Citation Nr: 21021786 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 16-53 027 DATE: April 14, 2021 REMANDED Entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, as a substitute claimant, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from May 1966 to May 1968. The Veteran died in July 2020. The appellant is the Veteran’s surviving spouse and has been substituted into his claim. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In a July 2019 decision, the Board denied the Veteran’s claim for entitlement to a rating in excess of 20 percent for diabetes mellitus type II. The Veteran appealed this decision to the U.S. Court of Appeals for Veterans Claims (the Court). In October 2020, the Court granted a Joint Motion for Partial Remand (JMPR) filed by the parties, which requested a vacatur and remand of the July 2019 decision. The Board’s July 2019 decision also remanded the Veteran’s claim for service connection for acute myelogenous leukemia to the RO for further evidentiary development. Subsequently, a June 2020 rating decision granted entitlement to service connection for that condition. As this constitutes a full grant of the benefit sought on appeal in regard to acute myelogenous leukemia, there remains no issue of controversy for adjudication by the Board on that claim. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997). Entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, as a substitute claimant, is remanded. An August 2015 Disability Benefits Questionnaire (DBQ) prepared by a private provider reflects that the Veteran required regulation of his activities but only states that activities “may” cause hypoglycemia. The report does not explain the examiner’s conclusion based on medical evidence, does not describe what activities should be restricted or avoided, and concludes that the diabetes mellitus did not impact the Veteran’s ability to work. On remand, the AOJ must seek additional clarification of the private Disability Benefits Questionnaire results from that private treatment provider. See Savage v. Shinseki, 24 Vet. App. 259 (2010). Secondly, the Board must obtain an adequate addendum opinion as to whether the Veteran had diabetic neuropathy. The August 2015 DBQ indicates that the Veteran had diabetic peripheral neuropathy but does not elaborate. VA requested a clarifying opinion, and the medical opinion obtained in July 2016 states only that the Veteran’s numbness and neuropathy is secondary to his chemotherapy treatment and improved when treatment was completed. No rationale was provided for this opinion, and the Veteran’s treatment records indicate that he had ceased chemotherapy treatment in 2011, yet in 2015 the Veteran was still diagnosed with neuropathy and his private physician indicated that due to numbness in his hands and bilateral feet, he should avoid standing for long periods of time. Under 38 C.F.R. § 4.120, Diagnostic Code 7913, Note 1, compensable complications of diabetes should be evaluated separately unless they are part of the criteria used to support a 100-percent rating. A remand is required for an addendum opinion as to whether the Veteran’s peripheral neuropathy was caused by his diabetes mellitus, type II. The addendum opinion should provide a complete rationale and address the evidence that the Veteran ended chemotherapy in 2011 but was diagnosed with peripheral neuropathy in 2015. The matter is REMANDED for the following actions: 1. After obtaining an appropriate release of information from the appellant, the AOJ must contact Dr. C. F., the physician who prepared the August 2015 Diabetes Mellitus Disability Benefits Questionnaire. (a.) The physician should be asked to (1) provide a rationale for the August 2015 conclusion that strenuous activities may cause hypoglycemia; (2) clarify what activities the Veteran was required to restrict or avoid; and (3) explain the two statements that the diabetes requires that the Veteran’s activities be restricted but the diabetes does not impact the Veteran’s ability to work. (b.) The physician should also be asked to provide a rationale or explanation for the August 2015 determination that the Veteran had diabetic peripheral neuropathy. 2. Obtain an addendum opinion from the clinician who provided the July 2016 VA medical opinion, or to a qualified medical professional if the July 2016 examiner is unavailable. (a.) The clinician should opine as to whether it was at least as likely as not that the Veteran’s peripheral neuropathy was caused or aggravated by his service-connected diabetes mellitus. (b.) The addendum opinion should provide a complete rationale and address the evidence that the Veteran ended chemotherapy in 2011 but was diagnosed with peripheral neuropathy in 2015. A. M. CLARK Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Dean 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.