Citation Nr: 21022742 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 19-23 250 DATE: April 19, 2021 ORDER Entitlement to service connection for erectile disorder is denied. REMANDED Entitlement to service connection for an acquired psychiatric disability, including PTSD, is remanded. FINDING OF FACT The preponderance of the evidence is against finding erectile disorder that began during service or is otherwise related to service. CONCLUSION OF LAW The criteria for service connection for erectile disorder are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1991 to February 1994. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an August 2018 rating decision and a November 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the August 2018 rating decision, the RO, inter alia, denied service connection for posttraumatic stress disorder (PTSD). In the November 2018 rating decision, inter alia, the RO denied service connection for male erectile disorder, claimed as penile condition. In August 2018 and in January 2019 the Veteran filed his notice of disagreement with, inter alia, the service connection denials for PTSD and erectile disorder, and was issued a statement of the case (SOC) in July 2019 for his claim for service connection for erectile disorder and in February 2020 for his claim for service connection for PTSD. In October 2019, the Board remanded the claim for service connection for erectile disorder for further development. Entitlement to service connection for erectile disorder Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Veteran contends that his erectile disorder is related to service or that it began while he was still in active service. His service treatment records do not contain any complaints or diagnoses related to erectile dysfunction or other similar disorder. The Veteran’s more recent VA treatment records do note erectile dysfunction listed under a problem list. The Veteran established care with the VA medical system, and his problem list includes erectile dysfunction. There are no earlier records showing a diagnosis of erectile dysfunction, and the Veteran has not alleged that he received treatment for this disorder in the years following his separation from service. His private treatment records show that in January 2009 he denied any decreased libido or importance. The Veteran was afforded a VA examination in February 2021 where the Veteran stated the onset of his symptoms was in 1993. The examiner diagnosed the Veteran with erectile dysfunction. Following a review of the evidence of record, the Veteran’s lay statements, and a physical examination, the VA examiner opined that the erectile dysfunction was less likely than not (less than 50 percent probability) due to service or to any substance used to control sexual urges that may have been given to him during service. The examiner reasoned that the short amount of time in service and the subsequent onset of the Veteran’s erectile dysfunction are inconsistent with a connection to any type of medication the Veteran may have been provided during service. The examiner further reasoned that the Veteran’s erectile dysfunction is more likely than not related to the Veteran’s diabetes mellitus or a prostate disorder. The Board finds this medical opinion to be highly probative evidence of the question of whether the Veteran’s erectile dysfunction was incurred in or is related to service. The opinion was provided by a competent physician who performed an in-person examination and reviewed the medical records. The physician discussed the Veteran’s medical history at length and provided an adequate rationale for his findings. This highly probative medical evidence weighs against the claim. While the Veteran has asserted that his erectile dysfunction began in service, and he is competent to report on his own symptoms as he observes them, the evidence does not establish that the Veteran has had a chronic disorder which manifests as erectile dysfunction consistently since service. The Veteran’s private treatment records show that in 2009 he denied any impotence or decreased libido. While the Veteran may have experienced some symptoms of erectile dysfunction when he was in service, the reasons for experiencing such symptoms at different times in his life may be based on varying and complex etiologies. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2013). While the Veteran is competent to report having experienced some erectile dysfunction in service, he is not competent to opine on whether the cause of these symptoms at that time is the same as what is causing his current complaints, or whether his current disorder was caused by an event or injury in service, and his assertions are far outweighed by the more probative opinion of the VA examiner. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). After weighing all the evidence, the Board finds that the preponderance of the medical evidence weighs against the conclusion that the Veteran’s erectile dysfunction either began during or was otherwise caused by his active service. Thus, the evidence fails to establish service connection for the Veteran’s erectile dysfunction, and the claim for service connection is denied. In reaching this conclusion the Board has considered the applicability of the benefit of the doubt doctrine.  However, as the preponderance of the evidence is against the claim, that doctrine is not applicable.  See 38 U.S.C. § 5107(b).  REASONS FOR REMAND Entitlement to service connection for an acquired psychiatric disability, including PTSD, is remanded. The Veteran has claimed service connection for PTSD, which the Board has expanded to include any acquired psychiatric disability. The Board notes that the record shows he has also been diagnosed with unspecified depressive disorder. The Veteran asserts that his acquired psychiatric disability is related to being shot at from a distance while in service. Specifically, the Veteran asserted in a March 2018 statement that his stressor occurred in service when he was performing a mission in Arizona, where his unit was tasked to do surveillance on possible drug smugglers. The Veteran stated that during this mission, his unit was fired upon. On a May 2018 DPRIS Response, it was noted that a DPRIS search was unable to verify that the 1st battalion, 502nd infantry, and Joint Task Force 6 were deployed in Arizona in 1993 and participated in anti-drug enforcement. Subsequently, the Veteran submitted a certificate of achievement dated in April 1993 which documented that the Veteran was part of a scout team from January 1993 to March 1993 at Fort Huachuca, Arizona. The Board notes that there may be additional documents available from the Veteran’s service that may corroborate the Veteran’s stressor. Further, the agency of original jurisdiction (AOJ) has not made a formal finding that the Veteran’s records are unable to be located. On remand, an additional search of records should be made. Additionally, while the Veteran was provided a VA examination for his acquired psychiatric disability in September 2018, a nexus opinion was not provided. On remand, this shall be accomplished. Further, the examiner should comment on a February 2009 private treatment record in which the Veteran reported that he first noticed the symptoms 6 months earlier but then the examiner noted that the Veteran’s symptoms worsened after his divorce in five years earlier and after he was involved in a train accident in November 2008. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Make an effort to obtain the Veteran’s service personnel records from his service in Arizona from January 1993 to March 1993, and any records of participation in an anti-drug enforcement scout team. If unable to locate, then a formal finding of unavailability must be made. 3. After completion of the above, schedule the Veteran for an appropriate examination for report on whether it is as likely as not (50/50 probability or greater) that any acquired psychiatric disability is related to his service. The Veteran has been diagnosed with a depressive disorder and PTSD. The examiner is asked to review the file and to conduct a complete examination, along with any necessary diagnostic tests. The examiner is asked to elicit from the Veteran a detailed history of the incident in service, and his symptoms since then. The examiner is asked to comment on the February 2009 private treatment record which indicated that the Veteran had longstanding symptoms that worsened after his divorce 5 years earlier, any change in his symptomatology since his 2008 train accident; and his reports of being traumatized in service when he participated in an anti-drug enforcement mission in Arizona in 1993. All opinions must be supported with explanation. Mary E. Rude Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Hammad Rasul, 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.