Citation Nr: 21009681 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 19-08 694A DATE: February 23, 2021 REMANDED Entitlement to service connection for erectile dysfunction, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1959 to April 1981. This matter comes before the Board of Veterans’ Appeals (Board) from a June 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The matter was previously remanded by the Board in October 2019 and October 2020 decisions for additional development and has now returned for further appellate review. Entitlement to service connection for erectile dysfunction, to include as secondary to service-connected disabilities, is remanded. Pursuant to the October 2020 Board remand decision, the Veteran received a VA examination in November 2020. The examiner reviewed the Veteran’s file, then copied the medical opinion from the March 2020 VA examination report directly into the opinion, with additions made for the Veteran’s recently service-connected disabilities such as hypertension. In the November 2020 examination report, the examiner opined that the Veteran’s ED was less likely than not proximately due to or the result of the Veteran’s service-connected disabilities nor was it aggravated beyond its natural progression by the service-connected disabilities. By way of rationale, the examiner provided the following: the Veteran’s diagnosis of ED preceded the Veteran’s diagnosis of service-connected diabetes mellitus by 10 years; and that the Veteran’s granuloma of the left lung, duodenitis, bilateral pseudophakia, bilateral knee strain, bilateral lower extremity peripheral neuropathy, bilateral hearing loss, and hypertension are all separate conditions from ED with no medical associations to ED; that none of the service-connected conditions cause or are caused by ED; and that none of the listed service-connected conditions aggravate, affect, or are aggravated or affected by ED. The examiner also opined that the Veteran’s ED did not significantly worsen after the diagnosis of service-connected diabetes and that medical evidence is not sufficient to support a determination of the baseline level of severity of the Veteran’s ED. Finally, the examiner stated that “there were no reported medicines that cause the side effect of ED.” The Board finds this opinion is inadequate because it merely contains conclusory statements without any supporting rationale. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that an adequate medical examination must contain not only clear conclusion with supporting data, but also a reasoned medical explanation connecting the two); Miller v. West, 11 Vet. App. 18, 22 (2007) (finding that a bare conclusion reached by a health care professional is not probative without a factual predicate in the record). The examiner did not provide any explanation as to why the Veteran’s claimed ED is not related to or aggravated by his service-connected disabilities, but merely states that there is no medical association. While the examiner noted that the Veteran’s ED had worsened, she stated that the condition had not significantly worsened since the on-set of diabetes, but did not provide any additional explanation. Further, with regards to whether medications taken for the Veteran’s service-connected disabilities may have caused or aggravated the Veteran’s claimed ED, the examiner again offered only a conclusory statement without any explanation. Accordingly, remand is warranted to obtain a new medical opinion regarding the nature and etiology of the Veteran’s claimed erectile dysfunction. The matter is REMANDED for the following action: Obtain a medical opinion from an examiner of appropriate expertise to determine whether it is at least as likely as not (50 percent probability or more) that the erectile dysfunction was caused or aggravated by the Veteran’s service-connected disabilities, to include any medications taken in relation to the Veteran’s service-connected disabilities. The examiner must provide a complete rationale for all opinions offered. If the examiner is unable to provide any required opinion, the examiner should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, a complete explanation as to why this is so should be provided. If the inability to provide a more definitive opinion is the result of a need for additional information, the additional information that is needed should be identified. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Gorum, 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.