Citation Nr: A21020554 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 200522-88284 DATE: December 27, 2021 REMANDED Entitlement to service connection for diabetes mellitus type II is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1982 to August 1985, from February 1987 to April 1992, and from February 7, 2015 to February 8, 2015. Although the period of service from February 7 to February 8 appears to have been inactive duty to training (IDT) the Veteran is service connected for a disability incurred during that period of IDT, and therefore it is considered active service for VA purposes. 38 U.S.C. § 101(2), (24). These issues come before the Board of Veterans' Appeals (Board) on appeal from a decision issued in March 2020 by a Department of Veterans Affairs (VA) Regional Office (RO). In the March 2020 decision, the RO denied service connection for diabetes mellitus type II. 38 C.F.R. §§ 3.2400(a)(1), 19.2(b). In May 2020, the Veteran appealed to the denial the Board and requested direct review of his claim. 38 C.F.R. §§ 3.2500(a)(1)(ii), 20.202, 20.203. As the Veteran has selected direct review, the Board will base its decision on the evidence of record at the time of the rating decision on appeal. 38 C.F.R. §§ 20.300, 20.301. Entitlement to service connection for diabetes mellitus type II. The Agency of Original Jurisdiction (AOJ) obtained a January 2020 medical opinion concerning the etiology of the Veteran's claimed diabetes mellitus prior to the March 2020 rating decision on appeal. The examiner stated that the diabetes mellitus was less likely than not related to service, stating that there was no evidence of a diagnosis of diabetes mellitus in service. However, a medical opinion based solely on the absence of documentation in the record is inadequate and a medical opinion is inadequate. Dalton v. Peake, 21 Vet. App. 23 (2007). As the January 2020 opinion is inadequate, the Board finds that a pre-decisional duty to assist error occurred and therefore a remand is required so that a new opinion may be obtained. 38 C.F.R. § 20.801(a). The matters are REMANDED for the following action: 1. Obtain a medical opinion concerning the etiology of the Veteran's diabetes mellitus type II. The examiner should answer the following: a) Is it at least as likely as not (a fifty percent probability or greater) that the diabetes mellitus is causally related to the Veteran's active service from September 1982 to August 1985 or from February 1987 to April 1992? b) Concerning the period of service in February 2015, did the diabetes mellitus type II clearly and unmistakably (obviously, manifestly or undebatably) pre-exist this period of active service? c) If yes, was the Veteran's diabetes mellitus type II clearly an unmistakably NOT aggravated (i.e., permanently increased in severity) by his period of active service in February 2015? d) If the answer to (b) or (c) is no, is it at least as likely as not (a fifty percent probability or greater) that diabetes mellitus type II is related to the Veteran's active service in February 2015? In addressing questions (b) through (d), attention is invited to the January 2020 VA examination noting a diagnosis date for diabetes mellitus type II of 2010, and an April 2015 reserve record noting that the Veteran was taking metformin (labelled "STR - Medical" pg. 8 uploaded 11/2/17). A detailed rationale for the opinion must be provided. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. CHRISTOPHER A. WENDELL Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Elliot Harris 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.