SoP LibraryErectile dysfunction

Statement of Principles

Erectile dysfunction — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Erectile dysfunction. DVA can only accept a claim for Erectile dysfunction if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Erectile dysfunction

RH No. 72 of 2022 · BoP No. 73 of 202295 factors

Meaning of erectile dysfunction: For the purposes of this Statement of Principles, erectile dysfunction: (a) means persistent or recurrent inability to develop or maintain an erection adequate for sexual intercourse; and (b) includes psychogenic and organic impotence; and (c) excludes transient failure of erection due to fatigue, situational anxiety, alcohol or drugs. (3) While erectile dysfunction attracts ICD-10-AM code F52.2 or N48.4, in applying this Statement of Principles the meaning of erectile dysfunction is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Reasonable Hypothesis (RH) — Statement of Principles No. 72 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting erectile dysfunction or death from erectile dysfunction with the circumstances of a person's relevant service:

  1. (1)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of erectile dysfunction;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  2. (2)
    having a cardiovascular disease from the specified list of cardiovascular diseases at the time of the clinical onset of erectile dysfunction;

    Note: specified list of cardiovascular diseases is defined in the Schedule 1 - Dictionary.

  3. (3)
    having a medical condition from the specified list of medical conditions at the time of the clinical onset of erectile dysfunction;

    Note: specified list of medical conditions is defined in the Schedule 1 - Dictionary.

  4. (4)
    having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of erectile dysfunction;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

  5. (5)
    having an endocrine disorder from the specified list of endocrine disorders at the time of the clinical onset of erectile dysfunction;

    Note: specified list of endocrine disorders is defined in the Schedule 1 - Dictionary.

  6. (6)
    having a neurological disorder from the specified list of neurological disorders at the time of the clinical onset of erectile dysfunction;

    Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.

  7. (7)
    having a urological condition from the specified list of urological conditions, where that condition causes lower urinary tract symptoms, for at least the 3 months before the clinical onset of erectile dysfunction;

    Note: specified list of urological conditions is defined in the Schedule 1 - Dictionary.

  8. (8)
    having an infection from the specified list of infections at the time of the clinical onset of erectile dysfunction;

    Note: specified list of infections is defined in the Schedule 1 - Dictionary.

  9. (9)
    having herpes zoster affecting a sacral dermatome at the time of the clinical onset of erectile dysfunction;
  10. (10)
    having hypertension at the time of the clinical onset of erectile dysfunction;
  11. (11)
    having chronic renal failure at the time of the clinical onset of erectile dysfunction;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  12. (12)
    having Peyronie disease before the clinical onset of erectile dysfunction;

    Note: Peyronie disease is defined in the Schedule 1 - Dictionary.

  13. (13)
    having hidradenitis suppurativa at the time of the clinical onset of erectile dysfunction;
  14. (14)
    having ischaemic priapism for a continuous period of at least the 4 hours before the clinical onset of erectile dysfunction;

    Note: ischaemic priapism is defined in the Schedule 1 - Dictionary.

  15. (15)
    having a surgical operation from the specified list of surgical operations within the 3 months before the clinical onset of erectile dysfunction;

    Note: specified list of surgical operations is defined in the Schedule 1 - Dictionary.

  16. (16)
    having a trauma or surgery involving the brain, spinal cord, thoracolumbosacral nerve roots, cauda equina or the nerve supply to the penis, where the trauma or surgery results in permanent neurological impairment, within the 3 months before the clinical onset of erectile dysfunction;
  17. (17)
    having blunt trauma, penetrating trauma including surgical trauma, explosive blast injury or gunshot injury to the external genitals, perineum or pelvis, within the 3 months before the clinical onset of erectile dysfunction;

    Note: blunt trauma is defined in the Schedule 1 - Dictionary.

  18. (18)
    having internal burns, substantial external burns, or electrical injury to the external genitals, perineum or pelvic region within the 3 months before the clinical onset of erectile dysfunction;

    Note: substantial external burns is defined in the Schedule 1 - Dictionary.

