Citation Nr: 21042600
Decision Date: 07/13/21	Archive Date: 07/13/21

DOCKET NO. 15-44 798
DATE: July 13, 2021

REMANDED

Entitlement to service connection for the cause of the Veteran's death is remanded.

REASONS FOR REMAND

The Veteran had active service from September 1954 to September 1957, January 1964 to January 1967, and May 1967 to June 1967, to include service in the Republic of Vietnam. The Veteran died in August 2012. The appellant is the Veteran's surviving spouse. 

In February 2019, the appellant was afforded a Board hearing before the undersigned. A copy of the transcript is of record. Following a lengthy procedural history, the Board remanded the issue on appeal for further development in March 2021. 

1. Entitlement to service connection for the cause of the Veteran's death is remanded.

Following an April 2020 order from the United States Court of Appeals for Veterans Claims (Court) which remanded the issue on appeal for compliance with a Joint Motion for Remand (JMR), the March 2021 Board remand instructed that an additional medical opinion was to be obtained to determine whether or not the Veteran's service-connected diabetes mellitus was a contributing factor to his death. Specifically, the March 2021 Board remand noted that an additional medical opinion was to be obtained because the February 2016 VA medical opinion of record provided a negative etiologic opinion based on the inaccurate factual premise that there was no evidence of uncontrolled diabetes at the time of the Veteran's death. As the April 2020 JMR noted, medical records dated August 2012, a few weeks before the Veteran's death, noted presumed low blood sugar and a diagnosis of hypoglycemia. A subsequent October 2020 and April 2021 VA medical opinions both provided a negative etiologic opinion based on the inaccurate factual premise that there was no medical evidence of uncontrolled diabetes at the time of the Veteran's death. As such, the Board finds that a remand for an adequate medical opinion is needed.     

The matters are REMANDED for the following action:

1.  Forward a copy of this remand to an appropriate VA examiner (other than the examiner(s) who provided the October 2020 and/or the April 2021 addendum opinion) for a medical opinion concerning the Veteran's cause of death. The examiner must provide the following opinion:

Whether it is at least as likely or not (50 percent or greater probability) that the Veteran's uncontrolled diabetes mellitus was a contributing factor to his death. 

The examiner is instructed to reconcile his or her opinion with medical records which detail that the Veteran was treated for presumed low blood sugar and diagnosed with hypoglycemia weeks before his death. Should the examiner provide a negative etiologic opinion, the examiner is instructed to provide a full rationale as to why treatment for low blood sugar, diagnosis of hypoglycemia, and/or diabetes mellitus was not a contributing factor to the Veteran's death. Simply stating that there is no evidence of uncontrolled diabetes at the time of the Veteran's death is inadequate and will not be accepted as a complete rationale.

2. Then readjudicate the claim on appeal. If the claim remains denied, send the appellant and her representative a Supplemental Statement of the Case (SSOC) and give her an opportunity to respond before returning the file to the Board for further appellate consideration of the claim.    

 

 

Thomas H. O'Shay

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N. Peden

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.