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VA Rating Assistant

DC 7522 · 38 CFR 4.115b

Penis, Deformity with Loss of Erectile Power (Erectile Dysfunction) C&P Exam Prep

To document the nature, severity, and functional impact of erectile dysfunction with or without penile deformity under DC 7522, and to establish a nexus to service or a service-connected condition. The examiner will determine whether the condition is related to a disease, traumatic injury, or secondary to another service-connected condition such as diabetes, prostate cancer, multiple sclerosis, spinal cord injury, or vascular disease.

Format:
Interview + Physical
Typical duration:
20-30 minutes
DBQ form:
Male_Reproductive_Organ (Male_Reproductive_Organ)
Examiner:
Urologist or Physician

What the examiner evaluates

  • Presence and severity of erectile dysfunction (complete vs. partial loss of erectile power)
  • Presence, nature, and extent of penile deformity, scarring, or structural abnormality
  • Etiology of the erectile dysfunction (vascular, neurogenic, hormonal, psychogenic, medication-induced, post-surgical, or Peyronie's disease)
  • History of onset, progression, and course of the condition
  • All treatments attempted including PDE5 inhibitors, vacuum erection devices, penile injections, penile implants, and their effectiveness
  • Current medications prescribed for the condition
  • Secondary effects including relationship impact and psychological consequences
  • Any associated voiding dysfunction, urinary symptoms, or other genitourinary conditions
  • Physical examination of the penis including assessment of deformity, scarring, or plaque (Peyronie's disease)
  • Relationship to any service-connected condition such as prostate cancer (DC 7528), multiple sclerosis, diabetes, or spinal cord injury
  • Eligibility for Special Monthly Compensation (SMC-K) for loss of use of a creative organ

The exam will include a detailed history interview and a focused physical examination of the genitalia. You have the right to request a same-sex examiner. You may have a chaperone or support person present. In most states you have the right to record the examination. The examiner will review your claims file, service treatment records, and any private medical evidence you have submitted. Be prepared for a brief physical exam of the penis and scrotum. The examiner may also assess for associated urinary symptoms and prostate findings.

Measurements and tests

Erectile Function Assessment (Clinical Interview)

What it measures: The degree of loss of erectile power, including whether the dysfunction is complete (total inability to achieve or sustain erection sufficient for sexual intercourse) or partial, and whether there is associated penile deformity affecting function.

What to expect: The examiner will ask detailed questions about your ability to achieve and sustain erections, frequency of attempts, rigidity, ability to complete intercourse, presence of nocturnal or morning erections, and the impact on your quality of life. Be honest and thorough - describe your worst typical experience, not your best day.

Critical thresholds

  • Complete erectile dysfunction (total loss of erectile power with or without penile deformity) 0% rating under DC 7522, but qualifies for Special Monthly Compensation (SMC-K) for loss of use of a creative organ - a significant benefit worth approximately $118/month (current rate) on top of any combined rating
  • Penile deformity from disease or traumatic injury with erectile dysfunction Rated under DC 7522 at 0% but still eligible for SMC-K; the presence of deformity must be documented to ensure correct diagnostic code assignment

Tips

  • DC 7522 has a single rating of 0% - the primary benefit associated with this condition is SMC-K, which requires documentation of loss of use of a creative organ, so accurate documentation of complete erectile dysfunction is critical
  • If your ED is secondary to a service-connected condition (e.g., prostate cancer DC 7528, diabetes, MS, spinal cord injury), make sure the examiner notes this nexus explicitly - secondary service connection may entitle you to SMC-K even if the primary condition's rating does not include it
  • Per M21-1 example, when prostate cancer (DC 7528) causes erectile dysfunction, SC for the ED should be established concurrently with the prostate cancer rating
  • Describe the frequency and consistency of erectile dysfunction - if it occurs nearly every time you attempt sexual activity, say so clearly
  • Mention any partial erections that are insufficient for penetration or intercourse, as this still constitutes functional loss of use

Pain considerations: Not applicable as a DeLuca musculoskeletal factor; however, if Peyronie's disease is present, describe any pain during erection or attempted intercourse, as this contributes to documentation of penile deformity and functional loss.

