Citation Nr: 21029462 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 17-57 916 DATE: May 13, 2021 ORDER Entitlement to service connection for diabetes mellitus type II, as secondary to service-connected disabilities, is granted. FINDING OF FACT The Veteran's diabetes mellitus type II is proximately due to his service-connected disabilities. CONCLUSION OF LAW The criteria for service connection for diabetes mellitus type II, as secondary to service-connected disabilities, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1983 to August 2000. This current matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) at the RO. A transcript of that proceeding has been associated with the claims file. In February 2020, the Board remanded this appeal for further development, to include obtaining a VA examination. The Board finds that the development conducted following the February 2020 remand is adequate and that there has been substantial compliance with the Board's remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran has not raised any issues in the current appeal that are not discussed herein, nor have any other issues been reasonably raised by the record. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Service connection for diabetes mellitus type II, to include as secondary to service-connected disabilities Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 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 in service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for chronic disabilities if such is shown to have been manifested to a compensable degree within one year after the Veteran was separated from service. 38 U.S.C. §§ 1101, 1113; 38 C.F.R. §§ 3.307, 3.309. Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury; or, any increase in severity of a nonservice-connected disease or injury which is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease or injury. 38 U.S.C. § 1131; 38 C.F.R. §§ 3.303, 3.310(a)-(b). In order to prevail on the theory of secondary service connection, there must be evidence of (1) a current disability, (2) a service-connected disability, and (3) a nexus, or link, between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 C.F.R. § 3.102. In the current appeal, the Veteran initially contended that his diabetes mellitus, type II, is related to his military service. However, at the October 2019 hearing, he contended that his service-connected musculoskeletal disabilities caused a decrease in his movement and ability to exercise which, in turn, caused his diabetes mellitus, type II. The Board will address both theories of service connection, but ultimately finds that the Veteran's diabetes mellitus, type II, is proximately due to his service-connected disabilities. Turning to direct service connection, the Board notes that the Veteran has been diagnosed with diabetes mellitus, type II. See, e.g., May 2011 Army Hospital Records and August 2013 Disability Benefits Questionnaire (DBQ). As such, the first element of direct service connection has been satisfied. However, the Veteran's service treatment records (STRs) do not reflect complaints of, or treatment for, diabetes mellitus or symptoms thereof. Rather, the record indicates that the Veteran was first diagnosed with diabetes mellitus in 2010, about 10 years after his separation from active service. He reported believing that he was diagnosed with diabetes in 2008 or 2009, which would still be 8 or 9 years after his separation. At the March 2020 VA examination, the examiner opined that the Veteran's diabetes mellitus, type II, was less likely than not related to his military service as the Veteran's contentions about possible diabetes mellitus symptoms during service were not considered to be diabetic-related. The examiner acknowledged the time between the Veteran's service separation and his diagnosis of diabetes and explained that a nexus to his service could not be established. Given this medical evidence of record, the record does not support a claim for direct service connection. Turning to secondary service connection, the record reflects that the Veteran has a current diagnosis of diabetes mellitus, type II, and that he is service connected for multiple musculoskeletal disabilities and neurological disabilities. In relevant part, he is service connected for the following: degenerative disc disease of the lumbar spine, effective September 1, 2000; arthritis of the neck, effective September 1, 2000; arthritis of the right shoulder, effective September 1, 2000; and radiculopathy of the right lower extremity, effective March 22, 2018. Accordingly, the first and second elements of secondary service connection are satisfied. Regarding a nexus, the March 2020 VA examiner opined that the Veteran's service-connected musculoskeletal and neurological disabilities more likely than not caused the Veteran's diabetes mellitus, type II. The examiner opined that it is as likely as not that the Veteran's diabetes mellitus, type II, is proximately due to, or the result of, his service-connected disabilities, as weight gain is strongly linked to the development of diabetes mellitus. The examiner explained that the pain from the Veteran's service-connected musculoskeletal and neurological disabilities prevented him from exercising and, as a result he gained weight. The examiner then explained that this weight gain at least as likely as not resulted in a diagnosis of diabetes. As such, the Veteran's diabetes mellitus, type II, is at least as likely as not proximately due to his service-connected disabilities. The March 2020 VA examination and opinion addressing secondary service connection are not contradicted by the record and are complete in their rendering. As such, the Board affords this medical evidence significant probative value. The elements of secondary service connection have been met, and entitlement to service connection for diabetes mellitus, type II, as secondary to multiple service-connected musculoskeletal and neurological disabilities, is granted. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Goreham 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.