Citation Nr: 22012385 Decision Date: 03/03/22 Archive Date: 03/03/22 DOCKET NO. 17-13 004 DATE: March 3, 2022 ORDER Service connection for erectile dysfunction is granted. FINDING OF FACT Resolving all doubt in the Veteran's favor, erectile dysfunction is proximately due by his service-connected peripheral neuropathy condition. CONCLUSION OF LAW The criteria for service connection for erectile dysfunction have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from September 1969 to September 1971, including service in the Republic of Vietnam. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In December 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. This issue was previously before the Board in December 2019 and September 2021 and it was remanded for further development. Service Connection Erectile Dysfunction The Veteran asserts that service connection for his erectile dysfunction is warranted since it is related to service and his service-connected conditions. See BVA hearing transcript (December2019). In general, service connection may be granted for a disability or injury incurred in or aggravated by active military service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. See Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may also be established by credible lay evidence and medical evidence provided by the Veteran or otherwise. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2018). Service connection may also be found on a secondary basis where the following criteria is met: (1) a current disability that is not already service-connected; (2) at least one service-connected disability; and, (3) evidence that the non-service-connected current disability is either proximately due to or as the result of a service connected disability; or, aggravated by a service connected disability. See 38 C.F.R. § 3.310 (2018); see also El-Amin v. Shinseki, 26 Vet. App. 136 (2013); Allen v. Brown, 7 Vet. App. 439 (1995). In order to prevail under a theory of secondary service connection, the evidence must demonstrate an etiological relationship between (1) a service-connected disability or disabilities and (2) the condition said to be proximately due to the service-connected disability or disabilities. See Buckley v. West, 12 Vet. App. 76, 84 (1998); see also Wallin v. West, 11 Vet. App. 509, 512 (1998). In addition, secondary service connection may also be found in certain instances when a service-connected disability aggravates another condition. See Allen v. Brown, 7 Vet. App. 439 (1995); 38 C.F.R. § 3.310(b). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. See Alemany v. Brown, 9 Vet. App. 518 (1996). Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA's policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. See 38 U.S.C. § 1154 (a); 38 C.F.R. § 3.303 (a). The Board is charged with the duty to assess the credibility and weight given to evidence. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). In Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104(a) (West 2002). Further, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. See Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). The Veteran has a diagnosis of erectile dysfunction. See VA medical examination (August 2020). Thus, the Veteran has a current condition and meets the first element of service connection. Further, the Board acknowledges that after the September 2021 remand a VA examination was provided in November 2021 and the examiner opined that the Veteran's erectile dysfunction is not related to service or his service-connected disabilities. However, upon reflection, the Board finds that service connection is warranted for the Veteran's erectile dysfunction since the credible and competent medical and lay evidence shows that the Veteran's erectile dysfunction is related to his service-connected peripheral neuropathy. In reaching this determination, the Board notes that in a September 2020 statement, a private urologist and specialist who treated the Veteran opined that his erectile dysfunction was caused by his service-connected peripheral neuropathy. See VA medical examination (October 2021). The rationale was that "there has been scientific research linking male erectile dysfunction to peripheral neuropathy. The specialist added that due to him being exposed to Agent Orange which is at least as likely as not related to his peripheral neuropathy, in my medical opinion it is as well at least as likely as not related to his erectile dysfunction." Thus, resolving all doubt in the Veteran's favor, because the Veteran's erectile dysfunction was caused and aggravated by his service-connected peripheral neuropathy, secondary service connection for erectile dysfunction is granted. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Alvarado- 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.