  19. (19)
    having smoked tobacco products: (a) in an amount of at least 10 pack-years before the clinical onset of erectile dysfunction; and (b) if smoking has ceased before the clinical onset of erectile dysfunction, then that onset occurred within 20 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

  20. (20)
    undergoing a course of therapeutic radiation for cancer, where the penis, pelvis or perineal region was in the field of radiation, within the 10 years before the clinical onset of erectile dysfunction;
  21. (21)
    being obese at the time of the clinical onset of erectile dysfunction;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  22. (22)
    taking a drug specified in the Schedule 2 - Drugs of this Instrument at the time of the clinical onset of erectile dysfunction;
  23. (23)
    inhaling, ingesting or having cutaneous contact with carbon disulphide, where inhalation occurred in an unventilated and confined space, on more days than not for a consecutive period of at least 5 years before the clinical onset of erectile dysfunction, and if exposure has ceased before the clinical onset of erectile dysfunction, then that onset occurred within 1 year of cessation;
  24. (24)
    inability to undertake any physical activity greater than 3 METs for at least the 5 years before the clinical onset of erectile dysfunction;

    Note: MET is defined in the Schedule 1 - Dictionary.

  25. (25)
    experiencing childhood sexual abuse before the clinical onset of erectile dysfunction;
  26. (26)
    having a clinically significant disorder of mental health as specified at the time of the clinical worsening of erectile dysfunction;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  27. (27)
    having a cardiovascular disease from the specified list of cardiovascular diseases at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of cardiovascular diseases is defined in the Schedule 1 - Dictionary.

  28. (28)
    having a medical condition from the specified list of medical conditions at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of medical conditions is defined in the Schedule 1 - Dictionary.

  29. (29)
    having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

  30. (30)
    having an endocrine disorder from the specified list of endocrine disorders at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of endocrine disorders is defined in the Schedule 1 - Dictionary.

  31. (31)
    having a neurological disorder from the specified list of neurological disorders at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.

  32. (32)
    having a urological condition from the specified list of urological conditions, where that condition causes lower urinary tract symptoms, for at least the 3 months before the clinical worsening of erectile dysfunction;

    Note: specified list of urological conditions is defined in the Schedule 1 - Dictionary.

  33. (33)
    having an infection from the specified list of infections at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of infections is defined in the Schedule 1 - Dictionary.

  34. (34)
    having herpes zoster affecting a sacral dermatome at the time of the clinical worsening of erectile dysfunction;
  35. (35)
    having hypertension at the time of the clinical worsening of erectile dysfunction;
  36. (36)
    having chronic renal failure at the time of the clinical worsening of erectile dysfunction;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  37. (37)
    having Peyronie disease before the clinical worsening of erectile dysfunction;

    Note: Peyronie disease is defined in the Schedule 1 - Dictionary.

  38. (38)
    having hidradenitis suppurativa at the time of the clinical worsening of erectile dysfunction;
  39. (39)
    having ischaemic priapism for a continuous period of at least the 4 hours before the clinical worsening of erectile dysfunction;

    Note: ischaemic priapism is defined in the Schedule 1 - Dictionary.

  40. (40)
    having a surgical operation from the specified list of surgical operations within the 3 months before the clinical worsening of erectile dysfunction;

    Note: specified list of surgical operations is defined in the Schedule 1 - Dictionary.

  41. (41)
    having a trauma or surgery involving the brain, spinal cord, thoracolumbosacral nerve roots, cauda equina or the nerve supply to the penis, where the trauma or surgery results in permanent neurological impairment, within the 3 months before the clinical worsening of erectile dysfunction;
  42. (42)
    having blunt trauma, penetrating trauma including surgical trauma, explosive blast injury or gunshot injury to the external genitals, perineum or pelvis, within the 3 months before the clinical worsening of erectile dysfunction;

    Note: blunt trauma is defined in the Schedule 1 - Dictionary.

  43. (43)
    having internal burns, substantial external burns, or electrical injury to the external genitals, perineum or pelvic region within the 3 months before the clinical worsening of erectile dysfunction;

    Note: substantial external burns is defined in the Schedule 1 - Dictionary.

