(ED) DBQ or Nexus Letter? VA doctor or Outside provider?

[jsimon757]

This is yet another ED post. I just wanted your thoughts on if I should have a DBQ or Nexus letter done, and who should fill it out,  my VA provider or since I am still a Dependent have my PCM at the army medical center complete one of the two?

(Backstory) I was diagnosed with PTSD w/Anxiety & Depression after an Iraq deployment in 2006, a year later another event on another deployment further caused trauma and that's when my ED and psychotropic medication started. I got out in 2011 and worked with VA providers to resolve the issue by changing medications. In 2015 I began being prescribed viagra after it became a bigger issue in our marriage. I am 70% rater, but 100%P&TIU. The ED has been documented since 2011 in my VA records.

[brokensoldier244th]

You don't really need a nexus letter for that. Any number of medications that you probably take already contribute to it, as also does depression/PTSD, etc. If you have been receiving active treatment for it it should be no problem to have it service connected secondary to your PTSD. They will do an exam to make sure nothing mechanical is not working correctly, and possibly a prostate exam since an enlarged prostate can contribute to that condition, but if thats not present then the service connection is probably already evident in your records. The DBQ is available online so you can see what you are in for at the C&P exam. 

10017.doc

[broncovet]

Medical evidence is medical evidence.  It needs to come from a medical provider "with experience or training" in the field.  Your college buddy who got a Phd in Basketball can not opine your ED is related to your PTSD.  Instead, get an opinion (nexus letter) from a person qualified, either in PTSD or in treating ED or both.  

My advice is you want to go with "the more favorable" of the 2.  

It sounds like your PTSD meds has negatively affected your ED.  I suggest you get both exams and read what they said.  Did either doc say your ED was because of PTSD meds?  If so, certainly submit that as evidence.  Remember, you only need "2" CAluza elements when it comes to secondary conditions, instead of the usual 3.  The reason is you dont need an "in service event" for ED, because that will already be established with your PTSD.  What you do need is a current diagnosis of ED (1)  and a nexus which states its "at least as likely as not" that your PTSD meds (name the medications) contribute to your ED.    Its likely you have a current diagnosis because you are unlikely to have been prescribed Viagra without it.  

Its not enough that a side effect of _____ (name of medication) is ED.   You still need to show that it caused YOUR ED, not just those people who were involved in a study of the medications.  That is, you need a nexus.  

Edited December 7, 2018 by broncovet

[Buck52]

I never had a C&P  for my S.C.   E.D. 

Just a Diagnose and medical records from VA Urology Dr  Secondary to my S.C. PTSD Meds  I even had a private urologist/specialist to Nexus to my PTSD Meds  but I never really needed Him (waste of $$$)   they never used him in their reasons & bases to make a decision   mostly it was based off my VA Medical Records.

since the blue pill did nothing for me  I use the penis injections at 30mg

These injections don't hurt,  only the mood maybe,  but they have the injections that come in 10mg ,20mg ,30mg ,40%mg 50mg  they start you off with the 10mg and if that don't seem to do it then they go to the next higher mg dose ,mine  is the 30%mg.

you have to take a class for penis injections  and inject your penis  with a small dosage  maybe 5% if it feels like it may work  then they start you off at the 10mg and go up from there if need be.

  But its not that bad  they work for me better than anything I've tried.  its just the mood that may kill things?  you take the injections 30/45 min before sexual contact.

[brokensoldier244th]

Huh. They sent me all the stuff, and never said anything about a class. I still have it all but I don't know if I want to teach myself. They gave me variable dosage injectors. 

[Buck52]

Yes The urology Dr had 2 specialist come in and do the class it was about an hour or so he had  us  go to the rest room and inject it.

  before that they teach you how to put the injector together and how to give yourself the shot...I have to take  b -12 injections twice month  so these penis injections needles are pretty small maybe about like take Insulin injections?

   it don't hurt  just a little sting  but after that you just turn the injector to push the medicine in the syringe part by turning the end knob and the medicine goes in automatically  takes about a Minute.  We use to have to push the injector like a regular syringe  but now they have a knob you turn that puts the medicine in the syringe part and through the needle...its not that bad.

Maybe TMI here?

your VA Urologist should show you how to do all this.

 

[vetquest]

Maybe I should seek this rating.  Been slowly becoming ineffective until totally ineffective.  I know nothing about injections.