Citation Nr: 18142235 Decision Date: 10/15/18 Archive Date: 10/15/18 DOCKET NO. 08-03 099 DATE: October 15, 2018 REMANDED Entitlement to service connection for diabetes mellitus, Type II, secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1984 to August 1991. This matter comes before the Board of Veterans' Appeals (Board) from an October 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In September 2012, March 2014, November 2015, and December 2016 the appeal was remanded to the agency of original jurisdiction for additional development. The Board denied the claim in September 2017. The Veteran appealed the Board’s September 2017 denial to the United States Court of Appeals for Veterans Claims (Court). In June 2018, the Court granted the joint motion for partial remand filed by representatives for both parties, vacating that portion of the decision in which the Board denied service connection for diabetes mellitus, on a secondary basis, and remanding that claim to the Board for further proceedings consistent with the joint motion. The Court left undisturbed insofar as the denial for service connection on a direct basis. In May 2017 and September 2018 statements, the Veteran contends that his service-connected disabilities and medications taken for such disabilities caused him to be overweight, despite his efforts in eating healthy and taking other proper healthy measures. He also contends that he has had his service-connected disabilities since 1985 and that his health declined since then and his disabilities caused psychological and physical effects that impacted his day to day living and ability to manage limitations as a result. The Veteran also included an article that discussed steroid induced diabetes mellitus, and here, the Veteran was prescribed steroids for his service-connected disabilities. Pursuant to the Joint Motion, the parties agree that the Board relied on an inadequate medical opinion in denying his claim for diabetes mellitus on a secondary basis. Thus, on remand, an addendum opinion is necessary to address whether the Veteran’s service-connected disabilities, to include medications taken for such disabilities, caused him to become obese and, if so, whether the obesity was a substantial factor in causing his diabetes and whether his diabetes would not have occurred but for the obesity caused by his service-connected disabilities. VAOPGCPREC 1-2017 (explaining although obesity is not a disability for VA compensation purposes, obesity may act as an “intermediate step” between a service-connected disability and a current disability that may be service-connected on a secondary basis under 38 C.F.R. § 3.310(a)). The matter is REMANDED for the following action: Request an opinion from an appropriate VA physician addressing the below. (A full VA examination should not be scheduled unless it is deemed necessary by the evaluator or otherwise required by the evidence.) The evaluator should review the electronic records contained in the electronic claims file, including a copy of this remand. Based on review of the record, the physician should determine whether it is at least as likely as not (50 percent probability or more) the Veteran’s service-connected disabilities, to include medications taken for such disabilities, caused him to become obese and, if so, whether the obesity was a substantial factor in causing his diabetes and whether his diabetes would not have occurred but for the obesity caused by his service-connected disabilities. In answering the above, the physician should address the Veteran contentions, to include those outlined in the May 2017 and September 2018 statements, as noted above, as well as the article discussing steroid induced diabetes. The physician is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account in formulating the requested opinions. (Continued on the next page)   A complete rationale should accompany any opinion provided. ERIC S. LEBOFF Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Sarah Campbell