  44. (44)
    having smoked tobacco products: (a) in an amount of at least 10 pack-years before the clinical worsening of erectile dysfunction; and (b) if smoking has ceased before the clinical worsening of erectile dysfunction, then that worsening occurred within 20 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

  45. (45)
    undergoing a course of therapeutic radiation for cancer, where the penis, pelvis or perineal region was in the field of radiation, within the 10 years before the clinical worsening of erectile dysfunction;
  46. (46)
    being obese at the time of the clinical worsening of erectile dysfunction;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  47. (47)
    taking a drug specified in the Schedule 2 - Drugs of this Instrument at the time of the clinical worsening of erectile dysfunction;
  48. (48)
    inhaling, ingesting or having cutaneous contact with carbon disulphide, where inhalation occurred in an unventilated and confined space, on more days than not for a consecutive period of at least 5 years before the clinical worsening of erectile dysfunction, and if exposure has ceased before the clinical worsening of erectile dysfunction, then that worsening occurred within 1 year of cessation;
  49. (49)
    inability to undertake any physical activity greater than 3 METs for at least the 5 years before the clinical worsening of erectile dysfunction;

    Note: MET is defined in the Schedule 1 - Dictionary.

  50. (50)
    inability to obtain appropriate clinical management for erectile dysfunction;

Aggravation-only factors: the factors in subsections 9(26) to 9(50) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 73 of 2022

45 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, erectile dysfunction or death from erectile dysfunction is connected with the circumstances of a person's relevant service:

  1. (1)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of erectile dysfunction;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  2. (2)
    having a cardiovascular disease from the specified list of cardiovascular diseases at the time of the clinical onset of erectile dysfunction;

    Note: specified list of cardiovascular diseases is defined in the Schedule 1 - Dictionary.

  3. (3)
    having a medical condition from the specified list of medical conditions at the time of the clinical onset of erectile dysfunction;

    Note: specified list of medical conditions is defined in the Schedule 1 - Dictionary.

  4. (4)
    having systemic sclerosis (scleroderma) at the time of the clinical onset of erectile dysfunction;
  5. (5)
    having an endocrine disorder from the specified list of endocrine disorders at the time of the clinical onset of erectile dysfunction;

    Note: specified list of endocrine disorders is defined in the Schedule 1 - Dictionary.

  6. (6)
    having a neurological disorder from the specified list of neurological disorders at the time of the clinical onset of erectile dysfunction;

    Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.

  7. (7)
    having a urological condition from the specified list of urological conditions, where that condition causes lower urinary tract symptoms, for at least the 6 months before the clinical onset of erectile dysfunction;

    Note: specified list of urological conditions is defined in the Schedule 1 - Dictionary.

  8. (8)
    having an infection from the specified list of infections at the time of the clinical onset of erectile dysfunction;

    Note: specified list of infections is defined in the Schedule 1 - Dictionary.

  9. (9)
    having herpes zoster affecting a sacral dermatome at the time of the clinical onset of erectile dysfunction;
  10. (10)
    having hypertension at the time of the clinical onset of erectile dysfunction;
  11. (11)
    having chronic renal failure at the time of the clinical onset of erectile dysfunction;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  12. (12)
    having Peyronie disease before the clinical onset of erectile dysfunction;

    Note: Peyronie disease is defined in the Schedule 1 - Dictionary.

  13. (13)
    having ischaemic priapism for a continuous period of at least the 4 hours before the clinical onset of erectile dysfunction;

    Note: ischaemic priapism is defined in the Schedule 1 - Dictionary.

  14. (14)
    having a surgical operation from the specified list of surgical operations within the 3 months before the clinical onset of erectile dysfunction;

    Note: specified list of surgical operations is defined in the Schedule 1 - Dictionary.

  15. (15)
    having a trauma or surgery involving the brain, spinal cord, thoracolumbosacral nerve roots, cauda equina or the nerve supply to the penis, where the trauma or surgery results in permanent neurological impairment, within the 3 months before the clinical onset of erectile dysfunction;
  16. (16)
    having blunt trauma, penetrating trauma including surgical trauma, explosive blast injury or gunshot injury to the external genitals, perineum or pelvis, within the 3 months before the clinical onset of erectile dysfunction;

    Note: blunt trauma is defined in the Schedule 1 - Dictionary.

  17. (17)
    having internal burns, substantial external burns, or electrical injury to the external genitals, perineum or pelvic region within the 3 months before the clinical onset of erectile dysfunction;

    Note: substantial external burns is defined in the Schedule 1 - Dictionary.

