Citation Nr: 21006068 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 11-24 903 DATE: February 3, 2021 ORDER Entitlement to service connection for erectile dysfunction (ED) is granted. FINDING OF FACT There is a balance of evidence on the question of whether the Veteran’s ED is secondary to his service connected diabetes. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran’s favor, the criteria for entitlement to service connection for erectile dysfunction have been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1964 to September 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decisions of the Department of Veterans Affairs (VA) Regional Office. A Board hearing was held before the undersigned Veterans Law Judge in December 2015, and a transcript of the proceeding has been associated with the record. This matter was previously before the Board in June 2016 when it was remanded for development, and in July 2017, at which time the Board issued a final decision. The Veteran then appealed that decision to the United States Court of Appeals for Veterans Claims (CAVC or Court). In March 2019, a memorandum decision was issued which set aside the July 2017 Board decision, and the case was thereafter remanded for additional development in September 2019. It has since been returned to the Board. Entitlement to service connection for ED. The Veteran contends that his erectile dysfunction is caused or aggravated by his service-connected diabetes mellitus. He was awarded service connection for diabetes mellitus type II, associated with exposure to herbicides, in a December 2009 rating decision. The Veteran’s self-reported onset of the disease has fluctuated throughout the period on appeal between the 1970s and contemporaneous to his 2007 diagnosis of diabetes mellitus. Compare October 2009 VA examination (“he states he is impotent and it began three years ago”); with September 2013 VA examination (“He developed erectile dysfunction in the early to mid-1970s”) Regardless of the unreliable subjective onset of the condition, the earliest medical assessment of ED associated with the record is the October 2009 VA examination. With respect to the etiology of ED, the October 2009 VA examiner gave seemingly conflicting remarks. In one section of the report he stated the Veteran’s impotence is not a complication of diabetes, but later in the same report stated ED is worsened or increased by diabetes. He indicated diabetes causes vascular damage which effects erectile strength and duration. In a March 2015 report, a private physician advised that the Veteran’s “erectile dysfunction has increased as his diabetes has progressed,” explaining that blood vessels and nerves which control erections can be damaged by diabetes. The Board acknowledges the negative VA medical opinions expressed; however, they all rely on the questionable premise that the claimed condition began in the mid-1970s, or precede the onset of the Veteran’s diabetes. While this condition would be one easily recognized by a patient, there is enough ambiguity in the record to question its onset prior to that of diabetes. As such, the VA examiners’ conclusions may not be considered definitive or controlling. In view of this, it may not be concluded the evidence preponderates against the claim. Accordingly, with the resolution of reasonable doubt in favor of the Veteran, service connection for ED secondary to diabetes is warranted. M. E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Marcus J. Colicelli 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.