Citation Nr: 18143088 Decision Date: 10/18/18 Archive Date: 10/17/18 DOCKET NO. 16-04 648 DATE: October 18, 2018 REMANDED Service connection for diabetes mellitus type II, to include as secondary to service-connected hepatitis C and as due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1972 to March 1974. In May 2016, Board remanded the issue on appeal for a video conference hearing. The Veteran was notified in August 2018 that a video conference hearing had been scheduled for September 2018. However, in September 2018, his attorney withdrew his Board hearing request and submitted a brief in lieu of a hearing. The Board observes that the Veteran’s attorney’s September 2018 brief addressed the issue of service connection for coronary artery disease (CAD). In May 2016, the Board remanded that issue for further development. There is no indication in the claims file that the Regional Office (RO) has begun to conduct the development ordered in the May 2016 remand, i.e., scheduling the requested VA medical opinions; nor has the RO issued a Supplemental Statement of the Case (SSOC). As that issue is still in remand status and another Veterans Law Judge took testimony on that issue in January 2016, the Board will address that issue in a separate decision when appropriate, if otherwise in order. The appeal is remanded for further development. The Veteran seeks service connection for diabetes type II, to include as secondary to service-connected hepatitis C. During the pendency of this appeal, the Board granted service connection for hepatitis C. See May 2016 Board Decision / Remand; July 2016 Rating Decision. The Veteran and his representative have submitted and cited medical literature showing a possible relationship between hepatitis C and diabetes mellitus, type II. See September 2018 appellate brief; medical articles submitted in July 2012 correspondence. A VA medical opinion is needed to address this secondary service connection theory raised by the record. Also, the RO previously obtained and considered the Veteran’s Social Security Administration (SSA) records. The May 2013 SSA cover sheet indicates that SSA submitted the enclosed records via CD; however, the accompanying SSA records themselves appear to be missing. The RO must attempt to locate the SSA records that it previously obtained and considered, and re-associate them with the file. The matter is REMANDED for the following action: 1. Locate and re-associate with the file the Veteran’s SSA disability claim records from approximately October 2006 through January 2011 that the RO received from SSA via CD in May 2013, and considered in the August 2013 Rating Decision and January 2016 Statement of the Case. If the RO cannot locate these records, then it must re-request them from SSA. If the RO receives a negative response from SSA, then it must give the Veteran an opportunity to submit the records himself. Document in the claims file all requests, negative responses, and communications with SSA and the Veteran or his representative. 2. Then, only after completing the above, schedule a VA medical opinion regarding the Veteran’s current diabetes mellitus, type II. The examiner must note his or her review of the complete claims file. The examiner must address the following, with full supporting rationales: (a.) Is it at least as likely as not that the Veteran’s current diabetes mellitus, type II was proximately due to or caused by his service-connected hepatitis C? (b.) Is it at least as likely as not that the Veteran’s current diabetes mellitus, type II has been aggravated (i.e., permanently worsened beyond its natural progression) by his service-connected hepatitis C? Regarding both opinions requested above, please expressly consider: medical literature cited by Veteran’s attorney in September 2018 brief (showing hepatitis C has been associated with diabetes mellitus and insulin resistance); and medical articles received in July 2012 (summarizing medical research showing hepatitis C can directly cause insulin resistance, which commonly leads to diabetes; and finding that having hepatitis C greatly increases risk of developing diabetes type II). If any opinion requested above is not possible without resort to mere speculation, then the examiner must explain why. If the VA examiner finds that he or she cannot provide the requested opinions without a VA examination, then the RO must schedule one. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Janofsky, Associate Counsel