Citation Nr: 18158267
Decision Date: 12/14/18	Archive Date: 12/14/18

DOCKET NO. 17-02 562
DATE:	December 14, 2018
REMANDED
Entitlement to service connection for diabetes mellitus, type II, to include as secondary to hypertension, is remanded.
REASONS FOR REMAND
The Veteran served in the U.S. Army from June 1994 to May 2002. 
The Board notes that the Veteran was also denied entitlement to service connection for an acquired psychiatric disorder, to include depression, in a March 2016 rating decision.  He disagreed with this determination and appealed.  Prior to the promulgation of a decision by the Board, the regional office granted the Veteran’s claim.  Thus, it is no longer before the Board. 
Entitlement to service connection for diabetes mellitus, type II, to include as secondary to hypertension, is remanded.
The record reveals that the Veteran has been diagnosed with both diabetes mellitus, type II, and hypertension, and has been granted entitlement to service connection for hypertension.  The Veteran believes that there is a relationship between his diabetes and his service-connected hypertension.
He was provided a VA examination in July 2017 in conjunction with his claim.  There, the VA examiner opined that his diabetes was not proximately due to or the result of his service-connected hypertension.  In support of this finding, the examiner reasoned that recognized medical literature and research studies do not show direct causation between hypertension and the development of diabetes mellitus, type II.  She then provided excerpts from two medical reference articles from the online medical reference “Up to Date” which listed several risk factors for the development of diabetes and the complications of hypertension.  The Board observes that the examiner did not address the medical treatise provided by the Veteran in January 2017 which indicates that people with elevated blood pressure are at an increased risk of diabetes.  On remand, the Board requests that the examiner specifically address this study to include whether it supports that diabetes is as likely as not secondary to service-connected hypertension.
The matter is REMANDED for the following action:
1. Obtain an addendum opinion from the July 2017 VA examiner, or equivalent medical professional if unavailable, to answer whether the Veteran’s diabetes mellitus, type II, is as likely as not either proximately due to service-connected hypertension or permanently worsened beyond normal progression (aggravated) as a result of service-connected hypertension.  The opinion should be rendered with express consideration of the medical treatise provided by the Veteran in support of his claim.  A complete rationale should be given for all opinions.
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2. Readjudicate.
 
C.A. SKOW
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L. Bush