  18. (18)
    having smoked tobacco products: (a) in an amount of at least 15 pack-years before the clinical onset of erectile dysfunction; and (b) if smoking has ceased before the clinical onset of erectile dysfunction, then that onset occurred within 20 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

  19. (19)
    undergoing a course of therapeutic radiation for cancer, where the penis, pelvis or perineal region was in the field of radiation, within the 10 years before the clinical onset of erectile dysfunction;
  20. (20)
    being obese at the time of the clinical onset of erectile dysfunction;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  21. (21)
    taking a drug from the specified list of drugs at the time of the clinical onset of erectile dysfunction;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  22. (22)
    inability to undertake any physical activity greater than 3 METs for at least the 5 years before the clinical onset of erectile dysfunction;

    Note: MET is defined in the Schedule 1 - Dictionary.

  23. (23)
    having a clinically significant disorder of mental health as specified at the time of the clinical worsening of erectile dysfunction;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  24. (24)
    having a cardiovascular disease from the specified list of cardiovascular diseases at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of cardiovascular diseases is defined in the Schedule 1 - Dictionary.

  25. (25)
    having a medical condition from the specified list of medical conditions at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of medical conditions is defined in the Schedule 1 - Dictionary.

  26. (26)
    having systemic sclerosis (scleroderma) at the time of the clinical worsening of erectile dysfunction;
  27. (27)
    having an endocrine disorder from the specified list of endocrine disorders at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of endocrine disorders is defined in the Schedule 1 - Dictionary.

  28. (28)
    having a neurological disorder from the specified list of neurological disorders at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.

  29. (29)
    having a urological condition from the specified list of urological conditions, where that condition causes lower urinary tract symptoms, for at least the 6 months before the clinical worsening of erectile dysfunction;

    Note: specified list of urological conditions is defined in the Schedule 1 - Dictionary.

  30. (30)
    having an infection from the specified list of infections at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of infections is defined in the Schedule 1 - Dictionary.

  31. (31)
    having herpes zoster affecting a sacral dermatome at the time of the clinical worsening of erectile dysfunction;
  32. (32)
    having hypertension at the time of the clinical worsening of erectile dysfunction;
  33. (33)
    having chronic renal failure at the time of the clinical worsening of erectile dysfunction;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  34. (34)
    having Peyronie disease before the clinical worsening of erectile dysfunction;

    Note: Peyronie disease is defined in the Schedule 1 - Dictionary.

  35. (35)
    having ischaemic priapism for a continuous period of at least the 4 hours before the clinical worsening of erectile dysfunction;

    Note: ischaemic priapism is defined in the Schedule 1 - Dictionary.

  36. (36)
    having a surgical operation from the specified list of surgical operations within the 3 months before the clinical worsening of erectile dysfunction;

    Note: specified list of surgical operations is defined in the Schedule 1 - Dictionary.

  37. (37)
    having a trauma or surgery involving the brain, spinal cord, thoracolumbosacral nerve roots, cauda equina or the nerve supply to the penis, where the trauma or surgery results in permanent neurological impairment, within the 3 months before the clinical worsening of erectile dysfunction;
  38. (38)
    having blunt trauma, penetrating trauma including surgical trauma, explosive blast injury or gunshot injury to the external genitals, perineum or pelvis, within the 3 months before the clinical worsening of erectile dysfunction;

    Note: blunt trauma is defined in the Schedule 1 - Dictionary.

  39. (39)
    having internal burns, substantial external burns, or electrical injury to the external genitals, perineum or pelvic region within the 3 months before the clinical worsening of erectile dysfunction;

    Note: substantial external burns is defined in the Schedule 1 - Dictionary.

  40. (40)
    having smoked tobacco products: (a) in an amount of at least 15 pack-years before the clinical worsening of erectile dysfunction; and (b) if smoking has ceased before the clinical worsening of erectile dysfunction, then that worsening occurred within 20 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

  41. (41)
    undergoing a course of therapeutic radiation for cancer, where the penis, pelvis or perineal region was in the field of radiation, within the 10 years before the clinical worsening of erectile dysfunction;
  42. (42)
    being obese at the time of the clinical worsening of erectile dysfunction;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  43. (43)
    taking a drug from the specified list of drugs at the time of the clinical worsening of erectile dysfunction;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  44. (44)
    inability to undertake any physical activity greater than 3 METs for at least the 5 years before the clinical worsening of erectile dysfunction;

    Note: MET is defined in the Schedule 1 - Dictionary.

  45. (45)
    inability to obtain appropriate clinical management for erectile dysfunction;

Aggravation-only factors: the factors in subsections 9(23) to 9(45) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

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Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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