tinnitus Filed For Ed And Had A C&p. Can You Help Me Interpret The Notes?

[BklynVet]

Hello,

I recently filed for disability for erectile dysfunction. Here are the notes from MyHealthEVet:

1. Diagnosis

Service connected 40%- 0% for ed.

Claiming testicular pain, ed, and low testosterone are due to epididymitis.

Also claiming increase in prostatitis condition at 0%.

------------

Does the Veteran now have or has he ever been diagnosed with any

conditions of the male reproductive system? [x ] Yes [ ] No

If yes, indicate diagnoses: (check all that apply)

[x ] Erectile dysfunction

ICD code: v11.8 Date of diagnosis: around 2005.

[ ] Penis, deformity (e.g., Peyronie's)

ICD code: Date of diagnosis:

[ ] Testis, atrophy, one or both

ICD code: Date of diagnosis:

[ ] Testis, removal, one or both

ICD code: Date of diagnosis:

[ x] Epididymitis, chronic

ICD code: 604.90 Date of diagnosis: 2000.

[ ] Epididymo-orchitis, chronic

ICD code: Date of diagnosis:

[ ] Prostate injury

ICD code: Date of diagnosis:

[ ] Prostate hypertrophy (BPH)

ICD code: Date of diagnosis:

[x ] Prostatitis, chronic

ICD code: 601.9 Date of diagnosis: 2000.

[ ] Prostate surgical residuals (as addressed in items 3-6)

ICD code: Date of diagnosis:

[ ] Neoplasms of the male reproductive system

ICD code: Date of diagnosis:

[ ] Other male reproductive system condition (specify diagnosis,

providing only diagnoses that pertain to male reproductive system): Other diagnosis #1:

ICD code:

Date of diagnosis:

Other diagnosis #2:

ICD code:

Date of diagnosis:

If there are additional diagnoses that pertain to the male

reproductive organ conditions, list using above format:

2. Medical history

Both epididymitis/prostatitis began year 2000 while in service.

Pt was sitting at a meeting and developed sharp right testicular pain- went to

sick-bay and given injection for pain. Two days later back to sick-bay and dre

showed tender prostate- given motrin/cipro x 3 weeks. Since then he gets flare-

ups about twice a year and takes nsaid and a/b's.

Concerning ed- slow decline began yrs ago- decreased tumescence, number of

morning erections, and difficulty with penetration, and also decrease libido

(states had low testosterone level from outside).

------------------

a. Describe the history (including onset and course) of the Veteran's male

reproductive organ condition(s) (brief summary):

b. Does the Veteran's treatment plan include taking continuous medication

for the diagnosed condition?

[ x] Yes [ ] No

List medications taken for the diagnosed condition:

viagra 50mg po weekly prn.

androgel topical x 1 week. c. Has the Veteran had an orchiectomy?

[ ] Yes [x ] No

Indicate testicle removed:

[ ] Right [ ] Left [ ] Both

Indicate reason for removal:

[ ] Undescended

[ ] Congenitally underdeveloped

[ ] Other, provide reason for removal:

3. Voiding dysfunction

----------------------

Does the Veteran have a voiding dysfunction?

[ ] Yes [x ] No

If yes, complete the following section:

a. Etiology of voiding dysfunction:

b. Does the voiding dysfunction cause urine leakage?

[ ] Yes [ ] No

Indicate severity (check one):

[ ] Does not require the wearing of absorbent material

[ ] Requires absorbent material which must be changed less than

2 times per day

[ ] Requires absorbent material which must be changed 2 to 4

times per day

[ ] Requires absorbent material which must be changed more than

4 times per day

[ ] Other, describe:

c. Does the voiding dysfunction require the use of an appliance?

[ ] Yes [ ] No

If yes, describe the appliance:

d. Does the voiding dysfunction cause increased urinary frequency?

[ ] Yes [ ] No

If yes, check all that apply:

[ ] Daytime voiding interval between 2 and 3 hours

[ ] Daytime voiding interval between 1 and 2 hours

[ ] Daytime voiding interval less than 1 hour

[ ] Nighttime awakening to void 2 times

[ ] Nighttime awakening to void 3 to 4 times

[ ] Nighttime awakening to void 5 or more times e. Does the voiding dysfunction cause signs or symptoms of obstructed

voiding?

