Citation Nr: 21067324 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 17-24 924 DATE: November 3, 2021 REMANDED Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for brain cancer, claimed as secondary to diabetes mellitus, is remanded. REASONS FOR REMAND 1. Entitlement to service connection for diabetes mellitus is remanded. 2. Entitlement to service connection for brain cancer, claimed as secondary to diabetes mellitus, is remanded. The Veteran served on active duty from July 1986 to March 1990. The Appellant asserts that the Veteran is entitled to service connection for diabetes mellitus because it is a chronic disability that began in-service. Medical records indicate that the Veteran was diagnosed with diabetes mellitus in October 1991. The medical evidence of record documents symptoms of diabetes mellitus, which led to the eventual diagnosis, that began approximately 14 months after separation from service in May 1991. In support of the claim and contention that symptoms began in service, the Appellant submitted several lay statements from various people who observed during service and following service that the Veteran experienced symptoms of diabetes such as rapid weight loss or weight gain, fatigue, nausea, and dizziness. VA must obtain a medical opinion where the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes an in-service event, injury or disease, or the presence of a presumptive disease during the pertinent period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The October 1985 enlistment examination recorded the Veterans weight as 180 pounds. There was no separation examination, but a service medical record dated January 1990, two months prior to separation, noted the Veteran's weight as 175 pounds. The Veteran submitted statements detailing symptoms he began to experience while in service including weight fluctuations. There has been no opinion provided on the etiology of the claimed disability. A VA medical opinion is necessary to determine if it is possible that the alleged symptoms the Veteran experienced in service were related to or indicative of the diagnosis 14 months following separation from service, or represented diabetes mellitus that manifested to a compensable degree within one year following separation from service. The claim of entitlement to service connection for brain cancer, to include as secondary to diabetes mellitus, is inextricably intertwined with the claim for service connection for diabetes mellitus. As a result, the claim for brain cancer cannot be decided without first addressing the claim for service connection for diabetes mellitus. The appropriate remedy where a pending claim is inextricably intertwined with a claim currently on appeal is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain a VA medical opinion from a medical doctor on the etiology of diabetes mellitus. The examiner must review the claims file and should note that review in the report. All indicated tests and studies should be accomplished and the findings reported in detail. The examiner should provide a complete rationale for any opinions offered. The examiner should opine whether it is at least as likely as not (50 percent or greater probability) that diabetes mellitus is related to service, including any weight fluctuations and whether those findings during service at least as likely as not (50 percent or greater probability) represented a manifestation of or led to the manifestation of diabetes mellitus in the Veteran, who was subsequently diagnosed with diabetes mellitus. In providing the requested opinion, the examiner must consider the Veteran's description of symptoms during and after service. If there is any medical reason to accept or reject the Veteran's reported symptoms during service and thereafter represented the onset of diabetes mellitus, that should be noted. The examiner should specifically opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are generally inconsistent with medical knowledge or implausible. The examiner should also address the lay statements detailing observations of the Veteran during and following service with symptoms that may have indicated diabetes mellitus. The examiner should opine whether it is at least as likely as not (50 percent probability or greater) that diabetes mellitus (1) began during active service, (2) manifested within 12 months after separation from service, or (3) was noted during service with continuity of the same symptomatology after service. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Cross, 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.