Penile Physical Examination

What it measures: Presence of anatomical deformity, scarring, fibrous plaque (Peyronie's disease), abnormal curvature, loss of penile tissue, or other structural abnormalities. The examiner may document findings such as normal, abnormal with deformity, loss of glans, loss of less than half, or loss of half or more.

What to expect: A brief visual and palpation examination of the penis. The examiner may assess for fibrous plaques along the tunica albuginea (associated with Peyronie's disease), post-surgical scarring, traumatic injury residuals, or congenital abnormalities. The examiner will document whether the penis examination is normal or abnormal and describe any specific findings.

Critical thresholds

  • Penile deformity with loss of erectile power Coded under DC 7522; presence of deformity ensures accurate diagnostic coding and supports documentation for SMC-K
  • Loss or removal of less than half of the penis May be rated separately under DC 7520 in addition to erectile dysfunction considerations
  • Loss or removal of half or more of the penis May be rated separately under DC 7520 at a higher level; ensure examiner documents extent of loss accurately

Tips

  • If you have Peyronie's disease, inform the examiner of when the plaques or curvature first appeared and any associated pain during erection
  • If the deformity resulted from a traumatic injury during service (e.g., combat injury, training accident), clearly describe the mechanism and date of injury
  • Post-surgical deformity (e.g., after prostate surgery) should be linked to the underlying service-connected condition
  • Ensure the examiner does not mark 'penis exam not relevant to condition' - the physical exam is directly relevant to DC 7522

Pain considerations: Report any pain during erection, pain during attempted intercourse, or chronic penile discomfort associated with deformity. These symptoms support the functional impact of the condition.

Treatment History and Medication Review

What it measures: The adequacy of treatment response, types of interventions attempted, and current medications. The examiner will document all treatments including PDE5 inhibitors (sildenafil, tadalafil, vardenafil), vacuum erection devices, intracavernosal injections, intraurethral suppositories, penile implants (inflatable or malleable), hormonal therapy, and psychotherapy.

What to expect: The examiner will ask about all treatments you have tried, including prescription medications, devices, and surgical interventions. They will document dates of treatment, effectiveness, side effects, and whether treatment is ongoing.

Critical thresholds

  • Failure of multiple treatment modalities including PDE5 inhibitors Supports documentation of severity and confirms clinical significance of the dysfunction for SMC-K purposes
  • Penile prosthesis/implant in place A penile implant does not preclude SMC-K - loss of natural erectile function is still the basis for the evaluation; ensure examiner notes this distinction

Tips

  • Bring a complete list of all medications you take for erectile dysfunction, including dosages and prescribing physicians
  • Note any medications prescribed for other service-connected conditions that cause or worsen ED (e.g., antihypertensives, antidepressants, opioids, androgen deprivation therapy) - these should be documented
  • If treatments have been partially effective but insufficient for satisfactory sexual function, say so explicitly - 'I take sildenafil but it still does not allow me to complete intercourse' is more informative than 'I take sildenafil'
  • Document the dates you first sought treatment and any gaps due to cost, access, or side effects

Pain considerations: Intracavernosal injections or other painful treatments should be mentioned as they reflect the severity of the condition and the burden of managing it.

Etiology and Nexus Assessment

What it measures: The examiner's clinical opinion on the cause of the erectile dysfunction and whether it is directly related to service, secondary to a service-connected condition, or caused or aggravated by a service-connected condition. This is the most critical element for establishing service connection.

What to expect: The examiner will provide a medical opinion addressing whether your erectile dysfunction is at least as likely as not caused by or related to your service or a service-connected condition. This may involve reviewing lab results, imaging studies, prior medical records, and the nexus between your service-connected conditions and the onset of ED.

