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November 11, 2024

Can I Get VA Disability for Erectile Dysfunction Secondary to Depression?

Last updated on November 13, 2024

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Yes, veterans can service-connect Erectile Dysfunction (ED) secondary to Depression for VA disability benefits.

Medical research has consistently demonstrated a strong link between ED and Depression.

Depression can lead to significant physical and emotional stress, impacting hormone levels, circulation, and nerve function—all essential for sexual health.

To qualify for VA disability for ED secondary to Depression, veterans must demonstrate three essential components to the VA:

  • Current Medical Diagnosis of ED: Evidence showing a diagnosis of ED, documented by a qualified healthcare provider.
  • Proof of Service-Connected Depression: A current VA rating establishing depression as a service-connected condition.
  • Medical Nexus Evidence (Nexus Letter): An independent medical opinion explaining how ED is proximately due to, caused, or aggravated by your service-connected depression.

In this article from VA disability expert Brian Reese, we’ll dive into VA disability compensation for ED secondary to Depression, including various medical research studies, necessary medical evidence, BVA case decisions, the VA rating criteria for SMC-K, and why a Nexus Letter for a secondary condition is mission critical for VA claim success.

Summary of Key Points

  • Connection Between Depression and ED: Substantial medical research shows that depression can affect sexual function, leading to or worsening ED through mechanisms such as hormonal changes, psychological stress, and medication side effects.
  • Secondary Service Connection Requirements: To establish VA disability compensation for ED secondary to Depression, veterans need three main components: (1) a current ED diagnosis, (2) evidence that depression is service-connected, and (3) a Nexus Letter explaining how depression has contributed to or aggravated the ED.
  • VA Rating for Erectile Dysfunction Secondary to Depression: The VA rates ED at 0% service-connected, which qualifies veterans for Special Monthly Compensation (SMC-K) for loss of use of a creative organ, providing an additional $136.06 per month in 2025. This is paid in addition to your regular monthly VA disability compensation pay.

What is Erectile Dysfunction?

Erectile Dysfunction (ED) is the ongoing inability to achieve or sustain an erection suitable for sexual activity.

Common symptoms of ED include:

  • Difficulty achieving an erection
  • Trouble maintaining an erection
  • Reduced sexual desire

In veterans with service-connected depression, ED is frequently linked to the physical and psychological impacts of depression.

Additionally, medications prescribed to treat depression may exacerbate ED as a side effect.

What is Depression?

Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and lack of motivation.

In veterans, depression may stem from service-related experiences, physical disabilities, or other factors impacting mental health.

Symptoms of depression include:

  • Persistent sadness or irritability
  • Loss of interest in previously enjoyed activities
  • Sleep disturbances
  • Fatigue and low energy

The physical and emotional toll of depression can create or worsen ED in many veterans.

Depression and Erectile Dysfunction: Is There a Connection?

Yes, there is a significant connection between Depression and ED.

Depression affects both physical and mental well-being, which can interfere with sexual function in several ways:

  • Hormonal Disruption: Depression may lower testosterone levels, which play a vital role in sexual health and libido.
  • Medications: Antidepressants, particularly SSRIs, are known to cause ED as a side effect.
  • Psychological Stress: Feelings of sadness, hopelessness, and low self-worth can impact sexual desire and function, making it difficult to achieve or sustain an erection.

Medical Research Supporting the Connection Between Depression and Erectile Dysfunction

Numerous medical studies have explored the relationship between depression and erectile dysfunction (ED), highlighting how depressive disorders can cause or exacerbate ED.

Here are three notable studies:

#1. The Relationship Between Depressive Symptoms and Male Erectile Dysfunction: Cross-Sectional Results from the Massachusetts Male Aging Study

  • Study Overview: This study analyzed data from the Massachusetts Male Aging Study, focusing on the association between depressive symptoms and ED in men aged 40–70.
  • Results: Findings indicated a significant correlation between depressive symptoms and the prevalence of ED. Men with higher depression scores were more likely to experience ED.
  • Conclusion: The study concluded that depressive symptoms are strongly associated with ED, suggesting that mental health plays a crucial role in sexual function among aging men.

#2. Association of Major Depression With Sexual Dysfunction in Men

  • Study Overview: This research examined the prevalence of sexual dysfunction, including ED, among men diagnosed with major depressive disorder (MDD).
  • Results: The study found that men with MDD had a higher incidence of sexual dysfunctions, particularly ED, compared to non-depressed individuals.
  • Conclusion: The findings underscore the significant impact of major depression on sexual health, highlighting the need for comprehensive treatment approaches addressing both mental and sexual health.

