Citation Nr: 18150661 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 15-00 928 DATE: November 15, 2018 REMANDED Entitlement to an increased disability rating in excess of 20 percent for diabetes mellitus type II (herbicide) with erectile dysfunction, bilateral hearing loss, and diabetic nephropathy with hypertension is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from August 1968 to July 1970. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2012 rating decision. The Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge in February 2018. A transcript from that proceeding is associated with the Veterans Benefits Management System (VBMS) folder. The Board notes that the Veteran requested a Decision Review Officer (DRO) hearing in connection with his appeal. See February 2016 Statement. The AOJ did not schedule the Veteran for this requested hearing. However, the Board finds that any question as to whether the Veteran was afforded due process in regard to the DRO hearing was addressed when the Veteran was provided the opportunity to testify at a Board hearing. See Bowen v. Shinseki, 25 Vet. App. 250, 253-54 (2012) (holding that there is no due process violation when VA denies the veteran a hearing before the RO in error, but the veteran maintains the ability to appeal and obtain a de novo hearing before the Board). 1. Entitlement to an increased disability rating in excess of 20 percent for diabetes mellitus type II (herbicide) with erectile dysfunction, bilateral hearing loss, and diabetic nephropathy with hypertension is remanded. The Veteran was last afforded a VA examination to evaluate his diabetes disability in October 2011. At that time, the examiner noted that the Veteran was not restricted in his ability to perform strenuous activities. The Veteran has since submitted a February 2018 Disability Benefits Questionnaire (DBQ) in which J.R. marked that the Veteran did require regulation of activities as part of his medical management of diabetes mellitus. J.R. also noted that the disorders associated with the Veteran’s diabetes included hypertension, cardiac conditions, skin conditions, erectile dysfunction, peripheral vascular disease, and other complications involving neurological and tactile complaints. However, J.R. did not follow the DBQ’s instructions to also complete separate DBQs related to these disorders. The Board notes that the Veteran is already in receipt of separate compensable disability ratings for peripheral vascular disease of the bilateral lower extremities and peripheral neuropathy of the bilateral upper and lower extremities. However, his erectile dysfunction, bilateral hearing loss, and diabetic neuropathy with hypertension have been rated with diabetes mellitus as noncompensable complications are deemed part of the diabetic process under 38 C.F.R. § 4.119, Diagnostic Code 7913. The question of whether separate compensable ratings are warranted for these complications is therefore intertwined with the increased rating claim for diabetes. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1990). Consequently, there is insufficient information to rate the diabetes mellitus in the absence of separate DBQs for these complications. Thus, the Board finds that a remand is necessary to obtain a more complete VA examination. The matter is REMANDED for the following action: 1. The AOJ should request that the Veteran provide the names and addresses of any and all health care providers who have provided treatment related to his diabetes mellitus type II with erectile dysfunction, bilateral hearing loss, and diabetic nephropathy with hypertension. 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 secure any outstanding, relevant VA medical records, to include records from the VA Caribbean Healthcare System dated since June 2011. 2. After the preceding development in paragraph 1 is completed, the Veteran should be afforded a VA examination regarding the current severity and manifestations of his diabetes mellitus with erectile dysfunction, bilateral hearing loss, and diabetic nephropathy with hypertension. 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. The Veteran is competent to attest to 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 report all signs and symptoms necessary for rating the Veteran's disability under the rating criteria. In particular, the examiner should indicate whether his diabetes requires insulin, a restricted diet, oral hypoglycemic agent, and regulation of activities. The examiner should also indicate whether there have been any episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic provider. In addition, the examiner should identify and describe all complications of the Veteran's diabetes mellitus, to include erectile dysfunction, bilateral hearing loss, and diabetic nephropathy with hypertension. In rendering these findings, the examiner should address the following: (1) the findings in the February 2018 Disability Benefits Questionnaire concerning the complications of diabetes; (2) the Veteran’s February 2018 Board hearing testimony that he experienced a heart attack that was due to diabetes; and (3) the Veteran’s February 2018 Board hearing testimony that he has problems with his teeth as a result of his diabetes. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K.C. Spragins, Associate Counsel