Citation Nr: 21023412 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 17-19 980 DATE: April 20, 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 in the United States Army from June 1984 to April 1990 and November 1991 to March 2009. In November 2018, June 2020, and November 2020, the Board remanded the issue of entitlement to service connection for erectile dysfunction for additional evidentiary development. The case has been returned to the Board for appellate review. Entitlement to service connection for erectile dysfunction, to include as secondary to service-connected disabilities Pursuant to the November 2020 Board remand directives, the Veteran was afforded a VA examination for male reproductive organ conditions and a VA medical opinion in February 2021. The remand directive noted the medical professional should identify any medication shown by the evidence as prescribed for the Veteran’s posttraumatic stress disorder (PTSD) symptoms, including consideration of the medication venlafaxine, and provide medical opinions regarding a nexus between the Veteran’s current erectile dysfunction and service-connected PTSD, including medications, taken to treat his PTSD on a secondary basis. In the February 2021 VA medical opinion, the VA examiner provided negative medical opinions on a secondary basis; however, the rationale provided, in part, noted “there is no objective evidence of Veteran being diagnosed with erectile dysfunction or being treated for condition as [c]laim’s file is silent for evaluation of, diagnosis of, or treatment for erectile dysfunction.” On the contrary, review of the record includes a current diagnosis of erectile dysfunction during the appeal period, as provided in the February 2017 VA examination report for male reproductive organ conditions. Additionally, the VA examiner did not identify or discuss any medications used to treat the Veteran’s service-connected psychiatric disability. “[A] remand by... the Board confers on the veteran or other claimant, as a matter of law, a right to compliance with the remand orders.” Stegall v. West, 11 Vet. App. 268, 271 (1998). As such, compliance with the terms of the November 2020 remand is necessary prior to appellate review, and if not, “the Board itself errs in failing to ensure compliance.” Id. The matter is REMANDED for the following actions: 1. Return the Veteran’s claims file to the examiner who conducted the February 2021 VA examination for male reproductive organ conditions and provided the February 2021 VA medical opinion so a supplemental opinion may be provided. If that examiner is no longer available, provide the Veteran’s claims file to a similarly qualified clinician. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination (physical or telehealth) is only required if deemed necessary by the examiner. Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following: The February 2017 VA examination report for male reproductive organ conditions shows the Veteran’s current diagnosis of erectile dysfunction Review of the claims file shows prescribed medication for the service-connected psychiatric disability includes venlafaxine The examiner must opine as to the following: (a.) Identify any medication(s) shown by the evidence as prescribed for the Veteran’s service-connected psychiatric disability (including PTSD, depression, and generalized anxiety disorder). (b.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s erectile dysfunction (even if resolved since February 2017) was proximately due to or the result of his service-connected psychiatric disability (PTSD, depression, and generalized anxiety disorder), including medication (including venlafaxine). (c.) Whether it is at least as likely as not that the Veteran’s erectile dysfunction (even if resolved since February 2017) was aggravated beyond its natural progression by his service-connected psychiatric disability (PTSD, depression, and generalized anxiety disorder), including medication (including venlafaxine). The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Then, review all examination reports and medical opinions provided to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the agency of original jurisdiction (AOJ) must implement corrective procedures. 3. Then, readjudicate the claim. If the decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Carter, 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.