Citation Nr: 21063949 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 17-64 190 DATE: October 18, 2021 ORDER Entitlement to service connection for diabetes mellitus is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, he exhibited symptoms of diabetes mellitus while in service or within one year after discharge. CONCLUSION OF LAW The criteria for service connection for diabetes have been met. 38 U.S.C. §§ 1110, 1113, 1116, 5103, 5103A, 5107 (2012); 38 C.F.R. § 3.102, 3.303, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active-duty service periods from September 17, 2002 to November 4, 2002, April 1, 2003 to July 10, 2003, September 6, 2007 to December 5, 2007, and from January 4, 2010 to April 5, 2010. The Veteran also has periods of National Guard service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a Board hearing in October 2020. The transcript has been associated with the record. 1. Entitlement to service connection for diabetes mellitus Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). For certain chronic diseases, such as diabetes mellitus, a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from a period of active duty. 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). When a chronic disease is not shown within one year after service, under 38 C.F.R. § 3.303 (b) for the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. When the fact of chronicity in service is not adequately supported, a showing of continuity after discharge is required to support a claim for such diseases; however, such continuity of symptomatology may only support a claim for those chronic diseases listed under 38 C.F.R. § 3.309 (a)). 38 C.F.R. § 3.303 (b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Board finds that in resolving reasonable doubt in the Veteran's favor, the evidence of record supports an award of entitlement to diabetes mellitus on a presumptive basis. 38 C.F.R. §§ 3.307, 3.309. The Veteran last served active-duty service between January 4, 2010 to April 5, 2010, which comprises of 92 consecutive days. As such, the Veteran qualifies for presumption of service connection for chronic disease. The Board finds that the Veteran has a current disability since he has been diagnosed with diabetes mellitus, type II, and then diabetes mellitus, type I. The Veteran's service treatment records (STRs) are silent for any symptoms, treatment, or diagnosis of diabetes mellitus. The Veteran testified during the October 2020 Board hearing that he had symptoms shortly after active-duty service where he was in the desert. He explained that he would get a low blood sugar feeling where he would feel weak and get shaky. He furthered that he had a conversation with his family about these symptoms around November or December of 2010. He explained that he did not seek treatment for these symptoms until 2011 since he was concerned about deployability and because it was not a daily or weekly concern. He also noted that no one in his family has diabetes, so he does not believe that his diabetes is hereditary. The Veteran was first diagnosed with diabetes type II in December 2011 with symptoms of polyuria and polydipsia. The Veteran was afforded a VA examination in June 2017 where the examiner reported that the Veteran was diagnosed with diabetes type II in 2010 and diabetes type I in 2012. The examiner opined that the Veteran's diabetes was less likely as not related to a specific exposure event experienced by the Veteran during military service in Southwest Asia since diabetes is caused by a lack of insulin. The Board acknowledges that the Veteran was not treated for diabetes during his active-duty service. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006); Barr v. Nicholson, 21 Vet. App. 303 (2007). Overall, the Board finds that the preponderance of the evidence supports the grant of service connection for diabetes mellitus on a presumptive basis. The Veteran competently and credibly reported that he started experiencing symptoms relating to his diabetes within a year from his separation of active-duty service in April 2010. Even though the Veteran did not seek medical treatment until 2011, the Board finds the Veteran's statements to be credible in explaining why he did not seek treatment once he first started experiencing the symptoms. The Board also finds that the June 2017 VA opinion had an inadequate rationale and did not address the Veteran's lay statements. In sum, the Board resolves any doubt in the Veteran's favor and concludes that his diabetes mellitus had its onset in service on a presumptive basis. Accordingly, service connection for diabetes mellitus is granted. Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Imam, 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.