Citation Nr: 18158326 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 16-36 011A DATE: December 14, 2018 REMANDED Entitlement to service connection for diabetes mellitus is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1970 to July 1994. This case is before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of the Waco, Texas Department of Veterans Affairs (VA) Regional Office (RO). Specifically, the Veteran’s claim for entitlement to service connection for diabetes mellitus was initially denied in a March 2011 rating decision. The Veteran disagreed with this determination and submitted additional evidence within one year of that decision. See December 2011 Correspondence. The RO continued to deny the Veteran’s claim in a July 2013 rating decision. This appeal followed. The Veteran seeks service connection for diabetes mellitus. He contends he developed diabetes mellitus while he was serving in active duty, but that he was not diagnosed or treated for it until well after leaving the service. The Veteran essentially contends that during a 1993 or 1994 medical examination, he experienced an unusually high fasting glucose test at 135 mg/dL, so the physician instructed him to return the next day for another fasting glucose test. The Veteran contends that his fasting glucose reading was 125 mg/dL the following day, and the doctor did not inform him of a possible diabetes diagnosis. The Veteran’s service treatment records (STRs) confirm that he experienced several elevated glucose readings during active duty service. Specifically, his highest fasting blood sugar reading occurred on January 16, 1994, and was 120 mg/dL. On January 19, 1994, the Veteran’s fasting blood sugar reading was 112 mg/dL. There are no readings of 125 or 135 mg/dL in the Veteran’s STRs, although he asserts that these were simply not recorded in his STRs. See October 2016 statement. The Veteran has a current diagnosis of diabetes mellitus, but he has not been provided an examination to determine the nature and etiology of this disability. In light of the several high blood sugar readings recorded in the Veteran’s STRs, the Board finds that a VA examination for a medical opinion is necessary to address whether these high blood sugar readings in service represented undiagnosed diabetes mellitus or the onset of the disability, as essentially asserted by the Veteran. The matter is REMANDED for the following actions: 1. Contact the Veteran and obtain the names and addresses of all medical care providers, VA and non-VA, who might have records, not already associated with the claims file, pertaining to post-service treatment or evaluation of diabetes mellitus. After the Veteran has signed the appropriate releases, those records not already of record should be obtained and associated with the claims file. 2. After all available treatment records are associated with the claims file, to the extent possible, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his diabetes mellitus. The examiner should be provided and review the electronic claims file, including a copy of this Remand. The examiner should address whether it is as least as likely as not (50 percent or greater probability) that Veteran’s diabetes mellitus had its onset during military service, within one year of separation from service, or is otherwise related to his active military service. In addressing these questions, the examiner should explain the significance, if any, of the elevated blood glucose readings noted in the Veteran’s STRs. The examiner should also provide a complete rationale for each opinion given, and cite to the medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resorting to speculation, it should be so stated and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resorting to speculation. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Griffin, Associate Counsel