of 10 percent for right upper extremity, diabetic neuropathy, is remanded. Entitlement to a disability rating in excess of 10 percent for left lower extremity, sciatic nerve, is remanded. Entitlement to a disability rating in excess of 10 percent for right lower extremity, sciatic nerve, is remanded. Entitlement to a disability rating in excess of 10 percent for left lower extremity, femoral nerve, is remanded. Entitlement to a disability rating in excess of 10 percent for right lower extremity, femoral nerve, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from April 1967 to April 1971. The Veteran died in April 2020, and the Veteran's spouse has been substituted as the appellant. These matters came before the Board of Veterans' Appeals (Board) on appeal from a September 2009 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) which denied entitlement to a disability rating in excess of 20 percent for diabetes mellitus, type II, with erectile dysfunction. In January 2017 and September 2018, the Board remanded the diabetes mellitus issue on appeal for further development. In July 2019, the Board denied a disability rating in excess of 20 percent for diabetes mellitus, type II, with erectile dysfunction. The appellant filed a timely appeal with the United States Court of Appeals for Veterans Claims (Court). Pursuant to a June 2021 Joint Motion for Remand (JMR) and Court Order, the Board's decision was vacated and remanded for action consistent with the JMR. Per the JMR, it was found that the Board failed to determine whether it had jurisdiction of the diabetic neuropathy issues as part of the diabetes mellitus issue. It is noted that during the course of the appeal in a May 2017 rating decision, service connection was granted for left upper extremity, diabetic neuropathy (10%); right upper extremity, diabetic neuropathy (10%); left lower extremity, sciatic nerve (10%); right lower extremity, sciatic nerve (10%); left lower extremity, femoral nerve (10%); right lower extremity, femoral nerve (10%), all effective May 12, 2011. The Board finds that such ratings are part and parcel of the diabetes mellitus issue, thus the Board will take jurisdiction of whether increased ratings are warranted. Per the JMR, with regard to the Veteran's erectile dysfunction, a retrospective opinion must be sought as to whether he had deformity with loss of erectile power, to include a determination as to whether his prostate hyperplasia constituted a penile deformity. A determination must also be made as to whether the Veteran is entitled to special monthly compensation (SMC) based on loss of use of a creative organ. SMC is payable at a specified rate if the Veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of one or more creative organs. 38 U.S.C. § 1114(k), 38 C.F.R. § 3.350(a). Impotence is tantamount to loss of use of a creative organ. See 38 C.F.R. § 4.115b, Diagnostic Code 7522. With regard to the Veteran's neuropathy, a retrospective opinion must be sought as to the severity of his neuropathy affecting the upper and lower extremities. On Remand, associate updated VA outpatient treatment records for the period from February 21, 2020 to April 3, 2020. The matters are REMANDED for the following actions: 1. Associate updated VA treatment records for the period from February 21, 2020 to April 3, 2020. 2. Request that a qualified clinician review the claims folder and provide a retrospective opinion as to whether for any period from May 12, 2011 the Veteran's erectile dysfunction is manifested by impotency, penile deformity, loss of erectile power, and burning on ejaculation. The examiner should also comment on whether his prostate hyperplasia constituted a penile deformity. The examiner must provide a comprehensive rationale for the opinions. 3. Request that a qualified clinician review the claims folder and provide a retrospective opinion as to the severity of his right and left upper and lower extremity neuropathy for any period from May 12, 2011. With regard to the left upper extremity, diabetic neuropathy; right upper extremity, diabetic neuropathy; left lower extremity, sciatic nerve; right lower extremity, sciatic nerve; left lower extremity, femoral nerve; and, right lower extremity, femoral nerve, the examiner should identify the neurological findings in the upper and lower extremities, and fully describe the extent and severity of those symptoms. The examiner should identify the specific nerve(s) involved, to include whether there is incomplete or complete paralysis, and offer an opinion as to the degree of impairment of the nerve (that is, whether it is mild, moderate, moderately severe, or severe in nature). The examiner should also identify any muscular atrophy. The examiner is to provide a statement concerning how the neuropathy, right and left upper and lower extremities, affected the Veteran's functioning and activities, to include in an occupational setting. The examiner is asked to describe the types of limitations he would have experienced as a result of his neuropathy. The examiner must provide a comprehensive rationale for the opinions. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.W. Kreindler, 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.