Citation Nr: 21007789 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 19-30 093 DATE: February 10, 2021 REMANDED Entitlement to service connection for erectile dysfunction to include 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 from December 1961 to December 1967, to include service in the Republic of Vietnam from June 1967 to November 1967. This matter comes before the Board of Veterans’ Appeals (Board) from an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Although the Veteran framed his claim as one for SMC, his claim clearly encompassed entitlement to service connection for erectile dysfunction. The issue has been recharacterized to adequately address the extent of his claim. The Veteran was scheduled for a Board hearing in December 2020. He failed to appear for the hearing, and the hearing request is considered withdrawn. 38 C.F.R. § 20.704(d). This appeal has been advanced on the Board’s docket pursuant to 38 U.S.C. § 7107(a) (2); 38 C.F.R. § 20.900(c). Entitlement to service connection for erectile dysfunction to include entitlement to SMC for loss of use of a creative organ The Veteran seeks entitlement to SMC under 38 U.S.C. § 1114(k) based on loss of use of a creative organ, asserting, in essence, that his erectile dysfunction is secondary to his service-connected diabetes mellitus, type II. See August 2017, February 2018, January 2019 and October 2019 statements. In a January 2021 statement, the Veteran further asserted that his erectile dysfunction is secondary to his service-connected coronary artery disease. A January 2018 VA examiner opined that the Veteran’s diagnosed erectile dysfunction is less likely than not caused by his diabetes mellitus, reasoning that the erectile dysfunction is part of the aging process and the Veteran is not on insulin to control his diabetes. However, the opinion did not address whether the erectile dysfunction was aggravated (worsened) beyond normal progression by the diabetes mellitus. Additionally, the opinion did not address the Veteran’s subsequently raised theory of whether the erectile dysfunction was caused or aggravated by the service-connected coronary artery disease. Thus, an additional VA opinion is needed. Updated treatment records should also be requested. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for erectile dysfunction. After securing any necessary releases, request any relevant records identified that are not duplicates of those associated with the claims file. In addition, obtain updated VA treatment records from August 2019. If any requested records are unavailable, the Veteran should be notified of such.   2. Provide the claims file to an appropriate VA examiner to obtain an addendum opinion on the claimed erectile dysfunction. If a new examination is deemed necessary to respond to the questions presented, one should be scheduled. After reviewing the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the claimed erectile dysfunction is caused by the service-connected coronary artery disease or medications taken for treatment of a service-connected disability? Please explain why or why not. (b.) If not caused by a service-connected disability, or medication to treat such disability, is it at least as likely as not (50 percent probability or greater) that the claimed erectile dysfunction was worsened (aggravated) beyond normal progression by service-connected diabetes mellitus or coronary artery disease, or by medications taken for treatment of a service-connected disability? Please explain why or why not. (c.) If the examiner finds that the claimed erectile dysfunction was worsened (aggravated) beyond normal progression by a service-connected disability, or by medications taken for treatment of a service-connected disability, the examiner should attempt to quantify the degree of worsening beyond the baseline level. A rationale for the opinions expressed must be provided. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. C. Birder 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.