Citation Nr: 21014038
Decision Date: 03/11/21	Archive Date: 03/11/21

DOCKET NO. 15-08 790
DATE: March 11, 2021

REMANDED

Entitlement to service connection for diabetes mellitus, type II is remanded.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from November 1972 to October 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  This matter was last before the Board in November 2018, when it was remanded for further development.

In a May 2020 rating decision, the RO granted service connection for hypertension. Thus, that issue is no longer on appeal before the Board.  See generally Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (because appellant’s first appeal concerned rejection of logically up-stream element of service connection, the appeal could not concern logically down-stream element of disability rating). 

 

REASONS FOR REMAND

1. Entitlement to service connection for diabetes mellitus, type II is remanded.

The Veteran contends that his diabetes mellitus, type II is secondary to his now service-connected hypertension. As the opinions obtained are inconsistent and/or did not provide sufficient rationale, an addendum opinion is needed.

The matters are REMANDED for the following action:

1. Obtain an addendum opinion with respect to the Veteran’s diabetes mellitus, type II claim. If a new examination is deemed necessary to respond to the request, one should be scheduled. After review of the claims file, the examiner should respond to the following:

(a.) Is it at least as likely as not (50 percent probability or better) that the Veteran’s diabetes mellitus has been caused by the service-connected hypertension?  Please explain why or why not to include addressing internet articles submitted by the Veteran’s representative contending that “patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals.”

(b.) If not caused by hypertension, is it at least as likely as not that the Veteran’s diabetes mellitus     has been worsened beyond the normal progression (aggravated) by the service-connected hypertension?  Please explain why or why not.

(c.) If the examiner finds the diabetes mellitus    has been aggravated by the service-connected hypertension, the examiner should attempt to quantify the degree of aggravation beyond the baseline level of diabetes mellitus. A rationale    for the opinion expressed should be provided.

2. If the claim remains denied, issue a supplemental statement of the case.

 

 

K. A. BANFIELD

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	A. Asare, 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.