Critical thresholds

  • Nexus to service or service-connected condition confirmed Establishes service connection - without a nexus opinion, the claim cannot be granted regardless of severity
  • ED secondary to SC prostate cancer (DC 7528) Per M21-1, SC for ED should be established concurrently with the 100% prostate cancer evaluation; SMC-K applies
  • ED secondary to SC multiple sclerosis, diabetes, or spinal cord injury Secondary service connection established; supports 0% under DC 7522 plus SMC-K

Tips

  • Clearly communicate the timeline: when did your service-connected condition begin, and when did the erectile dysfunction begin or worsen?
  • If you were prescribed medications during service or shortly after that caused ED, mention this as a potential direct cause
  • If a private physician or urologist has already documented the nexus, bring that letter or record to the exam
  • Do not assume the examiner will make the nexus connection independently - actively describe how your service-connected conditions affect your erectile function

Pain considerations: Not applicable as a standalone measurement, but the etiology assessment should capture the full burden of service-connected conditions on sexual function.

Rating criteria by percentage

0%

Erectile dysfunction with or without penile deformity. Under DC 7522, a single rating of 0% is assigned for erectile dysfunction regardless of severity. However, this 0% rating - when service-connected - qualifies the veteran for Special Monthly Compensation (SMC-K) under 38 U.S.C. - 1114(k) and 38 CFR - 3.350(a) for loss of use of a creative organ. SMC-K provides an additional monthly payment (currently approximately $118/month) on top of the veteran's combined disability rating. Disease or traumatic injury of the penis resulting in scarring or deformity is rated under this same code.

Key symptoms

  • Inability to achieve or sustain erection sufficient for sexual intercourse
  • Complete or near-complete loss of erectile power
  • Penile deformity, scarring, or fibrous plaque (Peyronie's disease) from disease or traumatic injury
  • Partial erections insufficient for penetration
  • Failure of pharmacological treatment (PDE5 inhibitors)
  • Requirement for vacuum erection device, penile injections, or penile implant
  • Psychological impact including depression, anxiety, or relationship distress secondary to condition

From 38 CFR: 38 CFR - 4.115b, DC 7522: 'Erectile dysfunction, with or without penile deformity - 0%. Note: For the purpose of VA disability evaluation, a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under diagnostic code 7522.' M21-1 example confirms that when prostate cancer (DC 7528) causes erectile dysfunction, SC for ED should be established concurrently. SMC-K coding per M21-1 is documented as '01-01-00-00-1' for loss of use of a creative organ.

Describing your symptoms accurately

Erectile Dysfunction Severity

How to describe it: Be explicit and specific about your inability to achieve or sustain erections. Do not minimize or use vague language. Describe what happens when you attempt sexual activity: whether you achieve no erection at all, a partial erection insufficient for penetration, or an erection that cannot be maintained. State the frequency - 'This happens virtually every time I attempt sexual activity.' Mention whether you have any nocturnal or morning erections and their quality. Report your experience on a typical bad day, not your best day.

Example: On my worst days, which represent most of my attempts at sexual activity, I achieve no erection whatsoever despite stimulation and arousal. Even on days when I notice slight engorgement, it is completely insufficient for penetration and disappears within seconds. I have not been able to complete sexual intercourse with my partner in [timeframe]. I have tried sildenafil 100mg and tadalafil 20mg - neither allows me to achieve a functional erection. This has caused significant distress to my relationship and I have been diagnosed with depression partly due to this condition.

Examiner listens for: Specific frequency of occurrence, complete vs. partial dysfunction, failure of pharmacological treatment, impact on quality of life and relationships, duration of the condition, and whether the dysfunction correlates temporally with a service-connected event or condition.

