Citation Nr: 21015264 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 16-28 868 DATE: March 17, 2021 ORDER Service connection for erectile dysfunction is granted. FINDING OF FACT The Veteran’s current erective dysfunction is at least as likely as not proximately due to his service-connected polymyositis. CONCLUSION OF LAW The criteria for service connection for erective dysfunction are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1974 to November 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision. The Veteran testified at a Board hearing in December 2018. The Board last remanded this matter in September 2020. *** The Veteran raised the issue of service connection for erectile dysfunction in a June 2012 statement. See 06/29/2012, Statement in Support of Claim. He asserts that this disability is related to exposure to contaminated water at Camp Lejeune, to include as secondary to a disease associated with such exposure. Veterans, reservists, or members of the National Guard who served no less than 30 days at Camp Lejeune during the period from August 1, 1953 to December 31, 1987 shall be presumed to be exposed to contaminated drinking water. 38 C.F.R. § 3.307(a)(7). Military records show that Veteran served at Camp Lejeune for more than 30 days in 1975. See 09/29/2011, Military Personnel Records, at 24. Therefore, he is presumed to have been exposed to contaminated drinking water at Camp Lejeune. There is, however, no indication that the Veteran’s erective dysfunction is directly related to exposure to contaminated water at Camp Lejeune. This aspect of the claim was considered in October 2020 by a VA examiner, who explained that the medical literature does not provide evidence of a link between exposure to contaminated water at Camp Lejeune and erective dysfunction. The opinion included a detailed discussion of the nature of erective dysfunction. As this is a strictly medical question, the Board finds that October 2020 VA opinion is adequate and probative, as it is based on considerable medical research. The Board acknowledges the Veteran’s assertion that his erective dysfunction is related to contaminated water at Camp Lejeune. Unfortunately, he is not competent to establish such a nexus, as this is a scientific matter that requires specialized knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). So, his opinion in this regard lacks weight. Nevertheless, service connection is warranted on a secondary basis. At his December 2018 Board hearing, the Veteran provided a detailed account of his medical history. He testified that, in service, he started to experience a penile discharge that has continued to the present day. Service treatment records confirm that the Veteran was treated in service for a urethral discharge with pain and burning on urination. See 06/18/2010, STR – Medical, at 31-33. He explained that the nature of his symptoms remained unclear for many years, and that, in 2010, he was told that he had erectile dysfunction due to muscle weakness. (VA treatment records confirm that the Veteran has been treated for erectile dysfunction since 2010. See 03/29/2012, CAPRI, at 282.) The Veteran further testified that, in recent years, he has been diagnosed with an autoimmune disorder that accounts for his muscle weakness. According to the Veteran, his treatment provider believes that this condition is related to contaminated water exposure at Camp Lejeune. In August 2018, the Veteran submitted a statement from his rheumatologist, Dr. TJL. See 08/13/2018, Medical Treatment Record - Non-Government Facility. In it, Dr. TJL indicated that the Veteran was being treated for polymyositis. He described polymyositis as an autoimmune disease which causes inflammation in the muscles that leads to weakness. He explained that polymyositis is a rare disorder categorized as a connective tissue disease related to scleroderma and systemic lupus erythematosus. Significantly, he concluded that, given the relationship of polymyositis to scleroderma and the association of scleroderma to exposure to organic solvents, it is reasonable to assume that there is a link between polymyositis and similar exposure. Based on this rationale, he endorsed the Veteran’s assertion that there is a nexus between his current diagnosis and his exposure to organic solvents while stationed at Camp Lejeune. A January 2020 rating decision granted service connection for polymyositis, rated as noncompensable, effective January 17, 2020. Based on the evidence above, the Board finds that the Veteran’s erective dysfunction is at least as likely as not secondary to his service-connected polymyositis. As explained above, the evidence establishes that polymyositis manifests as muscle weakness. The evidence further establishes that the Veteran’s erective dysfunction is due to muscle weakness. The Board acknowledges that the Veteran was diagnosed with polymyositis after being told that his erective dysfunction was due to muscle weakness. Resolving doubt in favor of the Veteran, the Board concludes that the competent evidence tends to show that his muscle weakness experienced by the Veteran around 2010 was an early manifestation of his still undiagnosed polymyositis. In November 2020, a VA examiner opined that the Veteran’s erective dysfunction is less likely than not secondary to his polymyositis. This opinion, however, is based on an inaccurate factual basis and, as such, is inadequate and lacks probative value. Specifically, the opinion indicates that the Veteran has reported a history of erective dysfunction since service. This, however, is not the case. As explained above, the Veteran has reported a history of penile/urethral discharge since service. While this symptomatology pertains to the same organ system as erective dysfunction, there is no indication that it is related to erective dysfunction. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. López, 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.