Citation Nr: 1323817 Decision Date: 07/26/13 Archive Date: 08/06/13 DOCKET NO. 08-38 872 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUE Entitlement to service connection for diabetes mellitus. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD S. Coyle, Counsel INTRODUCTION The Veteran served on active duty from January 1980 to January 1993. He had additional service in the U.S. Air Force Reserve from March 1995 to January 2007, which included various periods of active duty for training and inactive duty for training. This matter is before the Board of Veterans' Appeals (Board) on appeal of a May 2007 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A hearing on this matter was held before a Decision Review Officer at the RO on October 1, 2007. The hearing transcript is of record. 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 was diagnosed with diabetes mellitus in January 2005. He has submitted a statement from his private physician, Dr. G.O., stating that, although he was first diagnosed with diabetes mellitus in January 2005, he likely had the disease for some time prior to that. The Veteran was not serving a period of active duty for training at the time his diabetes was diagnosed. However, he did have several periods of active duty for training in the years immediately preceding his diagnosis, and one period of active duty for training in May 2005, approximately 4 months after his diagnosis. The Veteran must be scheduled for a VA examination to determine whether diabetes manifested during a period of active service, or, if not, whether pre-existing diabetes was aggravated as a result of active service in May 2005. Additionally, pending authorization from the Veteran, Dr. O.'s treatment records must be requested, and he must be asked to clarify his opinion as to the onset of the Veteran's diabetes. Accordingly, the case is REMANDED for the following action: 1. After obtaining the Veteran's written authorization, request all records of his treatment for diabetes mellitus from his private physician, Dr. G.O. Dr. O. must also be asked to provide medical evidence to support his conclusion that the Veteran's diabetes mellitus had its onset some time prior to January 2005, and, if possible, to opine as to the approximate date of onset. 2. Afford the Veteran the opportunity to submit evidence that his diabetes mellitus was aggravated beyond the natural progress of the disease as a result of active service in May 2005. 3. After the above development is completed, schedule the Veteran for a VA examination by an appropriate medical professional. The entire claim file (i.e., the paper claim file and any medical records contained in Virtual VA, CAPRI, and AMIE) must be reviewed by the examiner. If the examiner does not have access to Virtual VA, any relevant treatment records contained in the Virtual VA file that are not available on CAPRI or AMIE must be printed and associated with the paper claim file so they can be available to the examiner for review. The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that diabetes mellitus was incurred during a period of active duty for training, or, if not, whether it is at least as likely as not that it was aggravated as a result of active service. The term "aggravation" means a permanent increase in the claimed disability; that is, an irreversible worsening of the condition beyond the natural clinical course and character of the condition due to the service-connected disability as contrasted to a temporary worsening of symptoms. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 4. Then, readjudicate the appeal. If the benefit sought is denied, issue a supplemental statement of the case and return the case to the Board. 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 or by the Court for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ RONALD W. SCHOLZ Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the Court. 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) (2012).