Citation Nr: 21014426 Decision Date: 03/12/21 Archive Date: 03/12/21 DOCKET NO. 18-34 057A DATE: March 12, 2021 REMANDED Entitlement to service connection for erectile dysfunction as secondary to the service-connected disabilities of chronic congestive heart failure and/or posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served in the United States Army from March 1966 to March 1968, to include service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an August 2017 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for erectile dysfunction as secondary to the service-connected disabilities of chronic congestive heart failure and/or posttraumatic stress disorder (PTSD) is remanded. The Veteran contends his erectile dysfunction is due to either his service-connected chronic congestive heart failure or his service-connected PTSD. The Veteran was afforded VA examinations in December 2013 and May 2018. The December 2013 examiner did not discuss whether the Veteran’s erectile dysfunction was caused or aggravated by his PTSD because that theory of entitlement had not been raised at the time of the records review. The May 2018 examiner opined that the Veteran’s erectile dysfunction was less likely than not due to his service-connected PTSD because he began experiencing PTSD symptoms in the late 1960s, while he was not diagnosed with erectile dysfunction until 2006. However, while the examiner addresses the Veteran’s PTSD symptoms, the examiner failed to address whether any of the medications listed in the Veteran’s VA treatment records that he was prescribed for PTSD, to include anti-depressant medications, could have caused or aggravated his erectile dysfunction. Because the examiner failed to consider the Veteran’s PTSD medications, the Board finds that an addendum opinion is needed. Accordingly, the matter is REMANDED for the following action: Obtain an addendum opinion from the May 2018 examiner or other qualified clinician regarding the Veteran’s erectile dysfunction. If the reviewing clinician determines the Veteran should be given another examination (including via telehealth if an in-person examination is not possible) to answer the below questions, one should be scheduled. The clinician is asked to opine on the following: 1. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s erectile dysfunction was caused or aggravated by his service-connected chronic congestive heart failure, to include side-effects of any prescribed medications? 2. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s erectile dysfunction was caused or aggravated by his service-connected PTSD, to include side-effects of any prescribed medications? A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be given due to limitations of knowledge in the medical community at large and not those of the particular clinician. A.M. Clark Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Gabrielle Ongies, 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.