Citation Nr: 21001452 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 15-31 387 DATE: January 8, 2021 REMANDED Entitlement to service connection for hypertension, to include as secondary to service-connected diabetes mellitus (diabetes) is remanded. Entitlement to service connection for a pituitary gland condition, to include as secondary to service-connected diabetes is remanded. Entitlement to service connection for a thyroid condition, to include as secondary to service-connected diabetes is remanded. Entitlement to service connection for an adrenal gland condition, to include as secondary to service-connected diabetes is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from March 1970 to April 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ); a transcript is of record. Service connection claims. The Veteran contends that his endocrine conditions and his hypertension are secondary to his service-connected diabetes. While the Board regrets further delay, it finds that a remand is warranted. Evidence indicates that there may be outstanding VA treatment records. A July 2020 VA treatment record noted that the Veteran had an upcoming endocrine appointment on July 22, 2020. Unfortunately, the most recent VA records were obtained on July 20, 2020, prior to his scheduled appointment. Although it is unclear whether any outstanding VA treatment records would be relevant to the Veteran’s claim for hypertension, any VA treatment records are within VA’s constructive possession, and are considered potentially relevant to his claims. A remand is required to allow VA to obtain them. Additionally, pursuant to the June 2019 remand, the Veteran underwent a VA endocrine examination in April 2020. The examiner noted that the Veteran’s adrenal gland, pituitary gland, and thyroid conditions were all manifestations of his autoimmune polyglandular syndrome type II. While etiology opinions were obtained, none of the opinions addressed whether his polyglandular syndrome is secondary to his service-connected diabetes. Because all of the Veteran’s claimed endocrine conditions are manifestations of his polyglandular syndrome, another endocrine condition, the Board finds that an opinion should be obtained that also addresses whether this syndrome is secondary to his service-connected diabetes. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from July 2020 to the present. 2. Obtain a VA medical opinion regarding the etiology of the Veteran’s autoimmune polyglandular syndrome type II from a qualified medical professional. The need for a physical examination is left to the discretion of the VA examiner. The examiner must review the entire claims file and a copy of this Remand. The examiner must opine whether it is at least as likely as not that the Veteran’s autoimmune polyglandular syndrome type II is caused or aggravated by his service-connected diabetes. The term “aggravation” means a worsening of a disability beyond its natural progression. If aggravation is found, then, to the extent possible, the examiner should establish a baseline level of severity of the autoimmune polyglandular syndrome type II prior to aggravation by the service-connected diabetes. A complete rationale must be provided for all opinions expressed. The rationale must consider and discuss the pertinent evidence of record, to include the Veteran’s lay statements. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Mortimer, 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.