Citation Nr: 20006131 Decision Date: 01/24/20 Archive Date: 01/24/20 DOCKET NO. 17-21 382 DATE: January 24, 2020 REMANDED Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for migraine headaches is remanded. Entitlement to service connection for radiculopathy of the left upper extremity is remanded. Entitlement to service connection for radiculopathy of the right upper extremity is remanded. REASONS FOR REMAND The Veteran served as a member of the United States Army with active duty service from January 1985 to May 1985 and from December 1990 to July 1991. This appeal comes to the Board of Veterans’ Appeals (Board) from a rating decision, dated March 2014, issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas (hereinafter Agency of Original Jurisdiction (AOJ)). In its decision, the RO denied service connection for diabetes mellitus because this condition neither occurred in nor was caused by service. This appeal also comes to the Board of Veterans’ Appeals (Board) from a rating decision, dated February 2017, issued by the AOJ. In its decision, the RO denied service connection for migraine headaches, twitching fingers of the left upper extremity claimed as twitching fingers, and twitching fingers of the right upper extremity claimed as twitching fingers because these conditions neither occurred in nor were caused by service. A Board hearing was held before the undersigned Judge in August 2019. The hearing transcript has been associated with the Veteran’s file. 1. Entitlement to service connection for diabetes mellitus is remanded. Although the Board regrets the additional delay, the Veteran’s remaining claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran’s claim. The Veteran reported that his diabetes was diagnosed around 2006 that were treated by medication until about two or two and a half years prior to his hearing. See Hearing Transcript dated August 2019. He reported that diabetes mellitus ran in his family medical history. The Veteran contended that his diabetes arose while he was in service from receiving an Anthrax injection. He also believed that his diabetes arose from the environmental conditions present while he was in service, including burning human excrement and burning oil wells. A review of the Veteran’s CAPRI records show that the Veteran consistently received treatment for diabetes mellitus. However, while the Veteran has submitted extensive medical records regarding treatment for his diabetes mellitus, the Veteran has not undergone a VA examination specifically addressing his diabetes mellitus. The Board finds that a remand is required in order to obtain a VA examination which fully addresses the etiology of any current diabetes mellitus. 2. Entitlement to service connection for migraine headaches is remanded. Although the Board regrets the additional delay, the Veteran’s remaining claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran’s claim. The Veteran reported that while in service, he experienced many of the Scud attacks happening in Saudi Arabia. See Hearing Transcript dated August 2019. He recalled using MOPP gear and masks during these attacks. He remembered smelling something weird but did not experience any symptoms at the time. While in service, he started noticing some allergies which later became diagnosed as migraine headaches. He believed that the environmental hazards that he was exposed to flared up his conditions to where it became something noticeable. Some days, the migraines would become so painful that he would have to skip work or would come into work late. The Veteran underwent an examination in December 2002 for his joints. The examination showed that he suffered from occasional headaches that he believed were sinus-related. Tension headaches were noted. However, no further information or nexus opinion was provided with regards to the Veteran’s migraine headaches. A review of the Veteran’s CAPRI records show that the Veteran consistently received treatment for migraine headaches. However, while the Veteran has submitted extensive medical records regarding treatment for his migraine headaches, the Veteran has not undergone a VA examination specifically addressing his migraine headaches. The Board finds that a remand is required in order to obtain a VA examination which fully addresses the etiology of any current migraine headaches. 3. Entitlement to service connection for radiculopathy of the left and right upper extremities is remanded. Although the Board regrets the additional delay, the Veteran’s remaining claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran’s claim. The Veteran reported that he began noticing finger twitching while in service that has progressively gotten worse in the last several years. See Hearing Transcript dated August 2019. At the time of his hearing, the Veteran stated that there were days that his finger would be constantly moving. He had undergone a back and neck X-ray several years prior to his hearing. He testified that he experienced a nerve tingling sensation in his fingers. He would lose strength in his arms and his fingers would also lock up and stop working on occasion. A review of the Veteran’s CAPRI records show that the Veteran consistently received treatment for radiculopathy of the left and right upper extremities. However, while the Veteran has submitted extensive medical records regarding treatment for his left and right upper extremities, the Veteran has not undergone a VA examination specifically addressing his radiculopathy of the left and right upper extremities. The Board finds that a remand is required in order to obtain a VA examination which fully addresses the etiology of any current radiculopathy of the left and right upper extremities. Accordingly, the matters are REMANDED for the following action: 1. The AOJ should schedule the Veteran for a VA medical examination with an appropriate qualified physician. All necessary diagnostic testing and evaluation should be performed, and all findings set forth in detail. Based upon a review of the entirety of the claims file, the history presented by the Veteran, and the examination results, the examiner is requested to provide an opinion as to the following questions: (a.) Please identify any diabetes mellitus that is currently manifested. (b.) For any diabetes mellitus identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service? (c.) Please identify any migraine headaches that are currently manifested. (d.) For any migraine headaches identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service? (e.) Please identify any radiculopathy of the left upper extremity that is currently manifested. (f.) For any radiculopathy of the left upper extremity identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service? (g.) Please identify any radiculopathy of the right upper extremity that is currently manifested. (h.) For any radiculopathy of the right upper extremity identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service? Explanations for all opinions must be provided. In providing the requested rationale, the examiner is asked to cite to the pertinent evidence of record, including   clinical records and the Veteran’s statements regarding the onset of his symptoms. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Bristor 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.