Citation Nr: 21072697 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 16-30 135 DATE: December 6, 2021 ORDER Service connection for type II diabetes is granted. Service connection for bilateral diabetic retinopathy is granted. Service connection for a lung disease is dismissed. REMANDED The claim for service connection for bilateral cataracts is remanded. FINDINGS OF FACT 1. The evidence shows that it is at least as likely as not (50 percent or greater probability) that the Veteran's type II diabetes was due to exposure to heavy medals during service. 2. The Veteran's diabetic retinopathy is secondary to his type II diabetes. 3. At his Board hearing, prior to the promulgation of a decision in the appeal, the Veteran withdrew his claim for service connection for a lung disability. CONCLUSIONS OF LAW 1. The criteria for service connection for type II diabetes have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 2. The criteria for service connection for diabetic retinopathy have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310. 3. The criteria for withdrawal of the claim for service connection for a lung disability have been met. 38 U.S.C. § 7105 (b)(2), (d)(5); 38 C.F.R. § 20.204. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from April 1971 to December 1978. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (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 (nexus). Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of a service connected disability. 38 C.F.R. § 3.310 (a). At his Board hearing in July 2021, the Veteran testified that he worked as a sheet metal worker during service and had exposure to hazardous environmental materials, such as heavy metals, chemicals, acid, and asbestos, etc. Military personnel records (DD214) show that the Veteran's military specially (MOS) was sheet metal worker. Service treatment records (STRs) in March 1975 shows that the Veteran had been working in grading, welding, soldering, and metal forming, and had been exposed to asbestos. Although STRs did not show he was exposed to chemicals and acid, he testified in his Board hearing in July 2021 that he was exposed to chemicals and acid during welding/soldering process during service. The Veteran's testimony is consistent with his MOS and as such is consistent with the circumstances of his service. 38 U.S.C. § 1154. As such, in-service exposure to heavy metals, chemicals, acid, and asbestos is conceded. Type II diabetes and diabetic retinopathy At his Board hearing in July 2021, the Veteran argued that since he had no family history of diabetes (he was the only one diagnosed with diabetes in a big family), and he was not obese, his type II diabetes must have been caused by environmental risks, and that his greatest exposure to such heavy metals such as lead was during his military service. In his written argument dated July 2021, the Veteran's representative referenced to a medical article suggesting that exposure to heavy metal increased the risk of diabetes through endocrine disruption. A June 2015 VA examination diagnosed the Veteran with type II diabetes and diabetic retinopathy. A private Disability Benefit Questionnaire (DBQ) dated August 2021 diagnosed the Veteran with type II diabetes with symptoms of diabetic retinopathy. The physician opined that it was at least as likely as not (50 percent or more probability) that the Veteran's diabetes was caused by lead exposure during service. The physician explained that in an otherwise healthy patient with no significant family history of diabetes, an environmental cause should be considered, and that based on the Veteran's report, he had significant lead exposure in the course of his military working as a sheet metal worker and current studies suggested a strong connection between lead exposure and the development of diabetes. Accordingly, the Board finds that it is at least as likely as not (50 percent or more probability) that the Veteran's diabetes was caused by his exposure to heavy metals during service. Service connection for diabetes is granted. As diabetic retinopathy is a symptom of diabetes, service connection for diabetic retinopathy is also granted. Lung disease The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204 At his hearing, the Veteran knowingly withdrew his claim for service connection for a lung disability. As such, this claim is dismissed. REASONS FOR REMAND A June 2015 VA eye examination diagnosed the Veteran with bilateral cataracts. Private treatment records in August 2021 noted that the Veteran had his cataracts removed and that acid exposure had been associated with his cataract development. However, no rationale was given to the association between acid exposure and cataracts. As such further development is warranted. The matters are REMANDED for the following action: Obtain a medical opinion to assess the etiology of the Veteran's cataracts. The examiner should answer the following questions: Is it at least as likely as not (50 percent or more probably) that the Veteran's cataracts began during or was otherwise caused by his service, to include exposure to chemicals, acid, heavy metals, and asbestos working as a sheet metal worker during service? Why or why not? MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Wang, 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.