#3. Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis

  • Study Overview: This meta-analysis reviewed multiple studies to assess the association between depression and ED, aiming to quantify the strength of this relationship.
  • Results: The analysis revealed that depression significantly increases the risk of developing ED. The pooled odds ratio indicated that depressed individuals are more likely to experience ED than those without depression.
  • Conclusion: The study concluded that there is a robust association between depression and ED, emphasizing the importance of screening for ED in patients with depressive symptoms.

These studies collectively highlight the strong link between depression and erectile dysfunction, suggesting that addressing mental health is vital in the management and treatment of ED.

Important BVA Decisions for Erectile Dysfunction Secondary to Depression

The Board of Veterans’ Appeals (BVA) have recognized the connection between erectile dysfunction (ED) and depression in several cases, granting service connection for ED as secondary to service-connected depressive disorders.

Below are two notable decisions:

#1. BVA Decision on Erectile Dysfunction Secondary to Major Depressive Disorder IS GRANTED

Background of the Case:

A veteran appealed to the Board of Veterans’ Appeals (BVA) seeking service connection for erectile dysfunction (ED), which he claimed was secondary to his service-connected major depression. The veteran’s depression was initially rated at 30%, and he had a separate claim for a compensable rating for a surgical scar on his knee.

Claim Overview:

The veteran served from October 1979 to June 1989 and had a history of major depression, which he argued worsened his ED. The appeal included his claim that medications prescribed for his depression, specifically Bupropion (Wellbutrin), had contributed to his ED.

Findings and Medical Opinions:

  • Veteran’s Testimony: At a videoconference hearing, the veteran described his limited interest in sexual activity, his reliance on ED medications, and his continuing struggles despite maximum dosages. His wife’s statement supported this, noting their formerly active sex life had diminished following his treatment for depression.
  • VA Medical Examination: The veteran underwent a VA genitourinary exam in 2009, where the examiner initially denied a link between the veteran’s depression and ED. However, this opinion was based on the inaccurate understanding that the veteran was not taking antidepressants. Evidence later showed he was regularly prescribed Bupropion.
  • Additional Evidence: The veteran provided medical articles from WebMD and other sources showing that Bupropion is known to contribute to ED. The BVA found this evidence compelling, noting that VA treatment records confirmed the veteran’s ongoing prescription for Bupropion to manage his depression.

Conclusion and Decision:

The BVA ruled in favor of the veteran, granting service connection for ED as secondary to his service-connected depression. The Board emphasized the “benefit of the doubt” doctrine, as credible evidence suggested the antidepressant medication contributed to his ED symptoms. The BVA determined that the veteran’s ED was proximately caused or aggravated by his service-connected depression, meeting the criteria for secondary service connection.

Source: https://www.va.gov/vetapp13/Files2/1311150.txt

#2. BVA Decision for Erectile Dysfunction Secondary to Service-Connected Depression IS GRANTED

Background of the Case:

In December 2021, a veteran’s case before the Board of Veterans’ Appeals (BVA) established that erectile dysfunction (ED) could be service-connected as secondary to depression, particularly when depression treatment includes medications known to cause ED as a side effect.

Key Points of the Case:

  • The veteran served actively in both the U.S. Air Force and the U.S. Army and was previously awarded service connection for depression, stemming in part from traumatic events during his time as an Army recruiter. In this appeal, he sought secondary service connection for ED, which he asserted was due to side effects from the medication he took for his depression.
  • The veteran began taking an SSRI, specifically citalopram (Celexa), in early 2020 to manage depression. His physician, Dr. M.S., submitted a detailed medical opinion stating that the veteran’s ED was “at least as likely as not” caused by side effects from the SSRI prescribed for depression. Dr. M.S. noted that the timing of the ED symptoms closely followed the start of SSRI treatment, which is well-documented in medical literature to cause sexual dysfunction as a side effect.
  • The BVA examined the evidence, giving particular weight to Dr. M.S.’s expert opinion. His detailed explanation referenced peer-reviewed studies from reputable sources, such as the Mayo Clinic, that link SSRIs to ED. The physician also considered the veteran’s own statements about his symptoms, treatment history, and mental health challenges, finding them consistent with medical records and the known effects of SSRI medications.

