Citation Nr: 21005276 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 18-05 762 DATE: February 1, 2021 ORDER Service connection for diabetes mellitus, type II (DMII) is denied. Service connection for peripheral neuropathy left upper extremity is denied. Service connection for peripheral neuropathy right upper extremity is denied. Service connection for peripheral neuropathy left lower extremity is denied. Service connection for peripheral neuropathy right lower extremity is denied. FINDINGS OF FACT 1. The preponderance of evidence is against finding that the Veteran’s DMII was related to his active duty service. 2. The preponderance of the evidence is against finding that the Veteran’s peripheral neuropathy of the bilateral upper and lower extremities was caused or aggravated by a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for service connection for DMII have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303(a), 3.304, 3.307, 3.309. 2. The criteria for service connection for peripheral neuropathy of the bilateral upper and lower extremities have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303(a), 3.304, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1960 to May 1963. The Veteran testified before the undersigned Veterans Law Judge at a hearing in October 2019; a copy of the transcript is of record. The Board previously remanded these matters in December 2019 and October 2020. Service Connection 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. DMII The Veteran’s service treatment records (STRs) show that he was diagnosed with renal glycosuria in-service. See May 1963 medical record. On May 14, 1963 an STR noted that the Veteran was found to have glycosuria on a routine discharge physical examination. The physician noted that the Veteran was evaluated for DMII but that time they were unable to establish a diagnosis of DMI. It was noted that the diagnosis was established to observation medical (diabetes mellitus, renal glycosuria). On May 22, 1963, the Veteran’s separation report of medical examination showed he was noted to have been admitted to a Naval Hospital for possible diabetes mellitus, but that his final diagnosis was renal glycosuria. His urinalysis was noted to be negative. The Veteran’s private medical records of record, which span treatment from January 2008 until November 2014, do not show diagnosis of or treatment for DMII until November 2014. A January 2008 private medical record showed the Veteran presented for follow-up care for left knee problems. He did not report a history of diabetes diagnosis or treatment. Peripheral neuropathy of his bilateral feet was noted. 2009 records show the Veteran had elevated glucose. In his 2019 hearing, the Veteran stated that he was told he was told he had diabetes and glycosuria and should monitor his diet. He also testified that he managed his conditions with a regulated diet until symptoms of numbness in his hands and feet. See October 2019 hearing testimony. The Veteran has also stated that at the time of his 1963 testing, he was told by the treating physician that he was borderline diabetic. He was also advised to watch his diet, pay attention to how fast he healed, and watch for increased drinking as signs of diabetes. See July 2020 Correspondence. A VA medical opinion was obtained in November 2020. The examiner specifically noted review of the Veteran’s file, including his STRs. The examiner found that the Veteran’s current diagnosis of DMII was not related to his in-service diagnosis of renal glycosuria. The examiner stated that the STRs showed the Veteran’s blood glucose was normal and that several urine and oral glucose tolerance tests were also normal. The examiner noted that the Veteran’s diagnosis was renal glycosuria, which is a distinct clinical entity and that current medical literature included warnings regarding diagnosing diabetes when the diagnosis was actually glycosuria, as there could be dangerous complications. The examiner found that there was no evidence that the Veteran’s in-service glycosuria was related to his later development of DMII. Based on the foregoing, the preponderance of the evidence does not support a finding that the Veteran’s DMII was related to his active duty service, to include his diagnosis of glycosuria while in service. The Board admits that the Veteran’s STRs are confusing and appear to implicate a diagnosis of DMII. However, the final STR regarding the Veteran’s medical status, the May 22, 1963, medical examination report clearly states that the Veteran’s diagnosis was renal glycosuria. The Board finds the Veteran’s private medical records have considerable weight; at no time through his course of regular treatment, including elevated glucose levels and lower extremity peripheral neuropathy, did the records show the Veteran reported a history of DMII diagnosis or treatment, including watching his diet. Indeed, the Veteran did not appear to mention his active duty service or relate his 2014 diagnosis of DMII to his active duty service at any time through the course of his private medical care. The November 2020 VA medical examiner found that he Veteran’s in-service tests did not constitute a diagnosis of or for DMII. The VA examiner did not find that the Veteran’s DMII was related to his in-service diagnosis of glycosuria, noting that the conditions were two distinct clinical entries. Neither the Veteran nor his representative have identified any evidence in the record or introduced any evidence into the record which supports a link between the Veteran’s active duty service, including his diagnosis of glycosuria, and his DMII. A finding of service connection for DMII, then, is not supported by the record or warranted. The Veteran’s statements and his hearing testimony have been considered. While the Veteran is credible in his relation of his medical history and symptoms, he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed.Cir.2012). The Board affords more probative weight to the November 2020 VA medical examiner’s opinion. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Bilateral Upper Extremity Peripheral Neuropathy Bilateral Lower Extremity Peripheral Neuropathy The Veteran sought service connection for peripheral neuropathy of his bilateral upper and lower extremities as secondary to his DMII. See March 2015 Statement in Support of Claim. As discussed above, the Board has denied service connection for the Veteran’s DMII. As such, secondary service connection is not available. The Board notes that there is no evidence in the claims file to suggest that the Veteran's bilateral upper and lower extremity peripheral neuropathy conditions are either directly attributable to his service connected bilateral hearing loss or tinnitus or were permanently aggravated by those conditions. As the preponderance of the evidence is against the claims, the benefit-of-the-doubt rule is not for application, and the claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Parrish, 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.