VA Disability Benefits for Female Sexual Arousal Disorder (FSAD)

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What is Female Sexual Arousal Disorder (FSAD)?

Female sexual arousal disorder (FSAD) is defined as persistent, recurrent problems with sexual response, desire, orgasm, or pain that can distress you or strain your relationship with your partner.  Decreased blood flow to the genital area is believed to contribute to FSAD similar to the role of vascular disease in male erectile dysfunction.  Female sexual arousal disorder (FSAD) in particular can occur at any stage of life.  Common symptoms and associated disorders include the following:

• Low sexual drive. The most common symptom of female sexual dysfunction; involves a lack of sexual interest and willingness to be sexual.
• Sexual arousal disorder. Desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
• Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
• Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

Risk factors for FSAD can include depression or anxiety, heart and blood vessel disease, neurological conditions, gynecological conditions, certain medications, and a history of sexual abuse.  While FSAD may be in part caused by a psychiatric condition, FSAD is not a mental health condition in and of itself.  Instead, it is characterized by physiological findings/damage to the gynecological system.  Therefore, a diagnosis of FSAD cannot be rendered or confirmed by a mental health professional.

Importantly, FSAD can also be caused or aggravated by female veterans’ military service.  To receive VA disability compensation for FSAD, veterans must establish service connection.

Service Connection for FSAD

To establish service connection for FSAD, veterans must demonstrate the following:

• A current diagnosis of FSAD
• An in-service event, injury, or illness
• A medical nexus linking the current diagnosis of FSAD to the in-service event

In many cases, veterans will attend a Compensation & Pension (C&P) examination in order for VA to assess the cause and/or severity of their FSAD.  During the examination, a VA gynecologist or healthcare professional will ask the veteran questions about their condition and what they are experiencing.  In certain cases, the examiner will perform tests in order to rule out other potential conditions.  Once a diagnosis is established, the VA examiner will provide an opinion as to whether the veteran’s condition is “at least as likely as not” due to their time in service.  Additionally, the examiner will describe the effects the condition has on the veteran’s daily life.

How VA Rates FSAD

VA rates FSAD under 38 CFR § 4.116, Schedule of Ratings – Gynecological Conditions and Disorders of the Breast, Diagnostic Code 7632.  Service-connected FSAD is rated at 0 percent unless there is physical damage to the genitals, in which case, it is rated under the diagnostic codes for the affected parts.  FSAD may be entitled to additional compensation under Special Monthly Compensation (SMC) level K.  However, in order to be awarded SMC(K), it must qualify as loss of use of the reproductive organs, leading to infertility.  As of 2020, the additional compensation rate for SMC(K) is $110.31 per month.  Importantly, SMC(K) is added to veterans’ regular amount of monthly compensation.

When Did VA Start Awarding Disability Compensation for FSAD?

In September 2017, VA began updating its Schedule for Rating Disabilities.  On May 13, 2018 the new rating schedule for gynecological conditions and disorders of the breast became effective.  No conditions were removed from the new rating schedule for gynecological conditions and disorders of the breast; however, several new diagnostic codes were added and others were re-titled, restructured, or updated.  FSAD was among the new conditions added to the rating schedule.  The new rating schedule guarantees both men and women veterans are evaluated equally in this regard.