Decision and Grant of Service Connection:

Finding no evidence to refute Dr. M.S.’s conclusions, the Board determined that the veteran’s ED was indeed “proximately due to or aggravated by” his service-connected depression and its treatment. This ruling granted service connection for ED on a secondary basis, entitling the veteran to VA benefits for his condition.

Why This Decision Matters:

This BVA decision is a significant example of how veterans experiencing ED due to medication side effects from mental health treatments can obtain VA disability benefits. Here, the veteran’s well-supported claim demonstrated that secondary service connection can be successfully established when:

  • There is credible medical evidence linking the treatment of a primary service-connected condition (depression) to a secondary condition (ED).
  • Detailed physician opinions and reliable medical literature substantiate the claim.

Source: https://www.va.gov/vetapp21/Files12/A21020586.txt

These decisions underscore the importance of providing comprehensive medical evidence and expert opinions when establishing a secondary service connection for conditions like ED related to depression.

VA Rating for Erectile Dysfunction Secondary to Depression

The VA rates Erectile Dysfunction secondary to Depression at 0% service-connected; however, veterans qualify for Special Monthly Compensation (SMC-K) for loss of use of a creative organ, which entitles them to additional compensation each month.  

This extra monthly pay of $136.06 per month for SMC-K in 2025 is intended to recognize the negative impact ED has on a veteran’s quality of life.

Important Medical Evidence to Service-Connect Erectile Dysfunction Secondary to Depression for VA Disability

To successfully file a VA claim for Erectile Dysfunction (ED) secondary to service-connected Depression, you’ll need to provide specific medical evidence that meets the VA’s criteria for secondary service connection.

#1. Current Medical Diagnosis of Erectile Dysfunction (ED)

The first essential step in establishing secondary service connection for ED is to obtain a current diagnosis from a qualified healthcare provider.

This diagnosis should be well-documented in your medical records, clearly showing the existence of ED and detailing its severity.

The documentation should include information on how ED impacts your health, well-being, and daily functioning.

This is vital for proving the existence of a current secondary condition directly related to your service-connected depression.

#2. Evidence of Service-Connected Depression Rated at 0% or Higher

Since your ED claim relies on a secondary connection to depression, you must already have an established VA rating for depression, even if rated at 0% or higher.

The VA requires evidence verifying that depression is service-connected.

You’ll need to submit documentation, such as your VA Rating Decision, that confirms your depression is recognized as a service-connected disability.

This existing connection serves as the foundation for your ED claim as a secondary condition.

#3. Nexus Letter for a Secondary Condition from a Private Healthcare Provider

A Nexus Letter is a critical element of any secondary VA disability claim.

In this case, the Nexus Letter from a qualified healthcare provider should establish a clear link between your service-connected depression and ED, explaining how depression has contributed to or aggravated your ED.

The letter should specifically state that it is “at least as likely as not” (a 50% or greater probability) that your ED is proximately due to, caused, or aggravated by your service-connected depression.

Your private healthcare provider should include:

  • Detailed Medical Explanation: Describing the ways depression can impact sexual function, leading to or worsening ED.
  • Relevant Medical Research: Citing studies or literature linking depression and ED to support the claim.
  • Your Medical History: Personalizing the Nexus Letter with details from your own medical records, showing the progression from depression to ED.

A strong Nexus Letter that clearly links your conditions is essential to getting your VA claim for ED secondary to depression approved.

#4. Documentation of Severity of Symptoms and Impact on Work, Life, and Social Functioning

The VA needs to understand how ED affects various aspects of your life, including work performance, personal relationships, and day-to-day activities.

It’s important to demonstrate how ED, as it relates to your depression, limits your quality of life and overall well-being.

Consider providing the following supporting evidence:

  • Military, VA, or Private Medical Records: Records detailing your ED symptoms, any treatments you’ve undergone (e.g., medication, counseling), and the impact on your daily life.
  • Lay Evidence: Personal statements from yourself, family, or friends that provide firsthand accounts of how ED affects your life, helping to demonstrate the personal toll it takes.
  • Disability Benefit Questionnaires (DBQs): If available, a DBQ for male reproductive conditions completed by your healthcare provider can offer comprehensive documentation of your symptoms, diagnosis, and any functional limitations.

Providing a complete package of evidence, including a Nexus Letter and supporting documentation, can strengthen your claim and improve your chances of establishing a secondary service connection for ED due to your service-connected depression.

Each piece of medical evidence will help clarify the connection between your conditions, ensuring the VA accurately understands your situation and awards the compensation you deserve.

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About the Author

Brian Reese
Brian Reese

Brian Reese

Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.

A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.

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