Citation Nr: 21026346 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 18-04 371 DATE: April 30, 2021 ORDER An initial disability rating in excess of 20 percent for diabetes mellitus, type 2, with erectile dysfunction, is denied. FINDING OF FACT The Veteran’s diabetes mellitus, type 2, with erectile dysfunction, has required more than one injection of insulin per day, but has not required a restricted diet or regulation of activities. CONCLUSION OF LAW The criteria for an initial disability rating in excess of 20 percent for diabetes mellitus, type 2, with erectile dysfunction, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.119, DC 7913. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1964 to November 1968. 1. Entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type 2, with erectile dysfunction The Veteran contends that an initial disability rating in excess of 20 percent is warranted for his diabetes mellitus, type 2, because he does not engage in strenuous activities due to his diabetes and because although he is not specifically on a restricted diet, medical literature states that the primary objective of the treatment of diabetes is to maintain glucose levels through proper nutrition, showing that a restricted diet should be conceded. The Veteran is currently assigned an initial 20 percent disability rating for his diabetes mellitus, type II, under 38 C.F.R. § 4.119, DC 7913 (addressing diabetes mellitus). In order to warranted a disability rating in excess of 20 percent for diabetes mellitus, the evidence must show that diabetes mellitus requires one or more daily injections of insulin, a restricted diet, and regulation of activities. 38 C.F.R. § 4.119, DC 7913. After a review of the evidence of record, the Board concludes that an initial disability rating in excess of 20 percent is not warranted for the Veteran’s service-connected diabetes mellitus, type 2. In this case, the report from the October 2020 VA examination reflects that his diabetes is managed by insulin with more than one injection per day, but neither the report from the March 2017 VA examination nor the report from the October 2020 VA examination reflects that his diabetes requires the regulation of activities or a restricted diet. The Veteran’s treatment records also do not show that his diabetes has required a restricted diet or regulation of activities. Accordingly, because the evidence does not show that his service-connected diabetes mellitus, type 2, has required a restricted diet and regulation of activities in addition to one or more daily injections of insulin, the Board finds that an initial disability rating in excess of 20 percent is not warranted. Next, the Board notes that Note 1 to DC 7913 provides that compensable complications of diabetes will be evaluated separately unless they are part of the criteria used to support a 100-percent evaluation, and that non-compensable complications are considered part of the diabetic process. In this case, the Veteran is separately service-connected for coronary artery disease, nonproliferative diabetic retinopathy with macular edema and diabetic cataract, and peripheral neuropathy of the bilateral upper and lower extremities. The ratings for these service-connected disabilities associated with his diabetes mellitus, type 2, are not before the Board. See Tyrues v. Shinseki, 23 Vet. App. 166, 176 (2009) (in situations where an issue is bifurcated, an appellant must then specifically appeal each bifurcated issue). To the extent that he asserts that his erectile dysfunction is a separate disability caused by his diabetes, the Board finds that this contention is without merit given that the report from the September 2020 VA examination reflects that the examiner determined that his erectile dysfunction was less likely than not proximately due to or the result of his diabetes because his diagnosis of diabetes was several years after he was diagnosed with erectile dysfunction. With respect to hypertension, to the extent that he asserts that his hypertension has been caused by his diabetes and that a separate rating is warranted, the Board finds that this contention is without merit because the reports from the March 2017 and October 2020 VA examinations reflect that hypertension is not a complication of his diabetes. Finally, the reports from the March 2017 and October 2020 VA examinations reflect that peripheral vascular disease, strokes, and skin conditions are not complications of his diabetes. Accordingly, the evidence does not demonstrate that the Veteran has any additional separate disorders related to diabetes that would warrant a compensable rating. Additionally, the Board has considered the statements from the Veteran that his diabetes mellitus, type 2, is more severe than the 20 percent disability rating he currently receives. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Although the Veteran is competent to report symptoms of his diabetes mellitus, type 2, because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of his service-connected diabetes mellitus, type 2, according to the DC 7913. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (“although interest may affect the credibility of testimony, it does not affect competency to testify”). On the other hand, such competent evidence concerning the nature and extent of the Veteran’s service-connected diabetes mellitus, type 2, has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the March 2017 and October 2020 VA examination reports) directly address the criteria under which his diabetes mellitus, type 2, is evaluated. By virtue of the foregoing, the Board concludes that an initial disability rating in excess of 20 percent is not warranted for the Veteran’s service-connected diabetes mellitus, type 2, with erectile dysfunction. 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. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Crosnicker, Associate Counsel