Avoid: Saying 'I have some trouble sometimes' when you mean 'I am virtually never able to achieve an erection sufficient for intercourse.' Saying 'the pills help a little' when you mean 'the pills do not allow me to complete intercourse.' Minimizing the condition out of embarrassment will result in inadequate documentation.

Penile Deformity Description

How to describe it: If you have penile deformity (including from Peyronie's disease, traumatic injury, or surgical scarring), describe its onset, appearance, and functional consequences. Describe any curvature (direction and degree if known), palpable plaques or scar tissue, pain during erection, and how the deformity prevents or complicates sexual intercourse. Note whether the deformity resulted from a service-related injury, a disease process, or treatment for a service-connected condition.

Example: I have a significant curvature of my penis - approximately 45 degrees upward and to the left - that makes penetration physically impossible. I can feel a hard, fibrous ridge along the top of my penis that appeared approximately [timeframe] after [service event/treatment/injury]. When I do achieve any partial erection, the curvature and pain make any attempt at intercourse extremely uncomfortable and non-functional.

Examiner listens for: Whether the deformity resulted from disease (e.g., Peyronie's disease) or traumatic injury, the nature and extent of structural abnormality, the functional consequence of the deformity on sexual function, and the relationship between the deformity and erectile dysfunction.

Avoid: Failing to mention deformity because you think 'the ED is the main issue.' Under DC 7522, deformity from disease or traumatic injury is specifically included - documenting deformity ensures correct coding and supports the overall clinical picture. Do not describe deformity as 'minor' if it prevents or significantly impairs sexual function.

Secondary and Functional Impact

How to describe it: Describe how erectile dysfunction has affected your daily life, relationships, mental health, and overall well-being. Mention any diagnosed psychological conditions that developed after the onset of ED (e.g., depression, anxiety, loss of self-esteem), relationship strain or marital difficulties, withdrawal from intimacy, and the social and occupational consequences if applicable. These functional impacts strengthen the overall picture of the condition's severity.

Example: Since developing erectile dysfunction, I have experienced significant depression and anxiety that I attribute directly to my inability to function sexually. My relationship with my spouse has been severely strained - we have largely stopped attempting intimacy because of my repeated inability to perform, and the embarrassment and hopelessness I feel afterward. I was referred to a mental health provider for depression which began shortly after the onset of my erectile dysfunction. I feel a profound loss of dignity and masculine identity.

Examiner listens for: Functional impact statements are particularly important for the DBQ field asking about functional impairment. The examiner will document how the condition affects employment and daily life. While ED itself is rated at 0%, the functional impact supports secondary claims for depression or anxiety and the overall case for SMC-K.

Avoid: Saying 'it doesn't really affect me' to avoid discussing a sensitive topic. The examiner needs to understand the full functional burden. Understating psychological impact may prevent you from filing a successful secondary claim for a mental health condition.

Treatment History and Response

How to describe it: Provide a complete and chronological account of every treatment you have tried for erectile dysfunction, including the approximate dates, dosages, duration of use, effectiveness, and reasons for discontinuation. Be specific about what 'not working' means - 'I took sildenafil 100mg approximately 30 minutes before sexual activity on 10 separate occasions and in none of those instances was I able to achieve an erection sufficient for intercourse.'

Example: I have tried the following treatments without achieving satisfactory sexual function: sildenafil (Viagra) 50mg and 100mg - ineffective even under optimal conditions; tadalafil (Cialis) 20mg - minimal response, unable to complete intercourse; vacuum erection device - I could achieve partial tumescence but insufficient rigidity for penetration and the device caused discomfort; intracavernosal alprostadil injections - provided some rigidity but inconsistent and painful; testosterone supplementation - did not resolve the erectile dysfunction. I currently take tadalafil 5mg daily as prescribed but continue to be unable to complete sexual intercourse.

Examiner listens for: Evidence that the condition is persistent, severe, and treatment-resistant. The examiner needs a complete treatment history to document the condition accurately and to ensure that all relevant DBQ fields regarding medications and therapies are completed.

