Diabetes decisions — 2023

The Board denied an earlier effective date for the grant of service connection for diabetes mellitus, type II due to a lack of evidence showing that the RO received a claim prior to July 15, 2016.

The Veteran's appeal for avitaminosis, also claimed as weight loss, has been dismissed. The claims for service connection for various disabilities have been remanded due to the need for additional development of his service records and outpatient treatment records.

The Veteran's claims for service connection for ischemic heart disease, diabetes mellitus type II, prostate cancer, and erectile dysfunction were granted with an effective date of October 1, 1999.

The Veteran's hypertension, diabetes mellitus, peripheral neuropathy in the bilateral upper and lower extremities, and erectile dysfunction are presumed to be related to service due to their onset decades after separation.,Service records do not show any signs or symptoms of these conditions during active duty.

The Veteran's claims for increased ratings of his diabetic neuropathy are being remanded due to the need for a new VA examination.

The Board has decided to remand the case due to inadequacy of the previous VA examination, and a new opinion is needed regarding whether the Veteran's obstructive sleep apnea is proximately due to his service-connected type 2 diabetes mellitus.

The Board denied service connection for various disabilities, including pancreatic disability, left hand disability, diabetes mellitus, peripheral neuropathy of the upper and lower extremities, erectile dysfunction, hypertension, kidney disability with renal transplant, skin disability, and acquired psychiatric disorder. The evidence did not support a finding that these conditions were incurred or aggravated by service.

The Veteran's claims for diabetes mellitus, type II, hypertension, and pre-cancerous Barrett's esophagus are being remanded due to the need for additional development.

The Board has reopened the Veteran's claims for service connection for type two diabetes mellitus, hypertension, erectile dysfunction, and glaucoma of the left and right eyes. The claims are now remanded due to new evidence received since the January 2015 rating decision.

The Veteran's claims for service connection for diabetes and high blood pressure were denied as there was no evidence of exposure to herbicides or other chemicals during service, and the conditions did not have their onset during service.

The Veteran's service-connected PTSD, bilateral hearing loss, and diabetes mellitus type II have prevented him from maintaining substantially gainful employment since November 30, 2006. The Board has granted a TDIU on an extraschedular basis for this period.

The Board has granted service connection for left lower extremity peripheral neuropathy, right lower extremity peripheral neuropathy, and erectile dysfunction as secondary to the Veteran's service-connected diabetes mellitus type II.,However, the TDIU claim remains pending due to a need for additional evidence regarding the nature and etiology of any bilateral upper extremity neurological conditions.

The Board has decided to remand the case due to insufficient medical opinions regarding whether the Veteran's sleep apnea is caused or aggravated by his service-connected diabetes mellitus. Additional development, including obtaining new medical opinions and considering obesity as an intermediate step, is required.

The Veteran's diabetes mellitus has not required one or more daily injections of insulin, restricted diet, and regulation of activities to warrant a higher initial rating.,The Veteran's bilateral tinea pedis is currently rated as 0 percent due to the absence of systemic therapy. Further examination is needed to determine if his current treatment qualifies as such.,The Veteran's chloracne has not been found to cause deep acne other than on the face and neck, warranting a compensable rating.,For the left lower extremity, sciatic nerve, the Veteran's peripheral neuropathy was rated at 10 percent prior to August 4, 2022; and in excess of 20 percent since that date. Further examination is needed to determine if this rating should be changed.,For the right lower extremity, sciatic nerve, the Veteran's peripheral neuropathy was also rated at 10 percent prior to August 4, 2022; and in excess of 20 percent since that date. Further examination is needed to determine if this rating should be changed.,The Veteran's left lower extremity, femoral nerve, peripheral neuropathy has been rated at 10 percent. Further examination is needed to determine if a higher rating is warranted.,For the right lower extremity, femoral nerve, the Veteran's peripheral neuropathy was also rated at 10 percent. Further examination is needed to determine if a higher rating is warranted.

The Veteran's diabetes mellitus type II is rated at 20 percent, and a higher rating is denied.,PTSD and MDD are rated at 50 percent prior to August 30, 2016, and at 70 percent from that date. The issues of increased ratings for peripheral neuropathy of the upper and lower extremities are remanded.,The Veteran's left upper extremity peripheral neuropathy is rated at 20 percent, and a higher rating is remanded.,The Veteran's right upper extremity peripheral neuropathy is rated at 20 percent, and a higher rating is remanded.,The Veteran's right lower extremity peripheral neuropathy is rated at 10 percent, and a higher rating is remanded.,The Veteran's left lower extremity peripheral neuropathy is rated at 10 percent, and a higher rating is remanded.,TDIU is remanded.

The Board has remanded the cases for additional development due to non-compliance with previous instructions. The Veteran's service treatment records indicate he was exposed to Agent Orange in drums brought from Guam by B-52s, and he claims exposure during flights to Vietnam and Thailand.

The Board denied service connection for various conditions, including diabetes mellitus and its related complications, as well as sleep apnea and chronic fatigue. The examiner found no evidence linking these conditions to the Veteran's military service.

The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.,The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.,The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.,,The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.,The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.,The Board has determined that additional evidentiary development is necessary prior to the adjudication of the remaining issues on appeal. Specifically, efforts are required to obtain missing service treatment records from the Veteran's National Guard service and verify his claimed in-service stressors.

The Board has determined that additional medical opinions are needed to address the service connection claims for diabetes mellitus, heart disorder, cervical spine disorder, and lumbar spine disorder. The current VA medical opinions do not adequately address the exposure basis or provide a clear nexus opinion.

The Board has remanded the claims for ischemic heart disease, gastroesophageal reflux disease, skin cancer, diabetes mellitus, and thyroid cancer due to insufficient evidence of herbicide exposure during service.