Erectile Dysfunction, With or Without Penile Deformity Secondary to Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer)

How does secondary service connection work?

When the service-connected condition caused it

38 CFR § 3.310(a): “Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.”

When it made an existing condition worse

38 CFR § 3.310(b): “Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.” VA will not concede aggravation unless medical evidence establishes the baseline severity; it then deducts that baseline, and any natural progress, from the current level.

How strong the evidence for the link has to be

38 U.S.C. § 5107(b): “When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.” When the positive and negative evidence on the link is in approximate balance, VA gives the benefit of the doubt to the veteran.

What VA means by reasonable doubt

38 CFR § 3.102: “By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim.”

A statute that asks for an “at least as likely as not” medical opinion

38 U.S.C. § 1168(a)(1)(B): “obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.” § 1168 covers exams and opinions in toxic-exposure claims. For any claim for VA benefits, § 5107(b) above gives the veteran the benefit of the doubt when the evidence is in approximate balance.

How is Erectile Dysfunction rated as a secondary condition?

If Erectile Dysfunction, With or Without Penile Deformity was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Erectile Dysfunction, With or Without Penile Deformity existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)). Read 38 CFR § 3.310.

Common questions about Erectile Dysfunction secondary to Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer)

Can Erectile Dysfunction be service-connected as secondary to Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer)?

Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. You'll need a current Erectile Dysfunction, With or Without Penile Deformity diagnosis and a medical nexus opinion linking it to your service-connected Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer), the same standard the VA uses for any secondary claim.

What VA rating can I get for Erectile Dysfunction as a secondary condition?

Erectile Dysfunction, With or Without Penile Deformity is rated under VASRD diagnostic code 7522. Possible VA ratings for Erectile Dysfunction, With or Without Penile Deformity are 0%. If Erectile Dysfunction, With or Without Penile Deformity was caused by the service-connected condition, VA rates it on its own severity under its own diagnostic code, as part of the original condition (38 CFR 3.310(a)). If Erectile Dysfunction, With or Without Penile Deformity existed first and the service-connected condition made it worse, VA compensates only the worsening: it rates the baseline and current severity and deducts the baseline, and any natural progression, from the current level (38 CFR 3.310(b)).

What evidence do I need to service-connect Erectile Dysfunction as secondary to Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer)?

Strong evidence for the underlying Erectile Dysfunction, With or Without Penile Deformity diagnosis includes: A urology or primary care record stating the erectile dysfunction diagnosis; Exam documentation of any penile scarring or deformity and what caused it, since the note brings a disease or traumatic injury of the penis resulting in scarring or deformity under this code; Treatment records covering medications, injections, devices, or surgery; A provider's opinion connecting the condition to service, or to another service-connected condition or its treatment, where that is the basis of the claim. For the secondary link itself, a nexus letter from a treating provider explaining how Malignant Neoplasms of the Genitourinary System (Including Prostate Cancer) caused or aggravated Erectile Dysfunction, With or Without Penile Deformity is typically the deciding piece of evidence. If the claim is that a pre-existing Erectile Dysfunction, With or Without Penile Deformity got worse, include records showing how severe it was before it worsened: VA will not concede aggravation unless the baseline is established by medical evidence created before the worsening began, or by the earliest medical evidence after it (38 CFR 3.310(b)).