Citation Nr: 20003754 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 16-37 382 DATE: January 16, 2020 REMANDED Service connection for diabetes mellitus (DM) type II. Service connection for right upper extremity neuropathy as secondary to DM type II. Service connection for left upper extremity neuropathy as secondary to DM type II. Service connection for right lower extremity neuropathy as secondary to DM type II. Service connection for left lower extremity neuropathy as secondary to DM type II. REASONS FOR REMAND The Veteran served on active duty from June 2007 to November 2007, from August 2008 to April 2009, and from December 2010 to August 2011. The case is on appeal from a February 2015 rating decision. In July 2019, the Veteran testified at a Board hearing. 1. Service connection for DM type II. The Veteran seeks service connection for DM type II. She maintains that her current condition was diagnosed during active duty service and/or was a result of service, to include exposure to fumes in Afghanistan. Records show a diagnosis of DM type II in August 2013, approximately two years after service. In addition, the Veteran’s service personnel records (SPRs) show that she served in Afghanistan, and that her military occupational specialty (MOS) was security forces journeyman. Moreover, during the July 2019 Board hearing, the Veteran testified that while performing her duties in Afghanistan, she was exposed to environmental hazards including fumes. To date, no VA examinations have been conducted or medical opinions otherwise obtained on the matter of etiology of the Veteran’s DM type II as it relates to exposure to environmental hazards, including fumes. Additionally, the Veteran has not received a VA examination addressing DM type II since June 2014. In view of the Veteran’s assertions and the evidence, the Board finds an updated VA examination with a medical opinion is warranted from an endocrinologist to assess the nature and etiology of DM type II, including exposure to environmental hazards. Appropriate action to obtain and associate with the claims file all outstanding, pertinent records, should be taken on remand. As for VA records, the claims file reflects that the Veteran has been receiving treatment from the VA facilities in Minnesota: Bemidji; Saint Cloud; Brainerd; and Saint Paul; and, that records from these facilities dated through January 2019 have been associated with the file. However, additional and/or more recent records may exist. Therefore, the updated records from these facilities should also be obtained on remand. In addition, during the July 2019 Board hearing, the Veteran indicated that she was placed on the incorrect military orders as a result of military negligence. As a result, she indicated that the backpay received was incorrect. Despite contacting the Central Office, her military orders were not corrected. Therefore, on remand, the dates on which the Veteran was on active duty, for which she received incapacitation orders and Title 10 orders, and for which she received backpay, should be verified to the extent possible. 2. Service connection for right upper extremity neuropathy as secondary to DM type II. 3. Service connection for left upper extremity neuropathy as secondary to DM type II. 4. Service connection for right lower extremity neuropathy as secondary to DM type II. 5. Service connection for left lower extremity neuropathy as secondary to DM type II. The additional claims of service connection for neuropathy for each extremity are claimed secondary to the Veteran’s DM type II. Thus, these claims are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991); see also Tyrues v. Shinseki, 23 Vet. App. 166, 178 (2009These claims will also be remanded. The matters are REMANDED for the following action: 1. Obtain any updated VA treatment records not already associated with the claims file since January 2019, including any treatment received at the Bemidji, Saint Cloud, Brainerd, and Saint Paul VA facilities. 2. Verify through official sources periods active duty, ACDUTRA and INACDUTRA performed by the Veteran and correct her military orders to properly reflect periods of incapacitation and Title 10 orders. 3. Thereafter, schedule the Veteran for a medical examination with an endocrinologist to determine: Whether it is at least as likely as not (i.e., at least equally probable) that the Veteran’s DM type II had its onset during service, was manifested within one year of discharge from service, or is otherwise related to the Veteran’s service, giving particular consideration to the Veteran’s contention that she was exposed to environmental hazards, including fumes, while in Afghanistan. (Continued on the next page)   A complete rationale or explanation should be provided for any opinions reached. 4. If service connection is granted for DM type II, then obtain an additional medical opinion in connection with the claims of service connection for the Veteran’s neuropathy of the extremities under the theory of secondary service connection. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Becton, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.