Citation Nr: 22016127 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 13-12 448 DATE: March 21, 2022 REMANDED Entitlement to service connection for erectile dysfunction, including as due to service-connected diabetes mellitus is remanded. REASONS FOR REMAND The Veteran had active service in the U.S. Army from May 1970 to November 1971, including in combat in the Republic of Vietnam. This appeal has a long procedural history. Most recently, in March 2021, the Board denied the currently appealed claim. Both the Veteran, through an attorney, and VA's Office of General Counsel appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court) by filing a Joint Motion for Remand (Joint Motion). The Court granted the Joint Motion in November 2021, vacating and remanding the Board's March 2021 decision. The Board acknowledges that this appeal has been remanded previously. Having reviewed the record evidence, and although the Board is reluctant to contribute to "the hamster-wheel reputation of Veterans law" by remanding this appeal again, additional development is required before the underlying claim can be adjudicated on the merits. Cf. Coburn v. Nicholson, 19 Vet. App. 427, 434 (2006) (Lance, J., dissenting) (finding that repeated remands "perpetuate the hamster-wheel reputation of Veterans law"). The Veteran essentially contends that he incurred his current erectile dysfunction during active service and experienced continuous post-service disability. He alternatively contends that his service-connected diabetes mellitus caused or aggravated his current erectile dysfunction. Both parties to the Joint Motion successfully argued to the Court that the Board erred in the March 2021 decision by not addressing the medical question of whether the Veteran's erectile dysfunction was a symptom of his diabetes mellitus. Both parties specifically contended that the medical evidence of record also did not address certain medical articles identified in a February 2021 appellate brief which suggested that erectile dysfunction can be a symptom of diabetes mellitus. The Board notes in this regard that a medical article or treatise "can provide important support when combined with an opinion of a medical professional" if the medical article or treatise evidence discusses generic relationships with a degree of certainty such that, under the facts of a specific case, there is at least "plausible causality" based upon objective facts rather than on an unsubstantiated lay medical opinion. Mattern v. West, 12 Vet. App. 222, 228 (1999).; see also Sacks v. West, 11 Vet. App. 314 (1998). The medical articles referenced in the February 2021 appellate brief were not accompanied by the opinion of any medical expert linking the Veteran's erectile dysfunction to active service or to his service-connected diabetes mellitus. Thus, these medical articles are insufficient to establish the medical nexus opinion required for causation. See Sacks, 11 Vet. App. at 317 (citing Beausoleil v. Brown, 8 Vet. App. 459, 463 (1996)); see also Libertine v. Brown, 9 Vet. App. 521, 523 (1996). Both parties to the Joint Motion argued successfully to the Court that the Board is required to go beyond the "plausible causality" standard and discuss whether the medical articles referenced in the February 2021 appellate brief establish an alternative theory of service connection for erectile dysfunction as due to service-connected diabetes mellitus. This is a novel interpretation of how to analyze the probative value of medical articles or treatise evidence and appears to depart from well-settled precedent on this matter. Nevertheless, the Board is bound by the Court's Order granting the Joint Motion. The Board next notes in this regard that it is prohibited from resolving medical questions on its own. See also Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (finding Board prohibited from exercising its own independent judgment to resolve medical questions). Thus, the Board finds that, on remand, the RO should request an addendum opinion which addresses this matter. The matters are REMANDED for the following action: 1. Forward the claims file to the VA clinician who provided a medical opinion in October 2020 or another appropriate clinician for an addendum opinion concerning the nature and etiology of the Veteran's erectile dysfunction. The Veteran does not need to report for examination unless deemed necessary by the clinician. Based on a review of the claims file, the clinician is asked to state whether the Veteran's erectile dysfunction was a symptom of his diabetes mellitus. The clinician is asked to review and discuss the clinical significance, if any, of the medical articles cited in a February 23, 2021, appellate brief. A rationale must be provided for any opinion(s) expressed. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael T. Osborne, 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.