Avoid: Failing to mention treatments that 'kind of work' - a treatment that provides partial response but is still insufficient for functional intercourse is evidence of severity, not adequacy of treatment. Do not imply treatments are successful if they are not.

Nexus and Service Connection Narrative

How to describe it: Clearly articulate the connection between your erectile dysfunction and your military service or service-connected conditions. Identify the specific service-connected condition (e.g., prostate cancer treated with prostatectomy or radiation, multiple sclerosis, diabetes mellitus, spinal cord injury, peripheral vascular disease) and describe the timeline showing that the ED began after or worsened due to that condition or its treatment. If the condition began in service, describe the precipitating event.

Example: My erectile dysfunction began immediately following my radical prostatectomy performed in [year] to treat my service-connected prostate cancer. Prior to surgery I had normal erectile function. Following the nerve-sparing procedure, I developed complete erectile dysfunction. My urologist has documented this as a known complication of prostatectomy. The erectile dysfunction is directly caused by the surgical treatment of my service-connected prostate cancer. Alternatively: My multiple sclerosis - rated at 40% service-connected - causes neurogenic erectile dysfunction by disrupting the autonomic nerve pathways required for erection. My neurologist and urologist have both documented this relationship.

Examiner listens for: A clear and plausible medical nexus between a service event or service-connected condition and the onset of erectile dysfunction. The examiner must provide a nexus opinion on the DBQ - help them by clearly presenting the timeline and causal relationship.

Avoid: Assuming the examiner will make the connection without your input. If you have a service-connected condition known to cause ED (prostate cancer, diabetes, MS, spinal cord injury, vascular disease), explicitly state that you believe the ED is caused by or secondary to that condition and ask the examiner to address this in their opinion.

Common mistakes to avoid

Minimizing or being vague about the severity of erectile dysfunction due to embarrassment

Why: The C&P examination is the primary opportunity to document your condition for rating purposes. Vague or minimized descriptions result in an incomplete DBQ, which can lead to claim denial or failure to establish SMC-K eligibility. The examiner needs specific, accurate information.

Do this instead: Prepare in advance by writing down exactly what you experience. Use specific language: 'I cannot achieve an erection sufficient for sexual intercourse in virtually any attempt.' Practice saying these words before the exam so embarrassment does not prevent accurate reporting.

Impact: 0% / SMC-K eligibility

Failing to mention Special Monthly Compensation (SMC-K) eligibility or not understanding that 0% still has significant value

Why: Many veterans assume that a 0% rating means the claim has no value and do not pursue it. In fact, service-connected erectile dysfunction at 0% under DC 7522 qualifies for SMC-K for loss of use of a creative organ, which provides an additional monthly benefit. This benefit is worth pursuing even if the combined disability rating appears complete.

Do this instead: Ensure your claim explicitly references SMC-K. After the exam, verify with your VSO or accredited claims agent that your rating decision addresses SMC entitlement under 38 CFR - 3.350(a). Do not overlook this benefit.

Impact: SMC-K entitlement

Not connecting the erectile dysfunction to a service-connected condition

Why: Without a documented nexus, the claim for erectile dysfunction cannot be granted as service-connected even if the dysfunction is severe. Veterans with service-connected prostate cancer, diabetes, multiple sclerosis, spinal cord injuries, or peripheral vascular disease may not realize their ED is likely secondary to those conditions.

Do this instead: Research whether any of your service-connected conditions can cause erectile dysfunction. Bring documentation from your treating physicians establishing the relationship. Explicitly tell the examiner: 'I believe my erectile dysfunction is caused by [specific service-connected condition]' and ask them to address this in the nexus opinion.

