Citation Nr: 21064303 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 08-38 672 DATE: October 19, 2021 ORDER Entitlement to service connection for diabetes mellitus is denied. Entitlement to service connection for peripheral neuropathy is denied. FINDINGS OF FACT 1. The Veteran's diabetes mellitus was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. 2. The preponderance of the evidence of record is against finding that the Veteran has had peripheral neuropathy at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for service connection for diabetes mellitus are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for peripheral neuropathy are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1973 to April 1975. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was scheduled for Board hearing in October 2011, and the Veteran was deemed a no-show for the hearing. The Veteran has not provided evidence of good cause for the failure to show. As such, the Veteran's hearing request is withdrawn. 38 C.F.R. § 20.704(d). The Board previously remanded these matters in March 2010, July 2012, September 2016, August 2018, and October 2019 decisions. The Board finds that the RO has substantially complied with the Board's prior remand order as service personnel and treatment records were obtained and the Veteran was notified of the actions taken and results. Dyment v. West, 13 Vet. App. 141 (1999). Service Connection 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). Certain chronic diseases, such as diabetes mellitus and peripheral neuropathy as an organic disease of the nervous system, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). 1. Entitlement to service connection for diabetes mellitus. The Veteran contends that he was treated with medication for diabetes in service. See NOD (August 2007). The Veteran's attorney has not identified any errors in law or fact in the decision on appeal. The Veteran has a current diagnosis of diabetes mellitus as evidenced by an October 2015 VA examination. Diabetes mellitus is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. However, the disability was not shown as chronic in service, did not manifest to a compensable degree within a presumptive period, and was not noted in service with attributable continuity of symptomatology. VA treatment records show the Veteran was not diagnosed with diabetes mellitus until August 1994, almost two decades after his separation from service and almost two decades outside of the applicable presumptive period. While the Veteran is competent to report being treated with diabetes medication in service, he reported that he has not consistently needed medication since service, and that he had no symptoms and required no medication until 1991. See VA Examination (August 1994). Additionally, he is not competent to provide a diagnosis in this case or determine that any in-service symptoms were manifestations of diabetes as the Veteran has not demonstrated the necessary medical expertise. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and the interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, his reports regarding the onset of his diabetes are largely not credible due to internal inconsistency and inconsistency with other evidence in the record. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). The Veteran reported that he was diagnosed with diabetes in April 1973, see VA Examination (August 1994); then that he developed diabetes in 1972, see VA Examination (September 1997), and; then that diabetes was discovered during a routine examination in 1995, see C&P Exam (October 2015). The Board gives more probative weight to competent and credible medical evidence, which establishes that diabetes had its onset almost two decades after the Veteran's service. Service connection for diabetes may still be granted on a direct basis; however, the preponderance of the evidence is against finding that a medical nexus exists between the Veteran's diabetes and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303. Although the Veteran's service personnel records show that the underwent recruit training at the Naval Training Center in Orlando, Florida, as contended, his service treatment records provide no indication that diabetes began or is related to service. Rather, the treatment records obtained show that the Veteran reported no complaints or treatment for diabetes, and diabetes was not noted by the examiner, on reports of medical history and examination at service separation. Notably, those reports show several other complaints and notations, but none for diabetes. Additionally, personnel records contradict the Veteran's reports regarding diabetes onset. The Veteran reported that he was given position as yeoman but could not march due to diabetes, see NOD (August 2007), and then that he was an aviation officer candidate, but he was turned down because he was found to have eye changes which were suggestive of diabetes retinopathy, see C&P Exam (October 2015). However, service personnel records show that the Veteran enlisted for "guaranteed HM class "A" school..." and served as a dental assistant. See Military Personnel Record (January 2020). The August 2015 VA examiner opined that the Veteran's diabetes is not at least as likely as not related to an in-service injury, event, or disease, including the reports of in-service onset. The rationale was that there is no evidence of elevated glucose levels in service, and that the Veteran's reports regarding onset and diagnosis were inconsistent. Notably, the Veteran has provided no favorable medical opinion for the Board's consideration. While the Veteran believes his diabetes is related to an in-service injury, event, or disease, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and the ability to interpret complicated diagnostic medical testing. Jandreau, 492 F.3d 1372. Consequently, the Board gives more probative weight to the competent medical evidence. Overall, the Board assigns greater probative value to the decades intervening service and the first documented complaints and findings for diabetes, along with the negative VA medical opinion. See Curry v. Brown, 7 Vet. App. 59, 68 (1994) (contemporaneous evidence has greater probative value than history as reported by the claimant). The VA medical opinion is more probative than the Veteran's uncorroborated lay opinion as it was prepared after review of the claims file, interview of the Veteran, and examination of the Veteran by a skilled, neutral medical professional. On balance, the weight of the evidence is against the claim. Accordingly, the claim is denied. There is no doubt to resolve. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 2. Entitlement to service connection for peripheral neuropathy. The Veteran's attorney has not identified any errors in law or fact in the decision on appeal, but has indicated that peripheral neuropathy is intertwined with the claim for diabetes. See Third Party Correspondence (January 2015). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. As diabetes mellitus is not service-connected, only direct service connection will be considered. The Board concludes that the Veteran does not have a current diagnosis of peripheral neuropathy and has not had 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). Service treatment records show no complaints of numbness or tingling, and no diagnosis of peripheral neuropathy. The October 2015 VA examiner evaluated the Veteran and determined that, while he experienced subjective symptoms of hand numbness and tingling, he did not have a diagnosis of peripheral neuropathy. Further, private treatment records do not contain a diagnosis of peripheral neuropathy. While the Veteran believes he has a current diagnosis of peripheral neuropathy, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body and the ability to interpret complicated diagnostic medical testing]. Jandreau, 492 F.3d 1372. The VA medical opinion is more probative than the Veteran's uncorroborated lay opinion as it was prepared after review of the claims file, interview of the Veteran, and examination of the Veteran by a skilled, neutral medical professional. Notably, the Veteran has provided no favorable opinion for the Board's consideration. On balance, the weight of the evidence is against the claim. Accordingly, the claim is denied. There is no doubt to resolve. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. KRISTI L. GUNN Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Thaddaeus J. Cox, 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.