ERECTILE DYSFUNCTION

T. V. CASEY · 2026 · Case ID: A26038332

GRANTED

Summary

The veteran, who served in the United States Army from June 1973 to June 1993 and October 1993 to August 1996, appealed a June 2021 rating decision that reduced his disability compensation for erectile dysfunction. The veteran had previously been awarded service connection for erectile dysfunction with a non-compensable rating in September 2020, and subsequently sought a higher rating. A January 2021 rating decision awarded a 20 percent rating for erectile dysfunction with penile deformity, effective October 14, 2020. However, subsequent proposed decisions sought to reduce this rating to zero, citing clear and unmistakable error (CUE) in the January 2021 decision. The Board reviewed the case under the standard of whether the January 2021 decision contained clear error, as it had not become final. The Board found no clear error, concluding that the January 2021 rating was not CUE. The Board noted that the VA examiner's opinions were inadequate, as they failed to properly address the nexus between the veteran's Peyronie's Disease and the service-connected erectile dysfunction. The Board found that the evidence did not rebut the initial 20 percent award, as the subsequent decisions relied on inadequate medical opinions and misapplied procedural standards. Therefore, the Board reinstated the 20 percent disability rating for erectile dysfunction with penile deformity.

Rationale

No clear and unmistakable error in January 2021 decision; Inadequate medical opinions in subsequent decisions; Reinstatement of 20 percent rating for erectile dysfunction

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210708-171412

Full Decision Text

Citation Nr: A26038332
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 210708-171412
DATE: April 23, 2026

ORDER

The January 2021 rating decision that awarded a 20 percent disability rating for erectile dysfunction with penile deformity was not clearly erroneous and thus entitlement to a 20 percent disability rating for erectile dysfunction with penile deformity, effective October 14, 2020, is granted.

FINDING OF FACT

The award of a compensable rating for erectile dysfunction with penile deformity under Diagnostic Code (DC) 7255 in the January 2021 rating decision was not clearly erroneous because there was no clear and unmistakable error as to the favorable finding that the penile deformity was related to the service-connected erectile dysfunction.

CONCLUSION OF LAW

The criteria for entitlement to a 20 percent rating for erectile dysfunction with penile deformity, effective October 14, 2020, because there was no clear error in the January 2021 rating decision, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.104(c), 3.105(a)(2), 4.2, 4.3, 4.115b, DC 7522.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from June 1973 to June 1993 and October 1993 to August 1996.

The Veteran passed away in September 2025 while this matter was still pending. In November 2025, the Agency of Original Jurisdiction (AOJ) determined that the Appellant (the Veteran's surviving spouse) was a valid substitute claimant.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2021 rating decision by a Department of Veterans Affairs (VA) regional office, which is the AOJ.

The Veteran elected the Board's Evidence Submission docket. See July 2021 VA Form 10182. This restricts the Board's review to the evidence of record at the time of the June 2021 rating decision and any evidence submitted by the Veteran or his then-authorized representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303.

The Board notes that evidence was associated with the claims file during a period that is outside the applicable evidentiary window - more than 90 days following the VA Form 10182. Therefore, the Board has not considered this evidence in its present decision. 38 C.F.R. § 20.300(a).

If the Appellant would like VA to consider any evidence that that Board could not consider, the Appellant should consider whether a supplemental claim (VA Form 20-0995) is permissible and, if so, submit such claim and enclose the new evidence or sufficiently identify the evidence so that the AOJ can obtain it on her behalf. 38 C.F.R. § 3.2501. Specific instructions for filing a supplemental claim are included following this decision.

Entitlement to a 20 percent disability rating for erectile dysfunction with penile deformity, effective October 14, 2020.

The claims file shows that the Veteran filed an application for disability compensation in January 2019 seeking service connection, in part, for erectile dysfunction. An April 2019 rating decision denied the claim, and the Board received the Veteran's appeal in June 2019. See June 2019 VA Form 10182. In July 2020, the Board remanded the claim of service connection for additional development.

A September 2020 rating decision awarded service connection for erectile dysfunction and assigned a noncompensable rating under DC 7255 with an effective date of January 28, 2019. The rating decision also awarded special monthly compensation (SMC) under 38 U.S.C. § 1114(k).

In October 2020, within one year of the September 2020 rating decision, VA received an application for a higher rating for the service-connected erectile dysfunction. A January 2021 rating decision awarded a 20 percent rating with an effective date of October 14, 2020.

In February 2021, the AOJ proposed to reduce the disability rating for the erectile dysfunction to zero percent "due to a clear and unmistakable error."

In our previous rating decision January 14, 2021 we incorrectly awarded an increase to 20 percent based on penile deformity. However, medical opinion dated January 4, 2021 cited that your diagnosis of erectile dysfunction was less likely than not aggravated beyond the normal progression due to natural progression. As you are diagnosed with Peyronie's Disease [and] the examiner cited that it was impossible to opine without speculation what is the sole cause of the penile deformity because [erectile dysfunction] is a symptom of the new condition of Peyronie's Disease. We therefore are proposing to reduce your service connection from your current 20 percent to a non-compensable service connection. In the additional opinion that was rendered it was noted that Medical records show that the Veteran has a diagnosis of Peyronie's Disease. According to Mayo clinic it is a "noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections." ED is a result of the Peyronie's Disease and not a causative or aggravating factor of the penis deformity[.] This will reduce your service connection from 20 percent to 0 percent as previously was service connected before the improper rating increase.

The June 2021 rating decision formally "reduced" the disability rating for erectile dysfunction from 20 percent to zero percent "because the [January 2021 rating decision] was a clear and unmistakable error."

