Citation Nr: 21029716 Decision Date: 05/14/21 Archive Date: 05/14/21 DOCKET NO. 15-09 371 DATE: May 14, 2021 REMANDED Entitlement to service connection for type 2 diabetes mellitus is remanded. Entitlement to service connection for hypertensive retinopathy, as secondary to type 2 diabetes is remanded. Entitlement to service connection for a heart disability, as secondary to type 2 diabetes is remanded. Entitlement to service connection for hypertension, as secondary to type 2 diabetes is remanded. Entitlement to service connection for high cholesterol, as secondary to type 2 diabetes is remanded. Entitlement to service connection for peripheral neuropathy, bilateral upper extremities, as secondary to type 2 diabetes is remanded. Entitlement to service connection for peripheral neuropathy, bilateral lower extremities, as secondary to type 2 diabetes is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1992 to June 1992. 1. Entitlement to service connection for type 2 diabetes mellitus In August 2018, the Board denied the Veteran's claims of service connection for type 2 diabetes, hypertension, hypertensive retinopathy, a heart disability, cholesterol, and peripheral neuropathy of bilateral upper and lower extremities. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (CAVC); and in a July 2019 Order, the CAVC granted the parties' Joint Motion for Remand (JMR). In the JMR, the parties agreed that the Board failed to address a November 2015 lay statement on the Veteran's claimed medical expertise and training as a paramedic; an October 2013 lay statement indicating that the Veteran was relaying an in-service diagnosis of diabetes; a November 2015 lay statement on claimed continuity of symptomatology. Pursuant to a December 2019 Board remand directive, the Veteran was afforded a VA examination in February 2020. The examiner noted a diagnosis of diabetes mellitus and opined that it was less likely than not incurred in or caused by an event in service. The examiner provided the following rationale in support of this opinion: [The Veteran's] DD214 shows active military service from Jan 22, 1992 to Jun 23, 1992. Medical note on June 29, 2012 documents diagnosis and treatment of type II diabetes. Report of medical history and exam on 9/12/1991 did not reveal history or physical exam findings for ongoing acute or chronic treatment of type II diabetes condition. Medical record review did not reveal continuous ongoing medical treatment or aggravation of acute or chronic diabetes condition during time of discharge from active military service to present day. The diabetes condition occurred after discharge from military service. The claimed Type 2 diabetes WAS LESS LIKELY THAN NOT related to an in-service injury, event, or disease and WAS LESS LIKELY THAN NOT noted during service with continuity of the same symptomatology since service. The Board finds this opinion to be inadequate as it does not address the Veteran's lay statements regarding his symptoms during and after service nor does it address his blurry vision during service. Therefore, an addendum opinion is necessary prior to adjudication. 2. Entitlement to service connection for hypertensive retinopathy, as secondary to type 2 diabetes is remanded. 3. Entitlement to service connection for a heart disability, as secondary to type 2 diabetes is remanded. 4. Entitlement to service connection for hypertension, as secondary to type 2 diabetes is remanded. 5. Entitlement to service connection for high cholesterol, as secondary to type 2 diabetes is remanded. 6. Entitlement to service connection for peripheral neuropathy, bilateral upper extremities, as secondary to type 2 diabetes is remanded. 7. Entitlement to service connection for peripheral neuropathy, bilateral lower extremities, as secondary to type 2 diabetes is remanded. As the issues of service connection for hypertensive retinopathy, a heart disorder, hypertension, high cholesterol, and peripheral neuropathies of the bilateral upper and lower extremities are secondary to the Veteran's claim of service connection for diabetes, the Board finds they are inextricably intertwined with the remanded claim and remanded pending its adjudication. The matters are REMANDED for the following action: Return the claims file to the February 2020 VA examiner (or a similarly situated examiner). The examiner must review the claims file, including the Veteran's lay statements and reported medical qualifications, and provide an opinion as to the onset and etiology of his diabetes and any relationship, or lack thereof, between the Veteran diabetes and his blurred vision in service or symptoms post service, as described in his October 2013 and November 2015 lay statements. All opinions provided must be supported by a reasoned rationale based on a review of the record and the relevant medical principles. MICHAEL D. LYON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Shana Z. Siesser, 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.