[ ] Yes [ ] No

If yes, check all that apply:

[ ] Hesitancy

If checked, is hesitancy marked?

[ ] Yes [ ] No

[ ] Slow or weak stream

If checked, is stream markedly slow or weak?

[ ] Yes [ ] No

[ ] Decreased force of stream

If checked, is force of stream markedly decreased?

[ ] Yes [ ] No

[ ] Stricture disease requiring dilatation 1 to 2 times per year

[ ] Stricture disease requiring periodic dilatation every 2 to 3

months

[ ] Recurrent urinary tract infections secondary to obstruction

[ ] Uroflowmetry peak flow rate less than 10 cc/sec

[ ] Post void residuals greater than 150 cc

[ ] Urinary retention requiring intermittent catheterization

[ ] Urinary retention requiring continuous catheterization

[ ] Other, describe:

4. Urinary tract/kidney infection

---------------------------------

Does the Veteran have a history of recurrent symptomatic urinary tract or

kidney infections?

[ ] Yes [x ] No

If yes, complete the following section:

a. Etiology of recurrent urinary tract or kidney infections:

b. Indicate all treatment modalities used for recurrent urinary tract or

kidney infections (check all that apply):

[ ] No treatment

[ ] Long-term drug therapy

If checked, list medications used and indicate dates for courses of

treatment over the past 12 months:

[ ] Hospitalization

If checked, indicate frequency of hospitalization:

[ ] 1 or 2 per year

[ ] > 2 per year

[ ] Drainage

If checked, indicate dates when drainage performed over past 12

months:

[ ] Continuous intensive management

If checked, indicate types of treatment and medications used over

past 12 months:

[ ] Intermittent intensive management

If checked, indicate types of treatment and medications used over

past 12 months:

[ ] Other, describe:

5. Erectile dysfunction

-----------------------

Does the V

eteran have erectile dysfunction?

[ x] Yes [ ] No

If yes, complete the following section:

a. Etiology of erectile dysfunction:

osa, testicular pain, prostatitis, and lumbar spondylosis/stenosis/ddd.

b. If the Veteran has erectile dysfunction, is it as likely as not (at

least a 50% probability) attributable to one of the diagnoses in Section 1,

including residuals of treatment for this diagnosis?

[x ] Yes [ ] No

If yes, specify the diagnosis to which the erectile dysfunction is

as likely as not attributable:

prostatitis.

c. If the Veteran has erectile dysfunction, is he able to achieve an

erection sufficient for penetration and ejaculation (without medication)?

[ ] Yes [x ] No

If no, is the Veteran able to achieve an erection sufficient for

penetration and ejaculation (with medication)?

[x ] Yes [ ] No 6. Retrograde ejaculation

-------------------------

Does the Veteran have retrograde ejaculation?

[ ] Yes [x ] No

If yes, complete the following section:

a. Etiology of the retrograde ejaculation:

b. If the Veteran has retrograde ejaculation, is it as likely as not (at

least a 50% probability ) attributable to one of the diagnoses in

Section 1, including residuals of treatment for this diagnosis?

[ ] Yes [ ] No

If yes, specify the diagnosis to which the retrograde ejaculation

is as likely as not attributable:

7. Male reproductive organ infections

-------------------------------------

Does the Veteran have a history of chronic epididymitis, epididymo-

orchitis or prostatitis?

[x ] Yes [ ] No

If yes, indicate all treatment modalities used for chronic

epididymitis, epididymo-orchitis or prostatitis (check all that apply):

[ ] No treatment

[ ] Long-term drug therapy

If checked, list medications used and indicate dates for courses

of treatment over the past 12 months: [ ] Hospitalization

If checked, indicate frequency of hospitalization:

[ ] 1 or 2 per year

[ ] > 2 per year

[ ] Continuous intensive management

If checked, indicate types of treatment and medications used

over past 12 months:

[x ] Intermittent intensive management

If checked, indicate types of treatment and medications used

over past 12 months:

nsaids and a/b's prn.

