Citation Nr: 21026738 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 17-28 627A DATE: May 3, 2021 REMANDED Service connection for erectile dysfunction is remanded. Service connection for a prostate condition is remanded. Service connection for a skin condition is remanded. REASONS FOR REMAND The Veteran honorably served from July 1975 to September 1977. This matter is before the Board of Veterans Appeals (Board) on appeal from a July 2011 rating decision. In February 2021 a virtual hearing was held before the undersigned Veterans Law Judge (VLJ). The Veteran offered new theories of entitlement during the February 2021 hearing regarding these claims on appeal. He communicated that his erectile dysfunction, skin condition and prostate condition may be caused or aggravated by his service-connected PTSD, prescribed medication to treat his PTSD, or excessive alcohol consumption related to PTSD. There are no VA medical opinions addressing these theories of entitlement. Consequently, a remand is warranted for addendum VA medical opinions and/or new VA examinations if deemed necessary. The matters are REMANDED for the following action: 1. Obtain any outstanding VA or private treatment records. 2. Obtain a VA addendum opinion (and a new examination if deemed necessary) to determine whether the Veteran's erectile dysfunction is at least as likely as not proximately due to or aggravated beyond its natural progression by service-connected PTSD, to include any prescribed medications. If and only if the reviewing clinician determines a new examination is necessary to provide an adequate opinion should one be scheduled. 3. Obtain a VA addendum opinion (and a new examination if deemed necessary) to determine whether the Veteran's prostate condition is at least as likely as not proximately due to or aggravated beyond its natural progression by service-connected PTSD, to include excessive alcohol consumption caused by PTSD symptoms, and/or medication used to treat service-connected urethritis. If and only if the reviewing clinician determines a new examination is necessary to provide an adequate opinion should one be scheduled. 4. Obtain a VA addendum opinion (and a new examination if deemed necessary) to determine whether the Veteran's skin condition is at least as likely as not proximately due to or aggravated beyond its natural progression by medication prescribed to treat service-connected PTSD. If and only if the reviewing clinician determines a new examination is necessary to provide an adequate opinion should one be scheduled. In addressing secondary service connection, the examiner must provide separate opinions for causation and aggravation. Please noted that a recent precedential decision by the Court in Ward v. Wilkie, 31 Vet. App. 233 (2019), held aggravation under 38 C.F.R. § 3.310 (b) does not require that there be "permanent" worsening of the nonservice connected disability only an incremental worsening. In rendering these opinions, the reviewing clinician is advised that the Veteran is competent to report his symptoms and history. Rationale for any opinion expressed should be provided. If an opinion cannot be provided without resort to speculation, the examiner should state why an opinion cannot be provided. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kyle McKone 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.