Citation Nr: 18139878 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 15-06 784 DATE: October 1, 2018 REMANDED Entitlement to service connection for type II diabetes mellitus, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to July 1970, which included service in the Republic of Vietnam. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In July 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. The Veteran has contended that he developed diabetes mellitus due to his exposure to herbicides during his service in Vietnam during the Vietnam Era. VA has determined that if a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected if the requirements of section 3.307(a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of section 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). The diseases presumed to be associated with herbicide exposure include type II diabetes mellitus. 38 C.F.R. § 3.309(e). The Veteran was afforded a VA examination in March 2014 in connection with his claim. However, the examiner found that the Veteran did not have a diagnosis of type I or II diabetes mellitus. Instead, he noted that the Veteran had impaired fasting glucose. The claims file also does not contain any treatment records showing that the Veteran has been diagnosed with diabetes mellitus. During the July 2018 hearing, the Veteran reported that he was diagnosed with diabetes mellitus during an Agent Orange registry examination, yet such a diagnosis is not documented. He also indicated that he had not been treated for diabetes mellitus since his registry examination; however, he reported that he currently experiences daily symptoms of constant thirst and frequent urination. Given the Veteran’s reports of current symptomatology that were not noted at the time of the March 2014 VA examination, the Board finds that an additional examination is needed. The matter is REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should request that the Veteran provide the names and addresses of any and all health care providers who have provided treatment or testing for type II diabetes mellitus. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file The AOJ should also obtain any outstanding VA medical records, to include any Agent Orange registry examination reports. 2. After completing the foregoing development, the Veterans should be afforded a VA examination to determine the nature and etiology of any diabetes mellitus that may be present. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and lay statements. It should be noted that the Veteran is considered competent to attest to factual matters of which he had first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should determine whether the Veteran has a diagnosis of type II diabetes mellitus. If not, the examiner should provide an explanation addressing the prior assessment of impaired fasting glucose during the March 2014 VA examination report. (The term “at least as likely as not “does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of a certain conclusion as it is to find against it.) A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important “that each disability be viewed in relation to its history[,]”38 C.F.R. § 4.1, copies of all pertinent records in the Veteran’s claims file, or in the alternative, the claims file, must be made available to the examiner for review. 3. The AOJ should review the examination report to ensure that it is in compliance with this remand. If the report is deficient in any manner, the AOJ should implement corrective procedures. 4. After completing these actions, the AOJ should conduct any other development as may be indicated by a response received as a consequence of the actions taken in the preceding paragraphs. J.W. ZISSIMOS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Saikh, Associate Counsel