Impact: Service connection / 0% / SMC-K

Not reporting penile deformity or underreporting it as minor

Why: DC 7522 specifically includes disease or traumatic injury of the penis resulting in scarring or deformity. Failing to document deformity may result in an incorrect diagnostic code being assigned, and misses important clinical documentation. Even if the deformity does not independently increase the rating, it is part of the correct characterization of the condition.

Do this instead: Describe any deformity, curvature, plaque, scarring, or structural change thoroughly. Note when it appeared, what caused it, and how it affects function. Ensure the examiner checks the penile deformity field on the DBQ.

Impact: Correct DC assignment / 0% documentation

Assuming treatments that 'partially work' mean the condition is adequately controlled

Why: If a treatment provides some response but you are still unable to complete satisfactory sexual intercourse, your erectile dysfunction is NOT adequately controlled. Describing treatments as 'working' when they are merely providing partial, insufficient response can lead the examiner to understate severity.

Do this instead: Clearly state whether each treatment achieves the goal of satisfactory sexual intercourse. 'Sildenafil produces some engorgement but I am still unable to achieve penetration or complete intercourse' is accurate and important. Do not say a treatment 'helps' without clarifying that it remains insufficient.

Impact: 0% documentation / SMC-K

Not bringing a list of all current medications to the exam

Why: Many medications used for service-connected conditions (antihypertensives, antidepressants, antipsychotics, opioids, androgen deprivation therapy for prostate cancer) cause or significantly worsen erectile dysfunction. The DBQ has a specific field for medications. Failure to provide this list may result in incomplete documentation.

Do this instead: Bring a printed list of all current medications including dosages and prescribing conditions. Separately note which medications are prescribed for conditions that may cause ED. The examiner should document this in the medication field.

Impact: Nexus / etiology documentation

Failing to report psychological and relationship consequences of erectile dysfunction

Why: The functional impact of erectile dysfunction - including depression, anxiety, relationship breakdown, and loss of quality of life - may support a secondary claim for a mental health condition and strengthens the overall documentation of the condition's severity. Omitting this information results in an incomplete picture.

Do this instead: Describe psychological symptoms honestly. If you have been treated for depression or anxiety that began after or worsened due to erectile dysfunction, mention this. Consider whether to also file a claim for a secondary mental health condition.

Impact: Secondary claims / functional impact documentation

Prep checklist

  • critical

    Obtain and review all relevant medical records

    Gather service treatment records, VA medical records, and private medical records documenting the onset and treatment of erectile dysfunction, any penile deformity or Peyronie's disease, and any service-connected conditions that may cause ED (prostate cancer, diabetes, MS, spinal cord injury, vascular disease). Bring copies to the exam or ensure they are in your claims file.

    before exam

  • critical

    Obtain a nexus letter from your treating urologist or physician

    A private nexus opinion from your treating urologist stating that your erectile dysfunction is at least as likely as not caused by or secondary to your service-connected condition is highly valuable. Request this letter well before your exam. The letter should reference your specific diagnoses, the mechanism of causation, and use the legal standard 'at least as likely as not.'

    before exam

  • critical

    Prepare a written symptom and treatment history

    Write down the exact date (or approximate timeframe) when erectile dysfunction began, what event or condition you believe caused it, every treatment you have tried (with dates, dosages, and results), and a description of your current functional status. Include how ED has affected your relationships, mental health, and quality of life. Bring this written statement to the exam.

    before exam

  • critical

    Prepare a complete current medication list

    List all medications you currently take, including dosages, frequency, and the conditions they treat. Note any medications that are known to cause or worsen erectile dysfunction (antihypertensives, antidepressants, opioids, androgen deprivation therapy, antipsychotics, finasteride/dutasteride). This list should be given to the examiner.

    before exam

  • critical

    Understand the SMC-K benefit and ensure your claim requests it

    Confirm with your VSO or accredited representative that your claim or appeal explicitly requests Special Monthly Compensation under 38 CFR - 3.350(a) for loss of use of a creative organ. Service-connected erectile dysfunction at 0% under DC 7522 qualifies for this additional benefit. Do not assume VA will award it without a specific request or clear documentation.

