VA can grant erectile dysfunction (ED) secondary to service-connected diabetes, and VA's own diabetes exam form lists ED as a complication for the examiner to check. Diabetes is one of the strongest known risk factors: the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says more than half of men with diabetes will develop ED. Two rules decide what a grant pays. ED is rated 0%, and the diabetes rating code treats noncompensable complications as part of the diabetes rating. But service connection for ED also opens special monthly compensation for loss of use of a creative organ (SMC-K), which VA lists at $139.87 a month since December 1, 2025.

How VA's diabetes exam handles ED

VA's Diabetes Mellitus questionnaire (updated March 16, 2026) asks the examiner in Section 3B whether the veteran has erectile dysfunction that is at least as likely as not the result of diabetes, and in Section 3C whether ED or another condition is aggravated by diabetes. It defines aggravation as an increase in severity "that would not have occurred but for the Diabetes Mellitus, or where the nonservice-connected condition would have been less severe but for the Diabetes Mellitus," including when diabetes or its treatment interfered with treating the other condition.

You usually do not need a separate claim to raise it. 38 C.F.R. § 3.155(d)(2) says VA will consider complications of a claimed condition, including those its rating criteria identify, as part of the claim, and will decide ancillary benefits such as special monthly compensation even if you do not ask. Listing ED on a diabetes claim, and telling the examiner about it, still helps make sure it is addressed.

The medical link is usually the easier part. NIDDK's page on diabetes and sexual problems says men with diabetes are more than three times as likely to develop ED as men without diabetes, through damage to blood vessels and nerves. It also lists what raises the risk further, such as poorly controlled blood glucose, nerve damage, untreated high blood pressure or cholesterol, excess weight, certain medicines, alcohol and smoking. The clinician should still weigh the other causes in your record, including medicines and conditions NIDDK lists such as antidepressants, blood pressure medicines and low testosterone.

DC 7913 Note (1) and the 0% ED rating

VA rates ED under Diagnostic Code 7522 in 38 C.F.R. § 4.115b at 0%, with or without penile deformity, since November 14, 2021. Diabetes is rated under Diagnostic Code 7913 in 38 C.F.R. § 4.119, and Note (1) to that code says:

"Evaluate compensable complications of diabetes separately unless they are part of the criteria used to support a 100-percent evaluation. Noncompensable complications are considered part of the diabetic process under DC 7913."

Because ED is noncompensable, it is treated as part of the diabetes rating rather than given its own percentage. A decision may describe the disability as "diabetes mellitus with erectile dysfunction." In A25002778 (January 13, 2025), for example, the Board described a veteran's service-connected disability as diabetes mellitus, type II, with erectile dysfunction, nephropathy, peripheral vascular disease, hypertension and diabetic retinopathy. That wording is normal. It does not mean the ED was denied.

Why SMC-K still applies

Special monthly compensation is a separate award from the percentage rating. Under 38 C.F.R. § 3.350(a), SMC at the (k) rate is payable for the loss or loss of use of one or more creative organs, in addition to the basic compensation for your rating. The rating schedule flags DC 7522 for SMC review. VA's SMC rate table lists SMC-K at $139.87 a month effective December 1, 2025, added to basic compensation at any rating from 0% to 100%. If a decision recognizes ED as a diabetic complication but says nothing about SMC-K, ask about it. The SMC guide and the ED condition page explain the award.

What the Board did with ED secondary to diabetes

In A25005541 (January 22, 2025), VA had granted service connection for ED as related to diabetes and awarded SMC-K, both effective February 2024, the date of the veteran's first diabetes and male reproductive exams. The Board moved both dates back to April 8, 2019, the date of the veteran's claim for diabetes. It found that the ED claim fell within the scope of the original claim for diabetes and its complications, and that VA treatment records showed ED medication as early as 2009. It also explained that a secondary condition's effective date cannot come before the primary condition's, which is why April 2019 was the earliest date allowed.

Two practical points follow. Older ED treatment records matter, because they can show the condition existed when you filed for diabetes. And the SMC-K effective date follows the ED service-connection date.

Claim Raven does not publish an ED-specific Board rate, because its ED condition labels were excluded after a data-quality audit. Across secondary claims generally, opinions the Board described as strong went with favorable outcomes in 94.1% of 2,973 condition records and adequate ones in 68.5% of 5,351, against 1.7% where the opinion was weak. These are patterns in already-disputed Board appeals, mostly from 2024 to 2025, not a prediction for your claim.

If ED came before diabetes

If ED was documented before your diabetes began, the question becomes aggravation under 38 C.F.R. § 3.310. The regulation's text asks for a baseline from medical evidence before the worsening and pays only the increase. The Federal Circuit's decision in Spicer v. McDonough (2023) bars VA from using that regulation to reject a claim where the condition would be less severe but for the service-connected disability, and VA's diabetes form now uses the same "but for" language. Earlier urology or primary-care notes are the baseline.

Records to keep, and privacy

RecordWhy it belongs
The diabetes rating decision, and any later decisions on complicationsShows the primary condition and what VA already evaluated
The first ED complaint, diagnosis and any ED prescriptions, with datesSets onset and can support an earlier effective date
Diabetes care notes on blood glucose control and nerve or vascular findingsSupports the diabetic mechanism
Medication list, blood pressure, cholesterol and hormone historyLets the examiner weigh other causes
Earlier and later records, if worsening is the theoryShows the baseline and the change

You do not need to put intimate details into a public worksheet or an app. A short index that identifies a urology note by date and page lets a clinician or VA find it without copying its contents elsewhere.

Questions for the clinician about diabetes and ED

  • What supports the ED diagnosis, and when is it first documented?
  • Do my records show diabetes-related nerve or blood vessel involvement?
  • Were other causes, such as medicines, blood pressure, hormones or mental health factors, assessed?
  • If ED came first, would it be less severe today but for diabetes?

If PTSD or its medication is the proposed cause instead, see ED secondary to PTSD. The guide to nexus letters for secondary conditions explains how to frame causation and aggravation for any secondary opinion.

Sources and scope

Checked September 23, 2026: VA's Diabetes Mellitus questionnaire and SMC rate table; the current eCFR text of 38 C.F.R. §§ 3.155, 3.310, 3.350, 4.115b (DC 7522) and 4.119 (DC 7913); the Spicer opinion; NIDDK's diabetes sexual problems and ED causes pages; and the full text of Board decisions A25005541 and A25002778, each binding only its own appeal. Claim Raven sells claim-preparation tools, including the nexus readiness check offered here, so it has a commercial interest in this topic.