Citation Nr: 20022479 Decision Date: 04/01/20 Archive Date: 04/01/20 DOCKET NO. 15-38 229 DATE: April 1, 2020 REMANDED Entitlement to service connection for diabetes mellitus, type II is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1969 to January 1972. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision issued by a Regional Office (RO) of the United States Department of Veterans Affairs (VA). The Veteran and his wife testified at a February 2019 hearing held before the undersigned at the RO. A transcript of the hearing is associated with the claims file. The appeal was remanded by the Board for additional development in an August 2019 Board decision, and the Veteran was afforded a Diabetes Mellitus examination in December 2019. The directives have been substantially complied with and the matter is once again before the Board. D’Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran has contended that his currently diagnosed type II diabetes is caused by exposure to chemicals in service, stating that he was exposed to chemicals including trichlorethylene, PCBs, hydraulic fluids, and benzene. Alternatively, in the March 2018 Form 9, the Veteran contended that his diabetes is secondary to his coronary artery disease and hypertension. He has since been awarded service connection for both conditions. In conjunction with the December 2019 VA Diabetes Mellitus examination, the examiner opined that the Veteran’s diabetes was less likely than not incurred in or caused by service. The examiner noted the Veteran’s reported daily contact with trichloroethylene and other chemicals while working with laundry and hydraulic systems. She concluded, however, that “while research efforts have been made to show the adverse effects of trichloroethylene on health, there is no definitive medical literature to support Type II Diabetes is caused by trichloroethylene exposure.” The Veteran’s representative submitted an informal hearing presentation (IHP) in March 2020, arguing that per McCray v. Wilkie, No. 17-1875, slip op. at 12 (U.S. Vet. App. (June 18, 2019)), “a medical principal need not reach scientific consensus to support a grant of benefits.” The representative proceeded to include two additional medical studies, one which indicated that exposure to halogenated persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs) and trichlorethylene can contribute to the pathology of inflammatory diseases such as diabetes. The other study indicated that there is a “general positive pattern” between exposure to POPs and diabetes. Accordingly, an addendum opinion is required in order for the examiner to specifically consider these two studies. Additionally, during the December 2019 examination, the VA examiner failed to consider lay statements from the Veteran that are related to service connection for diabetes apart from chemical exposure. In a statement received by the VA in April 2018, the Veteran indicated that he while in service, he consumed five cartons of milk at breakfast, lunch, and dinner, and that he would “add sugar to my milk to help with the dizziness that I experienced.” He stated that he believed this could be related to his current diabetes. Additionally, in his March 2018 Form 9, the Veteran indicated that he believed his diabetes may be caused not only by the chemical exposure related to his military occupational specialty, but also to the “highly stressful situations” that he experienced. Such statements should receive consideration as well. The matters are REMANDED for the following action: 1. Obtain an addendum VA diabetes mellitus medical opinion; the claims folder must be reviewed in conjunction with such. The reviewer must opine as to whether the Veteran’s diabetes mellitus is at least as likely as not caused or aggravated by service, to include exposure to chemicals including trichlorethylene, PCBs, hydraulic fluids, and benzene, or a service-connected disability, including coronary artery disease and/or hypertension. The reviewer must consider the articles referenced in the March 2020 IHP. The reviewer must also consider the Veteran’s statements regarding diet and highly stressful situations in service. The reviewer must provide a full and complete rationale for all opinions. 2. Upon completion of the above, readjudicate the remanded issue. If the benefit sought remains denied, the Veteran should be provided with a supplemental statement of the case. The case should then be returned to the Board for appellate review if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.P. Faris 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.