Citation Nr: 21076306 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 18-34 288 DATE: December 23, 2021 REMANDED Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for kidney failure is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1982 to March 1985. These matters come to the Board of Veterans' Appeals (Board) on appeal from a July 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In January 2020, the Board issued a decision denying entitlement to service connection for diabetes mellitus and kidney failure. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In an October 2020 Order, the Court granted a Joint Motion for Partial Remand of the parties and remanded the case to the Board for action consistent with the Joint Motion. This case was most recently before the Board in May 2021, at which time the appeal was remanded to the Agency of Original Jurisdiction (AOJ) for further development. The case has now been returned to the Board for appellate action. Service Connection Claims The Board's May 2021 remand instructed the examiner to address the Veteran's lay statements; however, the September 2021 VA examiner noted a lack of records as the rationale behind the negative etiology opinion without addressing the lay statements of record. The Veteran was afforded the directed VA examination in September 2021. Regrettably, the Board finds that the September 2021 VA medical opinions are inadequate as the examiner did not address the Veteran's lay contentions of lightheadedness, frequent urination, and constant thirst since 1985, shortly after discharge from active service. In an October 2021 statement, the Veteran's wife noted that the Veteran was rushed to the emergency room at DePaul Hospital in 1994 when he could not focus or see. He was diagnosed with diabetes and treated with Metformin. Additionally, the Board notes that DePaul Hospital does not have treatment records for the Veteran. See July 2021 Notices. Also, in an October 2021 statement, the Veteran's brother noted that the Veteran has needed to go to the emergency room for many years to treat his diabetes. The Board notes that lay testimony is competent as to matters capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303, 309 (2007). Therefore, the AOJ should obtain a medical opinion to address whether the Veteran's claimed diabetes mellitus was caused by or had its onset during his active duty service. The evidence tends to show that the Veteran's kidney failure is caused by his Type II diabetes mellitus. Accordingly, the Veteran's claim for service connection for kidney failure is inextricably intertwined with his claim on appeal for service connection for diabetes mellitus. Therefore, 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). Thus, the claim for service connection for kidney disease must be remanded. The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Obtain a VA medical addendum opinion to determine the nature and etiology of the Veteran's diabetes mellitus at least as likely as not (a 50 percent or greater probability) began in or is otherwise related to active service. The examiner must address the Veteran's competent statements and testimony that he has had lightheadedness, frequent urination, and constant thirst since 1985, as well as provide a complete rationale for all opinions expressed and conclusions reached. A clear rationale for all opinions must be provided, and a discussion of the facts and medical principles involved would be of considerable assistance. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. Mariah N. Sim Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Costello, 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.