[ ] Other, describe:

8.Physical exam

---------------

a. Penis

[x ] Normal

[ ] Not examined per Veteran's request

[ ] Not examined per Veteran's request; Veteran reports normal anatomy

with no penile deformity or abnormality

[ ] Not examined; penis exam not relevant to condition

[ ] Abnormal If abnormal, indicate severity:

[ ] Loss/removal of half or more of penis

[ ] Loss/removal of glans penis

[ ] Penis deformity (such as Peyronie's disease)

If checked, describe:

b. Testes

[ ] Normal

[ ] Not examined per Veteran's request

[ ] Not examined per Veteran's request; Veteran reports normal anatomy

with no testicular deformity or abnormality

[ ] Not examined; testicular exam not relevant to condition

[x ] Abnormal If abnormal, check all that apply:

Right testicle

[ ] Size 1/3 or less of normal

[ ] Size 1/2 to 1/3 of normal

[ ] Considerably harder than normal

[x ] Considerably softer than normal

[ ] Absent

[ x] Other abnormality,

Describe: tender.

Left testicle

[ ] Size 1/3 or less of normal

[ ] Size 1/2 to 1/3 of normal

[ ] Considerably harder than normal

[x ] Considerably softer than normal

[ ] Absent

[ ] Other abnormality,

Describe:

c. Epididymis

[x ] Normal

[ ] Not examined per Veteran's request

[ ] Not examined per Veteran's request; Veteran reports normal anatomy

of epididymis with no deformity or abnormality

[ ] Not examined; epididymis exam not relevant to condition

[ ] Abnormal If abnormal, check all that apply:

Right epididymis

[ ] Tender to palpation

[ ] Other, describe:

Left epididymis

[ ] Tender to palpation

[ ] Other, describe:

d. Prostate

[ ] Normal

[ ] Not examined per Veteran's request

[ ] Not examined; prostate exam not relevant to condition

[x ] Abnormal If abnormal, describe:

enlarged/tender/soft (boggy).

9. Tumors and neoplasms

-----------------------

Does the Veteran have a benign or malignant neoplasm or metastases related

to any of the diagnoses in the Diagnosis section?

[ ] Yes [x ] No

If yes, complete the following section:

a. Is the neoplasm

[ ] Benign [ ] Malignant

b. Has the Veteran completed treatment or is the Veteran currently

undergoing treatment for a benign or malignant neoplasm or metastases?

[ ] Yes [ ] No; watchful waiting

If yes, indicate type of treatment the Veteran is currently undergoing

or has completed (check all that apply):

[ ] Treatment completed; currently in watchful waiting status

[ ] Surgery

If checked, describe:

Date(s) of surgery:

[ ] Radiation therapy

Date of most recent treatment:

Date of completion of treatment or anticipated date of

completion:

[ ] Antineoplastic chemotherapy

Date of most recent treatment:

Date of completion of treatment or anticipated date of

completion:

[ ] Other therapeutic procedure

If checked, describe procedure:

Date of most recent procedure:

[ ] Other therapeutic treatment

If checked, describe treatment:

Date of completion of treatment or anticipated date of

completion:

c. Does the Veteran currently have any residual conditions or

complications due to the neoplasm (including metastases) or its treatment,

other than those already documented in the report above?

[ ] Yes [ ] No

If yes, list residual conditions and complications (brief summary):

d. If there are additional benign or malignant neoplasms or metastases

related to any of the diagnoses in the Diagnosis section, describe

using the above format:

10. Other pertinent physical findings, complications, conditions, signs

and/or symptoms

-----------------------------------------------------------------------

a. Does the Veteran have any scars (surgical or otherwise) related to any

conditions or to the treatment of any conditions listed in the

Diagnosis section above?

[ ] Yes [x ] No

If yes, are any of the scars painful and/or unstable, or is the

total area of all related scars greater than 39 square cm (6 square

inches)?

[ ] Yes [ ] No

If yes, also complete a Scars Questionnaire.

b. Does the Veteran have any other pertinent physical findings,

complications, conditions, signs or symptoms?

[ ] Yes [ x] No

If yes, describe:

11. Diagnostic testing

----------------------

NOTE: If imaging studies, diagnostic procedures or laboratory testing has

been performed and reflects the Veteran's current condition, provide

most recent results; no further studies or testing are required for

this examination. When appropriate, provide most recent results. No

specific studies are required for this examination.

a. Has a testicular biopsy been performed?

[ ] Yes [x ] No

Date of biopsy:

Results:

[ ] Spermatozoa present

[ ] Other, describe:

b. Have any other imaging studies, diagnostic procedures or laboratory

testing been performed and are the results available?

