Citation Nr: 21014007 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 16-38 869 DATE: March 11, 2021 REMANDED Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for erectile dysfunction is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1975 to October 1986, July 1990 to September 1992, and October 1992 to April 1996. These matters were before the Board in November 2018 and September 2020 when they were remanded for additional development. The Board most recently remanded these service connection claims in September 2020 to afford the Veteran VA examinations to determine the nature and etiology of his erectile dysfunction and left ankle disability. The examiner was to provide opinions as to whether it is at least as likely as not that: (a) erectile dysfunction and left ankle disability are related to service; and (b) erectile dysfunction and left ankle disability were caused or aggravated (worsened beyond the natural progression) by a service-connected disability. In this regard, it was noted that the Veteran was service-connected for low back disability and psychiatric disability. Rationale was to be provided for all opinions. The Veteran underwent VA examinations November 2020 with an addendum opinion obtained in January 2021. The opinions obtained are inadequate for adjudication purposes. Regarding the claim for erectile dysfunction, the secondary service connection opinion provided pertains to erectile dysfunction secondary to service-connected low back disability only. Neither examiner provided an opinion as to whether this disability is secondary to service-connected psychiatric disability. Regarding the claim for left ankle disability, the secondary service connection opinion provided lacks any rationale. Therefore, while the Board regrets the additional delay caused by remanding these claims again, remand for additional medical opinions is necessary pursuant to Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: Forward the Veteran’s claims file to an appropriate VA examiner(s) who must review the claims file (to include this remand) and provide addendum opinions as to whether it is at least as likely as not (a 50 percent or greater probability): (a) that the Veteran’s erectile dysfunction is proximately due to or aggravated beyond its natural progression by a service-connected disability, including low back disability, lower extremity radiculopathy, and psychiatric disability; and (b) that the Veteran’s left ankle disability is proximately due to or aggravated beyond its natural progression by a service-connected disability, including low back disability and lower extremity radiculopathy. For the purposes of secondary service connection, the examiner is advised that aggravation is defined as “any increase in disability.” See Allen v. Brown, 7 Vet. App. 439, 448 (1995). If the examiner determines that the requested opinions may not be provided without a physical examination of the Veteran, then such should be scheduled. The examiner must provide a complete rationale for any opinion given. If the examiner is unable to provide an opinion without resorting to speculation, he/she should so state and provide an explanation as to the reason(s) therefor. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Fletcher, Kathleen 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.