    before exam

  • critical

    Research whether any service-connected conditions can cause erectile dysfunction

    Review your existing service-connected conditions. Prostate cancer (DC 7528), diabetes mellitus (DC 7913), multiple sclerosis (DC 8018), spinal cord injury, peripheral vascular disease, and many other conditions can cause neurogenic, vasculogenic, or hormonal erectile dysfunction. If any apply, you can file for ED as secondary to those conditions.

    before exam

  • recommended

    Consider requesting a same-sex examiner if desired

    You have the right to request a male examiner for this examination. Contact the VA scheduling office or your VSO in advance to make this request. Having a same-sex examiner may help you discuss sensitive symptoms more comfortably.

    before exam

  • recommended

    Check your state's laws on recording C&P examinations

    In most states, you have the right to record your C&P examination. Check your state's law on one-party vs. two-party consent for recording. If permitted, use a smartphone or recording device to capture the exam. Notify the examiner at the start that you are recording. A recording can be valuable if the exam report is later found to be inadequate.

    before exam

  • recommended

    Write down specific examples of worst-day functioning

    Using the 'worst day' standard per M21-1 guidance, prepare specific descriptions of your worst typical experiences with erectile dysfunction. Include: attempts at intercourse that failed completely, medications taken without effect, psychological distress experienced, and relationship consequences. These examples help you communicate accurately without minimizing.

    before exam

  • critical

    Arrive with all documents organized

    Bring your written symptom history, medication list, nexus letter, relevant medical records (especially urology notes, treatment records for service-connected conditions), and any prior C&P exam reports. Keep these organized so you can reference them quickly during the exam.

    day of

  • critical

    Do not minimize symptoms before or during the exam

    Report your condition as it actually is - neither exaggerating nor minimizing. Describe your worst typical day, not your best. If you are having a better day than usual on the day of the exam, explicitly tell the examiner: 'Today is not representative of my worst days - on my worst days, which are typical for me, I experience [description].'

    day of

  • optional

    Bring a support person if desired

    You may bring a spouse, partner, family member, VSO representative, or other support person to the examination. A partner may be able to corroborate statements about the impact of erectile dysfunction on your relationship and daily life. Confirm in advance with the VA scheduling office that this is permitted.

    day of

  • critical

    Explicitly address the nexus between ED and each service-connected condition

    Do not wait for the examiner to ask about the connection. Proactively state: 'I believe my erectile dysfunction is caused by [specific service-connected condition] because [reason/timeline].' Ask the examiner to address this in their medical opinion. Reference specific service-connected conditions by name.

    during exam

  • critical

    Ensure the examiner documents all treatment attempts and their inadequacy

    Go through your prepared treatment history with the examiner. For each treatment, explain what you tried, when, at what dose, and why it was inadequate. The DBQ has fields for treatment history - ensure the examiner completes these accurately.

    during exam

  • recommended

    Describe functional and psychological impact explicitly

    When asked about how the condition affects your life, provide specific examples: relationship strain, psychological symptoms (depression, anxiety, loss of self-esteem), avoidance of intimacy, and any secondary medical treatment sought for psychological consequences. The DBQ has a field specifically asking about functional impact.

    during exam

  • recommended

    Ask for clarification if any question is unclear

    You have the right to ask the examiner to clarify any question. If asked a yes/no question that requires more nuance, provide the nuance: 'Yes, but I should explain - [context].' Do not allow an oversimplified answer to stand if it would misrepresent your condition.

    during exam

  • recommended

    Do not allow the examiner to mark the penis exam as 'not relevant to condition'

    For DC 7522, the physical examination of the penis is directly relevant. If the examiner attempts to skip the physical exam, politely note that penile deformity is a component of DC 7522 and request that the examination be completed.

