Erectile Dysfunction & SMC-K: How VA Compensates Loss of Use

Current DC 7522 lists "Erectile dysfunction, with or without penile deformity," at 0%. Its footnote directs review for special monthly compensation under 38 CFR 3.350. The note says a disease or traumatic injury of the penis resulting in scarring or deformity is rated under DC 7522. The older 20% criterion for deformity with loss of erectile power was removed effective November 14, 2021.

The DC 7522 footnote directs a review for special monthly compensation under 38 CFR 3.350. VA decides whether SMC-K applies.

Most veterans establish service connection for erectile dysfunction on a secondary basis under 38 CFR 3.310. The most prevalent secondary pathways include: medication side effects from SSRIs, SNRIs, or other psychiatric drugs prescribed for service-connected PTSD or depression; antihypertensive medications like beta-blockers prescribed for service-connected hypertension; neurological impairment resulting from service-connected lumbar spine conditions, radiculopathy, or pelvic trauma; and surgical outcomes, particularly radical prostatectomy for service-connected prostate cancer (DC 7528) or surgery for benign prostatic hyperplasia.

Records VA may consider for secondary service connection (38 CFR 3.310) and SMC-K often include a current diagnosis, the service-connected condition, and a medical opinion about the link. VA decides.

During a VA C&P examination for erectile dysfunction, the examiner completes the Male Reproductive Organ Conditions DBQ. The exam consists primarily of a clinical interview and a review of medical records. The examiner asks about the date of symptom onset, underlying medical conditions, prescribed medications, and whether treatments like oral PDE5 inhibitors (such as sildenafil or tadalafil) or penile injections restore functional capacity. Physical examination is limited to assessing for surgical scars or anatomical deformity. The exam is conducted professionally and focuses on documenting physiological loss.