Citation Nr: 21076456 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 14-09 786 DATE: December 23, 2021 ORDER Service connection for erectile dysfunction is granted. FINDING OF FACT The probative evidence of record is at least in equipoise as to whether the Veteran's erectile dysfunction is etiologically related to his service-connected hypertension. CONCLUSION OF LAW With resolution of reasonable doubt in the Veteran's favor, the criteria for a grant of service connection for erectile dysfunction have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Air Force from December 1965 to February 1969, including service in the Vietnam War. This matter is on appeal from a February 2012 rating decision. In an August 2018 decision, the Board remanded this issue to afford the Veteran a VA examination. The Veteran was afforded a VA examination for male reproductive system conditions in July 2019. The VA examination is adequate with regard to the claim being decided below because it was based upon consideration of the Veteran's pertinent medical history, his lay assertions and current complaints, and because it describes his reproductive system symptoms in detail sufficient to allow the Board to make fully informed determinations. Barr v. Nicholson, 21 Vet. App. 303 (2007) (citing Ardison v. Brown, 6 Vet. App. 405, 407 (1994)). In a December 2019 decision, the Board remanded this issue again for development of an inextricably intertwined claim for service connection for hypertension. The Agency of Original Jurisdiction (AOJ) has done so. In a July 2021 decision, the Board remanded this issue again for further development of the hypertension claim. In an October 2021 rating decision, the AOJ granted service connection for hypertension. That issue is no longer before the Board. There was therefore substantial compliance with the remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Erectile Dysfunction The Veteran contends that his erectile dysfunction was caused or aggravated by his hypertension which, as stated above, is now service-connected. He has also raised other theories of service connection, such as causation by presumed exposure to herbicides but, because this theory is dispositive, the Board will not address the Veteran's other contentions. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may be granted for a disability that is proximately due to, the result of, or aggravated by a service-connected disability. 38 C.F.R. § 3.310. In such an instance, the Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995). The benefit of the doubt rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when (1) the weight of the evidence supports the claim or (2) when the evidence is in equipoise. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). (Continued on the next page) The Veteran was afforded a VA examination for male reproductive system conditions in July 2019. The clinician diagnosed erectile dysfunction and opined that it was as likely as not attributable to hypertension and aging. The record contains no medical evidence to the contrary. In light of the totality of the circumstances, and after resolving all reasonable doubt in the Veteran's favor, the evidence of record supports a finding that it is at least as likely as not that the Veteran's erectile dysfunction is caused, at least in part, by his service-connected hypertension. Accordingly, the Board finds that granting service connection for erectile dysfunction is the decision that is the most consistent with VA's policy to administer the law under a broad and liberal interpretation consistent with the facts of the case. 38 C.F.R. §§ 3.303 (a), 3.310. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ryan Frank, 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.