Citation Nr: 21008005 Decision Date: 02/11/21 Archive Date: 02/11/21 DOCKET NO. 17-41 056 DATE: February 11, 2021 REMANDED Entitlement to service connection for erectile dysfunction (ED) is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1970 to January 1972. He appeals a June 2016 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) denying entitlement to service connection for ED. See June 2016 Notice of Disagreement (NOD). The Veteran contends that his ED is secondary to his service-connected diabetes. The Veteran was afforded a VA examination in January 2020. The examiner opined that the Veteran’s ED was less likely than not related to his service-connected diabetes because “onset of erectile dysfunction 9 years before the onset of erectile dysfunction [sic].” See January 2020 VA examination report. The Board notes that the examiner likely meant the onset of his ED predated his diabetes, but mistakenly wrote “erectile dysfunction” in the opinion portion instead. Despite this error, this opinion also does not consider evidence provided by the Veteran at his Board hearing in March 2020, as well as private medical treatment records, that indicate he could have been diabetic and /or prediabetic as early as 1999. Specifically, the Veteran stated at his March 2020 hearing that he was told his glucose levels were high from his treating physician as early as 1999. See hearing transcript at 5. The Veteran submitted glucose testing results for the years 1999 to 2009 where his levels are shown to be higher than average. See Quest Diagnostics reports dated 1999 to 2009. The Veteran reported that his ED was diagnosed in 2006. See January 2020 VA examination report. Further, the record reflects that the Veteran may have been diabetic and/or prediabetic as early as 1999. Therefore, the Board finds that remand is warranted for a new opinion to address the nature and etiology of his ED in light of this evidence. Further, the Veteran is also service connected for post-traumatic stress disorder (PTSD). See June 2016 Rating Decision. On remand, the reviewing clinician shall be asked to address any possible relationship between his ED and his service-connected PTSD as well. The matters are REMANDED for the following action: 1. Obtain any outstanding VA or private treatment records relevant to treatment the Veteran received for his ED. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. Thereafter, obtain an opinion from an appropriately qualified VA clinician to determine the nature and etiology of the Veteran’s ED. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the reviewing clinician. The opinions must include a notation that this record review took place. It is up to the discretion of the reviewing clinician whether a physical examination of the Veteran is needed to answer the questions below. The reviewing clinician should answer the following: (a.) Is it at least as likely as not that the Veteran’s ED was caused OR aggravated by his service-connected diabetes? The examiner should specifically consider the Veteran’s Quest Diagnostics treatment records containing glucose levels from the years 1999 to 2009. (b.) Is it at least as likely as not that the Veteran’s ED was caused OR aggravated by his service-connected PTSD, to include medications used to treat the same? In rendering these opinions, the reviewing clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the reviewing clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that question. 3. After the above has been completed to the extent possible, readjudicate the claim. If the benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Katie Poe, Associate 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.