Citation Nr: 18160232
Decision Date: 12/26/18	Archive Date: 12/26/18

DOCKET NO. 16-60 721
DATE:	December 26, 2018
ORDER
Service connection for a gallbladder disorder is granted.
REMANDED
Service connection for a liver disorder is remanded.

FINDING OF FACT
The Veteran’s gall bladder disease is the result of his service connected diabetes mellitus.
CONCLUSION OF LAW
The criteria for service connection for gall bladder disease have been met.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304, 3.306, 3.307, 3.309. 
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
Service Connection
The Veteran served on active duty from July 1987 to March 2013.  He is seeking service connection for gallbladder disorder which he believes is the result of his diabetes mellitus.  In support of his claim, the Veteran submitted a medical opinion linking his gallbladder disorder to his service connected diabetes mellitus.  As such, the criteria for service connection are met and the Veteran’s claim is granted.
REASONS FOR REMAND
The Veteran’s is seeking service connection for a liver disorder which he believes is secondary to his service-connected diabetes mellitus type II, or if not was present during service, but misdiagnosed. The Veteran is service connected for DM.  It is unclear what liver disease the Veteran has and whether it is the result of either service or his service connected disabilities diabetes mellitus. 
The matters are REMANDED for the following action:
1. Schedule the Veteran for a VA examination to evaluate his liver condition.  The examiner should diagnose any current liver disorder, (to include elevated liver enzymes and fatty liver disease). The examiner should address the following questions:
a. Is it at least as likely as not (50 percent or greater) that any current liver disorder either began during or was caused by the Veteran’s active service from 1987-2013? Why or why not?  In so doing the examiner should consider the Veteran’s allegation that in his initial claim filed the month he separated from service he complained about pain in abdomen, frequent bowel movements, and fatigue which he believes were signs of liver and gallbladder problems.
b. Is it at least as likely as not (50 percent or greater) that any current liver disorder was directly caused by a service-connected disability to include diabetes mellitus? Why or why not?
c. Is it at least as likely as not (50 percent or greater) that any current liver disorder was aggravated (made worse) by a service connected disability to include diabetes mellitus? Why or why not?
If aggravation is found, the examiner should identify the baseline level of severity of the liver disability by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the liver disability.
 
MATTHEW W. BLACKWELDER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Franklin, Associate Counsel