Citation Nr: 1040652 Decision Date: 10/29/10 Archive Date: 11/04/10 DOCKET NO. 07-01 646 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Winston-Salem, North Carolina THE ISSUE Entitlement to service connection for diabetes mellitus, to include as due to herbicide exposure. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD M. Riley, Associate Counsel INTRODUCTION The Veteran served on active duty with the Air Force from July 1972 to September 1976 and with the Navy from December 1980 to October 1995. This case comes before the Board of Veterans' Appeals (Board) on appeal from a March 2006 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran contends that service connection is warranted for diabetes mellitus as it was incurred due to exposure to herbicides during active duty service in Thailand. Under the VCAA, VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002). The evidence of a link between current disability and service must be competent. Wells v. Principi, 326 F.3d 1381 (Fed. Cir. 2003). The threshold for getting an examination under the VCAA is low. McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). Service treatment records do not contain a diagnosis of diabetes, but they contain numerous blood glucose test results during the Veteran's naval service. His fasting blood glucose was described as mildly elevated in July 1986. Subsequent blood glucose test results laboratory results dated throughout the remainder of his active duty included many above 100 mg/dL but below the high end of the normal reference range, when listed, of either 110 or 115. The post-service record contains multiple findings of elevated blood sugar, and the Veteran's VA physician in November 2003 noted that the Veteran's blood sugar levels had been trending upwards for several years. When the Veteran filed his claim for service connection in October 2005, he reported he was diagnosed with diabetes type II one year ago; a treatment note dated in February 2004 includes an assessment of type II diabetes mellitus. Thus, in addition to the exposure to Agent Orange in Thailand reported by the Veteran, there are blood glucose test results at the high end of normal - and at least one above normal - in the service treatment records and current references to diabetes in the VA treatment records. Therefore, the Board finds that a VA examination and medical opinion are required to determine the nature and etiology of the Veteran's diabetes mellitus. This will also give the Agency of Original Jurisdiction (AOJ) the opportunity to ensure that the Veteran's claim has been developed in accordance with the current provisions of VA's Adjudication Procedure Manual (M21-1 MR) pertaining to claims based on exposure to herbicides in Thailand, including adding to the claims folder a copy of the Compensation and Pension (C&P) Service's "Memorandum for the Record" addressing herbicide exposure in Thailand, and taking any other necessary steps to develop the Veteran's claim as outlined in the M21-1 MR. See M21-1 MR, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 10(p). Accordingly, the case is REMANDED for the following action: 1. Ensure that the Veteran's claim for service connection based on exposure to herbicides in Thailand has been properly developed in accordance with M21-1 MR, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 10(p). 2. Schedule the Veteran for a VA examination with an appropriate examiner. The claims folders or copies of relevant evidence from the claims folders, and a copy of this remand, must be made available to and be reviewed by the examiner. After examining the Veteran and reviewing the claims folder, including service records, the examiner should proffer an opinion as to whether it is at least as likely as not (a 50 percent or better probability) that current diabetes mellitus is etiologically related to any incident of the Veteran's active duty service, to include the alleged exposure to herbicides during active duty service. The rationale for any opinions should also be provided. 3. The claim should then be readjudicated with consideration of all evidence. If the claim remains denied, issue a SSOC before returning the case to the Board, if otherwise in order. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2010). _________________________________________________ Mary Gallagher Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2010).