The regulations address the standard of review when revising a prior decision. 38 C.F.R. § 3.105; see also 38 C.F.R. § 3.104. For decisions that have become "final" under 38 C.F.R. § 3.160(d), the standard of review is whether there was a clear and unmistakable error (CUE) as to the evidentiary record and/or the law that existed at the time of the decision. 38 C.F.R. § 3.105(a)(1). CUE is defined as an "error, of fact or of law, that when called to the attention of later reviewers compels the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error." 38 C.F.R. § 3.105(a)(1)(i). Of note, a claimant is required to "set forth clearly and specifically the alleged clear and unmistakable error, or errors, of fact or law in the prior decision, the legal or factual basis for such allegations, and why the result would have been manifestly different but for the alleged error." 38 C.F.R. § 3.105(a)(1)(vii)(B).

For binding decisions that have not been finally adjudicated, e.g., have not yet become final because the one-year period to appeal the decision has not run, the decision is to be accepted as correct with respect to the evidentiary record and law existing at the time of the decision unless the decision is clearly erroneous after considering whether any favorable findings may be reversed as provided in 38 C.F.R. § 3.104(c). 38 C.F.R. § 3.105(a)(2).

The regulations state that a favorable finding may be reversed if the finding is rebutted by evidence that identifies a clear and unmistakable error as to the favorable finding. 38 C.F.R. § 3.104(c).

The Court held, in Gilbert v. Derwinski, that "clearly erroneous" requires only that the reviewer is left with the definite and firm conviction that a mistake has been committed. Gilbert, 1 Vet. App. 49, 52 (1990), citing United States v. United States Gypsum Co., 333 U.S. 364, 395 (1948).

Prior to November 14, 2021, a veteran was entitled to a 20 percent disability rating if there was evidence of deformity of the penis with loss of erectile power. 38 C.F.R. § 4.115b (2020), DC 7522.

The Board finds that the appropriate standard of review in this matter is whether the January 2021 rating decision contains a clear error. Here, the proposed February 2021 rating decision and the June 2021 rating decision were not "correcting" an error made in a prior final determination
49, 52 (1990), citing United States v. United States Gypsum Co., 333 U.S. 364, 395 (1948).

Prior to November 14, 2021, a veteran was entitled to a 20 percent disability rating if there was evidence of deformity of the penis with loss of erectile power. 38 C.F.R. § 4.115b (2020), DC 7522.

The Board finds that the appropriate standard of review in this matter is whether the January 2021 rating decision contains a clear error. Here, the proposed February 2021 rating decision and the June 2021 rating decision were not "correcting" an error made in a prior final determination. The AOJ appears to have relied on language in Part X.ii.5.A of VA's Adjudication Procedures Manual

(M21-1) that does not mirror the language in 38 C.F.R. § 3.105(a)(2). Though the February 2021 and June 2021 rating decisions identify the standard of review for this matter to be CUE, the procedural history as outlined above shows that the January 2021 rating decision never became final. The "proposed corrective" rating decision was issued about one month after the January 2021 rating decision. The rating decision that finalized the "correction" was issued about five months after the January 2021 rating decision. Thus, because the January 2021 never became final, the proper standard of review is whether there was clear error as to the January 2021 rating decision.

The Board finds no clear error as to the January 2021 rating decision because there is no CUE as to VA's favorable finding that a 20 percent rating for the service-connected erectile dysfunction was warranted. The evidence does not rebut the assignment of the 20 percent disability rating because the AOJ relied on inadequate medical opinions. As noted in the proposed February 2021 rating decision (but not restated in the June 2021 rating decision), the January 2021 VA medical opinions found that the "erectile dysfunction was less likely than not aggravated beyond the normal progression due to natural progression" and that the examiner could not "opine without speculation what is the sole cause of the penile deformity because it is a symptom of the new condition of Peyronie's Disease." See January 2021 C&P Exams.

The claims file clearly shows that the Veteran had already been awarded service connection for erectile dysfunction prior to the December 2020 VA examination and January 2021 VA medical opinions. At best, the question before the VA examiner was whether it was at least as likely as not that the Peyronie's Disease/penile curvature was due to or aggravated by the service-connected erectile dysfunction, not whether the service-connected erectile dysfunction was due to or aggravated by Peyronie's Disease. A second question before the VA examination was not whether the penile curvature was solely the result of the service-connected erectile dysfunction but rather if it was at least as likely as not due to or aggravated by the service-connected erectile dysfunction.

The Board recognizes that the VA treatment records show that the Veteran first reported concerns related to erectile dysfunction during a January 2001 encounter. See March 2019 CAPRI. It is not until a 2017 VA treatment note that the provider's impression includes a diagnosis of Peyronie's Disease. The provider, however, included no objective or clinical findings to support such diagnosis. The diagnosis appears to be solely based on the Veteran complaint of "penile curvature" during the encounter. It remains unclear whether it is at least as likely as not that 16 years of erectile dysfunction might have caused or aggravated Peyronie's Disease.

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Having considered the law and evidence at the time of the January 2021 rating decision, the Board finds no clear error because the rating official reasonably considered the Veteran's lay statement and attributed the reported penile curvature to be a symptom or condition related to the service-connected erectile dysfunction when assigning a 20 percent disability rating for the service-connected disability. The evidence fails to rebut the award of a higher disability rating for the service-connected disability. For these reasons, the award of a 20 percent disability rating for erectile dysfunction with penile deformity was not clearly erroneous and the claim is granted to reinstate the disability rating. 38 C.F.R. §§ 3.104, 3.105.

T. V. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Burden, 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.

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