Citation Nr: 18144461 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 16-19 238A DATE: October 24, 2018 REMANDED Entitlement to service connection for diabetes mellitus is remanded. REASONS FOR REMAND The Veteran served as a member of the United States Army, with active duty service from October 1980 through July 1981, July 1984 through September 1990, and July 1992 through February 1994. This appeal comes to the Board of Veterans’ Appeals (“Board”) from rating decisions, issued August 2013 and June 2014, by the Department of Veterans Affairs (“VA”) Regional Office (“RO”) in St. Paul, Minnesota (hereinafter Agency of Original Jurisdiction (“AOJ”)). The Board notes that the RO has treated this claim as a claim to reopen essentially finding that an August 2013 rating decision that denied service connection for diabetes mellitus was not appealed. However, the Board observes that in response to the August 2013 rating decision, the Veteran submitted a VA Form 21-4138, “Statement in Support of Claim” in September 2013. While the Veteran requested that her claim be “reopened,” it is clear from the statement that the Veteran was expressing disagreement with the denial of service connection for diabetes mellitus. Accordingly, the Board accepts the Veteran’s September 2013 statement as a timely notice of disagreement (“NOD”). Therefore, the Veteran need not submit new and material evidence to reopen the claim and the Board will address the merits of the Veteran’s claim. The Veteran was scheduled to appear at an August 2018 Travel Board hearing before a Member of the Board. However, the record reflects that the Veteran did not appear for the scheduled hearing. A request to reschedule the hearing was not received prior to the date of the hearing. Additionally, the record does not show that she has requested that the hearing be rescheduled. Accordingly, the Board will proceed with review of the appeal. 1. Entitlement to service connection for diabetes mellitus is remanded. Although the Board sincerely regrets the delay, the Veteran’s claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds the AOJ has not fully complied with the VA’s statutory duty to assist the Veteran in developing her claim. The Board finds that a remand is required in order to obtain a medical opinion which fully addresses the etiology of the Veteran’s diabetes mellitus. A review of the medical evidence of record indicates that no VA examiner has provided an opinion or diagnosis with regard to the Veteran’s claim for diabetes mellitus, type II. The Veteran was discharged from the Army in February 1994 and first applied for service connection for diabetes mellitus in May 2013. On her initial application form, the Veteran identified her treatment dates for diabetes mellitus as December 1990 to the present. The earliest indication of diabetes is in the Veteran’s medical records. Lab results from April 1995 suggest pre-diabetic glucose levels of 127. However, there is no evidence of a diagnosed condition, or medical findings consistent with diabetes, during the Veteran’s active duty service as no VA medical examination was administered. Rather, the first diagnosis of diabetes mellitus is documented in the Veteran’s February 1998 lab results contained in her service treatment records. These records suggest “a provisional diagnosis of diabetes.” Finally, as the Veteran’s claim is being remanded, the Board requests that the AOJ contact the Veteran to ensure all available medical records have been obtained and associated with the claims file. The VA’s duty to assist includes obtaining records of relevant VA medical treatment. 38 U.S.C. §5103A (c)(2); 38 C.F.R. § 3.159 (c)(2), (c)(3). See also Bell v. Derwinski, 2 Vet. App. 611 (1992) (The VA is charged with constructive, if not actual, knowledge of evidence generated by the VA). Therefore, the AOJ should obtain and associate with the claims file any outstanding VA medical records, assuming they are adequately identified by the Veteran after any necessary clarification. Accordingly, the case is REMANDED for the following action: 1. The AOJ should contact the Veteran, and, with her assistance, identify any additional outstanding records of pertinent medical treatment from the VA or private health care providers that have treated her for disabilities. Follow the procedures for obtaining the records set forth by 38 C.F.R. § 3.159 (c). If the AOJ’s attempts to obtain any outstanding records results in a finding that such records are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159 (e). 2. After any additional records are associated with the claims file, the AOJ should schedule the Veteran for a VA examination to assess the etiologies of the Veteran’s diabetes mellitus, type II. All necessary diagnostic testing and evaluation should be performed, and all findings set forth in detail. Based upon a review of the entirety of the claims file, the history presented by the Veteran, and her medical records, the examiner is requested to provide an opinion as to the following questions: (a.) Does the Veteran have a current diagnosis for type II diabetes mellitus? (b.) If the Veteran has a current diagnosis for type II diabetes mellitus, did this disability arise while the Veteran was in active service or one year following her discharge from active service or did this disability arise more than one year after the Veteran was discharged? In rendering the above opinions, the examiner must consider and address the following evidence: (a.) the April 1995 Jesse Brown VAMC report, showing glucose levels of 127; and (b.) the February 1998 service treatment record documenting the first evidence/treatment for a diabetes mellitus diagnosis. Explanations for all opinions must be provided. In providing the requested rationale, the examiner is asked to cite to the pertinent evidence of record, including clinical records and the Veteran’s statements regarding the onset of her symptoms. 3. After completing the above development, the AOJ should review the claims file and ensure that all of the foregoing development actions have been conducted and completed in full. See Stegall v. West, 11 Vet. App. 268 (1998). 4. Thereafter, the AOJ should consider all of the evidence of record and readjudicate the claim on appeal. If the benefit sought is not granted, issue a Supplemental Statement of the Case (“SSOC”) and allow the Veteran and her representative an opportunity to respond. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). The 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. §§ 5109B, 7112 (West 2012). DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Kathryn Bristor