Citation Nr: 21024115 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 07-07 028 DATE: April 22, 2021 REMANDED Service connection for diabetes mellitus, including as secondary to the service-connected recurrent fibroma of the left maxilla, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from July 1970 to November 1972. At a July 2012 videoconference hearing, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. This matter was previously denied by the Board in a February 2019 decision. The Veteran appealed to the Court of Appeals for Veterans Claims (Court) which, pursuant to a Joint Motion for Remand (Joint Motion), vacated the decision and remanded the issue for further development in a December 2019 order. The Board has previously remanded the case in May 2020 and October 2020 to perform development in accordance with the directives of the Joint Motion. Since then, medical opinions were obtained in June 2020 and January 2021 addressing whether the Veteran’s diabetes mellitus type 1 was caused by poor dentition that had resulted from his service connected left maxilla recurrent fibroma, or assuming he has diabetes mellitus type 2, whether that was caused by the poor dentition that resulted from the recurrent fibroma. In November 2020 and December 2020, opinions were obtained that appear to be an attempt to address, among other things, whether type 1 or type 2 diabetes was aggravated by the Veteran’s poor dentition. The reasoning that was provided, however, does not make clear whether diabetes type 1 or type 2 was being addressed. Further clarification is necessary as set out below. The matters are REMANDED for the following action: 1. Provide the claims file to an appropriately qualified person to determine the following: (a.) Whether it as least as likely as not (50 percent probability or better) the Veteran's poor dentition related to his service connected maxillary fibroma has aggravated the Veteran's diabetes mellitus type I. (b.) Assuming the Veteran has diabetes mellitus type II, whether it is at least as likely as not (50 percent probability or better) that the Veteran's diabetes mellitus type II was proximately aggravated by poor dentition related to his service-connected maxillary fibroma. Aggravation is defined as a worsening beyond the natural progression of the disability. If aggravation is present, the examiner should indicate, to the extent possible, the approximate level of disability (i.e., a baseline) before the onset of aggravation. To the extent possible, the opinion should include a detailed description of symptoms as a baseline, and a similar description of symptoms considered in determining whether any aggravation occurred. The need for an examination of the Veteran is left to the discretion of the person offering the opinions. A complete rationale for all findings and conclusions with citation to relevant evidence found in the claims file should be provided for all opinions. 2. Readjudicate the claim. M. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dodd, Ryan 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.