    during exam

  • critical

    Request a copy of the DBQ/exam report

    After the examination is complete, you can request a copy of the DBQ through your VBMS portal, MyHealtheVet, or via a FOIA request. Review the report carefully to ensure it accurately reflects what you reported. If the report contains significant inaccuracies or omissions, contact your VSO or representative immediately.

    after exam

  • recommended

    Submit a buddy statement from your partner or family member

    A written buddy statement (VA Form 21-10210) from your spouse or partner describing the impact of your erectile dysfunction on your relationship and daily life can strengthen your claim. This is particularly valuable for supporting the functional impact section of the DBQ and any secondary mental health claim.

    after exam

  • recommended

    File a claim for secondary mental health condition if applicable

    If you have developed depression, anxiety, or another mental health condition as a result of your service-connected erectile dysfunction, consider filing a secondary claim for that condition. Erectile dysfunction has a well-established relationship with depression and anxiety, and a secondary claim can result in an additional rating that better reflects your overall disability.

    after exam

  • critical

    Verify SMC-K is addressed in the rating decision

    When you receive your rating decision, verify that it addresses Special Monthly Compensation under 38 CFR - 3.350(a) (SMC-K) for loss of use of a creative organ. If the decision grants service connection for erectile dysfunction at 0% under DC 7522 but does not award SMC-K, file a supplemental claim or appeal specifically requesting SMC-K.

    after exam

  • recommended

    Challenge an inadequate exam report if necessary

    If the DBQ report is inadequate - for example, if the examiner did not address the nexus to your service-connected condition, did not document your treatment history, or contains factual errors - you can challenge the report through a supplemental claim with new evidence, a Notice of Disagreement, or a request for a new examination. Work with your VSO or accredited representative.

    after exam

Your rights during a C&P exam

  • You have the right to request a same-sex examiner for this examination. Contact the VA scheduling office or your VSO in advance to make this request.
  • In most states, you have the legal right to record your C&P examination. Check your state's one-party or two-party consent laws before recording. Notify the examiner that you are recording at the start of the appointment.
  • You have the right to bring a support person (spouse, family member, VSO representative, or advocate) to the examination.
  • You have the right to request a copy of the completed DBQ examination report. This can be accessed through your VA claims file in VBMS, MyHealtheVet, or via a Freedom of Information Act (FOIA) request.
  • You have the right to submit private medical opinions (nexus letters) and other evidence to support your claim. The examiner must consider this evidence, and if the VA examiner's opinion is less persuasive than a well-reasoned private opinion, the private opinion may be given greater weight.
  • You have the right to challenge an inadequate C&P examination. If the exam report fails to address key elements - such as the nexus to your service-connected condition, your complete treatment history, or your full symptom severity - you can request a new examination or file a supplemental claim with additional evidence.
  • You have the right to receive an explanation of your rating decision, including the specific criteria used to evaluate your condition and the evidence considered.
  • Under the Veterans Appeals Improvement and Modernization Act (AMA), you have multiple review lanes to challenge an unfavorable decision: Supplemental Claim, Higher-Level Review, or Board of Veterans' Appeals appeal.
  • You have the right to be treated with dignity and respect during the examination. The examination is a medical-legal proceeding and the examiner is obligated to conduct it professionally and thoroughly.
  • You have the right to submit buddy statements (VA Form 21-10210) from your partner, family members, or fellow veterans who can attest to the functional impact of your condition on your daily life.
  • Service-connected erectile dysfunction at 0% under DC 7522 entitles you to Special Monthly Compensation (SMC-K) under 38 U.S.C. - 1114(k) and 38 CFR - 3.350(a) for loss of use of a creative organ. You have the right to ensure this benefit is fully considered and awarded if you qualify.
  • You have the right to have the VA assist in developing your claim, including obtaining relevant VA medical records and requesting service treatment records, under the duty to assist provisions of 38 CFR - 3.159.

Related conditions

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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.