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Thursday, August 3, 2017

VA Proposes to Eliminate Erectile Dysfunction Ratings

The VA recently released its proposed changes to the VASRD for ratings of the Genitourinary System, the details of which can be found in our blog post.

While most of the changes are intended to make the ratings criteria clearer and fairer, we anticipate that one section will be more controversial than the rest—the ratings for erectile dysfunction (ED), code 7522.

Currently, erectile dysfunction caused by deformity is rated 20%, but under the proposed changes, erectile dysfunction, for any reason, would be rated 0%.

The VA justifies this proposed change by stating that the “VA provides disability compensation for conditions that result in reduced earning capacity. Erectile dysfunction . . . is not associated with reductions in earning capacity.”

The basic idea behind all VA disability is to compensate veterans for the inability to work and make money because of their service-connected condition. This is the principle that guides all rating decisions—Does the condition decrease the veteran’s ability to work?

If this change is officially made, erectile dysfunction will not be the only condition rated 0% even though it is clearly a medical condition and disability by definition. For example, currently, the ratings for the eyes grant a 0% if contacts or glasses are able to fully correct a veteran’s vision. So even though the veteran can’t see across the room without their glasses (a clear disability), they aren’t compensated since it can be corrected and they can presumably still work just fine.

Now even though ED would only be rated 0%, this 0% rating, as opposed to no rating at all, is an important distinction. A 0% rating means that the VA recognizes it as a service-connected condition. As such, it could still qualify for Special Monthly Compensation, Category K (SMC-K). SMC-K provides a small amount of compensation for the loss of use of a creative organ. So if the erectile dysfunction effectively makes the veteran infertile, he would qualify for SMC-K.

Also, because the condition is considered service-connected, any conditions that it causes (“secondary conditions”) would also be eligible for compensation. So if the veteran developed depression because of his ED (a very common symptom), it would qualify for compensation. Depression is a condition that can definitely interfere with the ability of a veteran to properly function in his daily life and earn a living. So, even though the ED itself would only be rated 0%, any condition that it causes that interferes with the veterans ability to work, would still qualify.   

While it is still unknown whether or not this change will officially be made, the VA has made a distinct stand on the issue of infertility with this proposal. In 2016, when the VA published their proposed changes to the ratings for the Female Reproductive System, there was a significant push from female veterans claiming that they should receive compensation for sexual dysfunction since the men receive it for erectile dysfunction. This proposed change would seem to indicate that the VA is no longer going to consider any type of sexual dysfunction, regardless of gender, as a ratable condition.

If this change goes into effect, it is not clear in the proposal whether or not veterans who have already been awarded a disability rating for ED will retain that benefit.

Historically, ratings, once given, have often not been reduced or taken away when changes like this have been made. Sometimes, however, a rating that is being eliminated because of new changes to the VASRD will have a definite end-date for current beneficiaries. We will not know what the ruling will be in the case of erectile dysfunction until the VA publishes the final regulation in its entirety.

For all proposed changes, the VA grants a period of time when we can give feedback. How do you feel about eliminating the rating for ED? Check out our blog post about the changes and let us know your thoughts.