[x ] Yes [ ] No

If yes, provide type of test or procedure, date and results (brief

summary):scrotal sonogram march/2014- Impression:

No evidence of testicular torsion. Mild sized bilateral

varicoceles

12. Functional impact

---------------------

Does the Veteran's male reproductive system condition(s), including

neoplasms, if any, impact his ability to work?

[ ] Yes [x ] No

If yes, describe the impact of each of the Veteran's male

reproductive system condition(s), providing one or more examples:

13. Remarks, if any:

--------------------

Chronic prostatitis with intermittent testicular discomfort (flare-ups with

treatment since 2000).

In my opinion erectile dysfunction/testicular pain is at least as likely as not

related to or aggravated by both service connected prostate condition and also

bil varicoceles.

Low testosterone is most likely secondary to bil varicoceles.

No evidence of epididymitis at this time.

Order hormone w/u today (tsh/prolactin/fsh/lh/testosterone).

NOTE: VA may request additional medical information, including additional

examinations if necessary to complete VA's review of the Veteran's

application.

The also ran some blood tests:

Lab Test: Follicle Stimulating Hormone

Result: 3.4

Reference Range: (1-12)

=========================================================================

Lab Test: Luteinizing Hormone

Result: 3.0

Reference Range: (2-12)

=========================================================================

Lab Test: Prolactin

Result: 8.6

Reference Range: (3.0-19.0)

=========================================================================

Lab Test: Thyroid Stimulating Hormone

Result: 0.719

Reference Range: (0.350-5.500)

=========================================================================

Test Name: TESTOSTERONE

Result: 292 Low

Reference Range: (348-1197)

----------------------

Test Name: TESTOSTERONE.FREE

Result: 8.88

Reference Range: 5.0- 21.0 ng/dL

----------------------

Test Name: TESTOSTERONE.FREE/TESTOSTERONE.TOTAL

Result: 3.04

Units: %

Reference Range: (1.5-3.2)

Interpretation: %

FREE TESTOSTERONE REFERENCE RANGES: 1.5 - 3.2%

=========================================================================

Lab Test: Testosterone

Result: 210.17 Low

Reference Range: (270-1194)

I've been reading on forums about erectile dysfunction and it seems like if a person has low testosterone, they'll get denied. I saw the VA urologist and they already prescribed Viagra and Androgel. I'm service connected for low back pain (20%), radiculopathy (10%), Tinnitus (10%), chronic prostatitis (0%), chronic epididymitis (0%), bilateral knee condition (0%).

The claim I filed recently (the one that I just had the exam for) was:

increase in epididymitis

(secondary) testicular pain

(secondary) erectile dysfunction

(secondary) low testosterone

Increase in prostatitis

(secondary) testicular pain

(secondary) erectile dysfunction

(secondary) low testosterone

(secondary) BPH

From what you guys read here, do you think they'll deny the erectile dysfunction? They are already prescribing me Viagra and it works very well.

Thanks

[BklynVet]

The VA also wants to start me on Androgel for the low testosterone.

[Navy04]

You will get approved for the ED bud, no problem. I just got approved for ED and SMC-K for loss of a reproductive organ. You will be fine, no issues. Good luck and keep us posted

[BklynVet]

Thanks for the vote of confidence Navy04.

What about the testosterone therapy? The VA urologist started me on Androgel. I know that stuff is expensive (my regular insurance doesn't cover it). Will they keep me on it?

Does the VA rate for low testosterone or does that all fall under the erectile dysfunction thing?

[63SIERRA]

ED is rated as SMK. special monthly comp. looking at what the opine was, looks like your in like flynn.

looks like u have also been lowballed (no pun intended) on some other conditions. a zero rating is almost ALWAYS too low. maybe request a increase/

[john999]

I have read that the DX of low T as being a disease is a scam. T levels drop as men age. I guess if you are 20 years old and have T levels of an 80 year old you have a disease of some sort.

[BklynVet]

I think they have to attach it to something to make it a legit diagnosis. For me, my T levels were 210 and the range was 290-1100 or something. After they ran a whole bunch of tests, they determined that it was due to varicoceles causing my testiscles to not make enough testosterone.

I have the Androgel but I'm not too crazy about starting it up just yet. From what I'm reading, I'll need to take it for the rest of my life. I'm not too crazy about that.