Citation Nr: 21004921 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 15-27 615A DATE: January 28, 2021 ORDER Entitlement to service connection for diabetes mellitus, type II, as due to herbicide agent exposure, for accrued benefits purposes, is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran had diabetes mellitus, type II, at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for diabetes mellitus, type II, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1966 to June 1970. He died in July 2017. The Appellant is the Veteran’s surviving spouse. She has been substituted as the claimant in this matter. See 38 U.S.C. § 5121A. The Appellant testified at a videoconference hearing before the undersigned in December 2018. A transcript of the hearing is of record. This matter was previously before the Board in September 2019, at which time it was remanded for further development. Entitlement to service connection for diabetes mellitus, type II, as due to herbicide agent exposure, for accrued benefits purposes. Prior to his death, the Veteran maintained that he had a diagnosis of diabetes mellitus, type II, that was related to in-service herbicide exposure while serving in Thailand and the Republic of Vietnam as a Radar Operator with the College Eye Task Force. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The Board conceded herbicide exposure in its September 2019 decision; and VA regulations provide that, if a veteran was exposed to an herbicide agent during active service, presumptive service connection is warranted for several disorders, to include diabetes mellitus, type II. 38 C.F.R. § 3.309(e). The key question at issue in this case is whether the Veteran at least as likely as not was diagnosed with diabetes, type II prior to his death. After review of all the evidence of record, the Board concludes that the Veteran did not have a current diagnosis of diabetes mellitus, type II, and did not have one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In its September 2019 decision, the Board directed the agency of original jurisdiction (AOJ) to obtain a VA medical opinion addressing whether the Veteran indeed had diabetes mellitus, type II. The October 2020 VA examiner reviewed the Veteran’s claims file, as well as VA electronic health record and determined that, while the Veteran experienced occasional symptoms of elevated glucose levels, the preponderance of the evidence was against the Veteran having a diagnosis of diabetes mellitus, type II. The examiner noted that VA treatment records dated in 2017 indicated multiple glucose levels that were well above normal fasting glucose measurements including several that were greater than 126mg %, which, if fasting, would be considered diagnostic for diabetes mellitus, type II. However, the examiner indicated that these elevated glucose levels were not noted as fasting and occurred during a stressful period of extreme illness, therefore were likely due to that illness. The examiner stated that the Veteran was extremely ill in the months prior to his death in July 2017 with multiple co-morbidities that resulted in random hyperglycemia. However, the examiner specified that the record did not reflect any formal diagnosis of diabetes mellitus, type II. Indeed, she concluded that impaired fasting glucose, which is not the same as a diagnosis of diabetes mellitus, type II, was the confirmed in the record and had been properly included on the Veteran’s problem list. She noted that while some of the Veteran’s VA treatment records indicated a history of diabetes mellitus, type II, this was incorrect as it was not confirmed or corroborated by any laboratory testing, prescribed medication, or other chronic treatment records. The Board affords the findings of the October 2020 VA examiner great probative value, as they were based upon the examiner’s thorough review of the claims file, as well as the Veteran’s pertinent medical history. Despite consistent treatment for other conditions, VA treatment records do not contain a diagnosis of diabetes mellitus, type II, beyond the Veteran’s self-reported medical history. In fact, on several occasions, VA treatment records explicitly discount a diagnosis of diabetes mellitus, type II. See November 2012 VA Addendum Note; October 2013 VA Audiology Note; November 2015 VA Nursing Admission Evaluation Note; December 2016 VA Nursing Admission Evaluation Note; February 2017 VA Interdisciplinary Patient Assessment; May 2017 Nursing Admission Note. While the Veteran and the Appellant may assert that the Veteran had a current diagnosis of diabetes mellitus, type II, they are not competent to provide a diagnosis in this case. The issue is medically complex, as it requires the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). While the Veteran was competent to relay a contemporaneous diagnosis, as there is no additional evidence of record to support his assertions, and the Board does not afford probative value to the statements. Consequently, the Board gives more probative weight to the competent medical evidence, and the medical opinion described above that provides a cogent explanation in support of a conclusion that the Veteran did not have diabetes mellitus, type II. For the above reasons, the Board finds that the preponderance of the evidence is against the claim of entitlement to service connection for diabetes mellitus, type II. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Bristow Williams, 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.