DIABETES MELLITUS

L. HOWELL · 2025 · Case ID: A25086721

DENIED

Summary

The Veteran served in the Army from November 1986 to November 1988, with subsequent Army Reserve service. The Veteran appealed the denial of service connection for diabetes mellitus (DM) and a vision disorder. The Board reviewed the evidence under the Appeals Modernization Act, considering the record as it existed at the time of the agency of original jurisdiction's decision. For DM, the Board found a current diagnosis in 2001, but the service treatment records (STRs) were silent regarding any in-service complaints, treatment, diagnosis, or symptoms of DM. The separation examination was also negative. The Board determined VA was not required to schedule an examination due to the lack of competent evidence of an in-service event. Presumptive service connection was also denied, as DM was not shown in service, nor did it manifest with continuity of symptomatology or within one year of separation. For the vision disorder, diagnosed as advanced macular degeneration and diabetic retinopathy, the Board found no in-service incurrence or nexus to service. As DM was denied service connection, the claim for the vision disorder as secondary to DM was also denied as a matter of law. The Veteran's lay statements regarding DM and vision disorder being service-related were considered, but the Board found the Veteran competent only to report symptoms, not to offer opinions on etiology. The Board concluded the evidence persuasively weighed against service connection for both conditions. The appeal was denied.

Rationale

Service treatment records silent regarding DM in-service; Separation examination negative for DM; No presumptive service connection established

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

240925-477023

Full Decision Text

Citation Nr: A25086721
Decision Date: 10/07/25 Archive Date: 10/07/25

DOCKET NO. 240925-477023
DATE: October 7, 2025

ORDER

Service connection for diabetes mellitus type II (DM) is denied.

Service connection for a vision disorder is denied.

FINDINGS OF FACT

1. The Veteran served on active duty from November 1986 to November 1988 with additional service in the Army Reserve.

2. DM was not shown in service, not shown to a compensable degree within one year of service, was not continuous since service, and is not casually or etiologically related to service.

3. A vision disorder, diagnosed as advanced macular degeneration and diabetic retinopathy, was not shown in service, is not etiologically related to service, and was not caused by or aggravated by a service-connected disability.

CONCLUSIONS OF LAW

1. DM was not incurred in service and cannot be presumed to have been incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2025).

2. A vision disorder was not incurred in service and was not the result of a service-connected disability. 38 U.S.C. §§ 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.310 (2025).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

This decision has been written under the guidelines of the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). In May 2024, the agency of original jurisdiction (AOJ) denied the claim. In September 2024, the Veteran appealed to the Board via a VA Form 10182 and elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the AOJ decision on appeal. 38 C.F.R. § 20.301.

Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).

Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307.

Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998).

As an initial procedural matter, the Veteran contends he served in the Active Guard Reserve (AGR), which would be considered active-duty service under Title 32. Accordingly, in addition to the laws and regulations outlined above, active military, naval, or air service includes any period of active duty training (ACDUTRA) during which the individual concerned was disabled from a disease or injury incurred or aggravated in the line of duty, and any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101(21) and (
. West, 11 Vet. App. 509, 512 (1998).

ACDUTRA is defined as full-time duty in the Armed Forces performed by Reserves for training purposes, and includes full-time duty performed by members of the National Guard of any State. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c)(1). Thus, service connection may be granted for a disability resulting from disease or injury incurred or aggravated while performing ACDUTRA or from an injury incurred or aggravated while performing INACDUTRA. 38 U.S.C. §§ 101(24), 106, 1110, 1131.

When in Title 10 status, a person serves active duty in the United States Army or Air Force, just like an active component member. Such persons are directed by the President and have been activated for Federal service. When in a Title 32 status, a person is paid by the Federal Government. The primary purpose of Title 32 duty is to prepare for the contingency of being called to Title 10 duty. Title 32 duty includes active duty for training (annual training), inactive duty training (drills), and other "duty under 32 U.S.C. § 316, 502, 503, 504, or 505" and active duty as a member of the Active Guard Reserve. See 10 U.S.C. §§ 13201(d), 12302, 12304, 331, 332, 333, 12406; 32 U.S.C. §§ 316, 328, 502, 503, 504, 505, 901, 902; 38 U.S.C. §§ 4303(15). Title 32 service is considered ACDUTRA.

As the Veteran's AGR status is relevant to the service connection determinations, the Board will address this issue, initially. To that end, the AOJ requested the Veteran's service records to include the military personnel records. The Defense Personnel Retrieval Imaging System (DPRIS) responded with an Information Report dated September 2018. The report indicated that the Veteran had active duty service, as noted above, and Army Reserve service from November 1988 through May 2007; however, the report indicated he did not have Guard/Reserve Active Service.

The Board has considered the Veteran's lay statements that he served in the AGR; however, the objective evidence of record contradicts the contention. As such, the Board finds that the only period of active duty service was reflected in the DD 214, i.e. from November 1986 to November 1988.

Diabetes Mellitus

The Veteran contends that DM was diagnosed in service and, as such, is as a result of active duty. As to a current diagnosis, a review of VA treatment records noted a diagnosis of DM in March 2001. As such, the first element of service connection has been met.

As to an in-service incurrence, the service treatment records (STRs) are silent as to any complaints of, treatment for, a diagnosis of, or symptoms reasonably associated with DM such as excessive thirst, excessive or difficulty with urination, or elevated glucose in the urine. Further, the Veteran's separation examination is negative for complaints related to DM, and the clinical evaluation was normal. Therefore, the evidence does not support an in-service incurrence of DM, and the second element of direct service connection has not been met.

To the extent that the Veteran asserts a nexus between DM and service, he did not undergo a VA examination for this disability. VA is required to provide an examination or obtain a medical opinion in a claim for service connection when there is: (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence of an in-service event, injury, or disease; (3) an indication that the current disability may be associated with the in-service event; and (4) otherwise insufficient evidence to decide the claim. See 38 U.S.C. § 5103A (
the evidence does not support an in-service incurrence of DM, and the second element of direct service connection has not been met.

To the extent that the Veteran asserts a nexus between DM and service, he did not undergo a VA examination for this disability. VA is required to provide an examination or obtain a medical opinion in a claim for service connection when there is: (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence of an in-service event, injury, or disease; (3) an indication that the current disability may be associated with the in-service event; and (4) otherwise insufficient evidence to decide the claim. See 38 U.S.C. § 5103A (d)(2); 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The threshold for finding a link between current disability and service is low. McLendon, 20 Vet. App. at 83.

Nonetheless, as there is no competent evidence in the record of an in-service event, injury, or disease, VA was not required to schedule an examination. Despite the Veteran's asserts to the contrary, DM or any symptoms reasonably associated with DM were not shown in service. Without evidence of in-service incurrence or a nexus, the medical evidence persuasively weights against direct service connection.

As for presumptive service connection for qualifying chronic diseases, DM is a chronic disease listed under 38 C.F.R. § 3.309(a), and presumptive service connection will be considered. As noted above, the STRs do not show that a chronic disease was shown in service. The STRs fail to show complaints of, treatment for, or a diagnosis of DM in service or any symptoms reasonably attributed to the disease. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis.

Next, the medical evidence does not support presumptive service connection based on continuity of symptomatology since service. Specifically, the Veteran was not diagnosed with DM until March 2001. As he was discharged from service in 1988, and symptoms of DM were not identified until 2001, nearly 13 years later, the medical evidence does not support service connection on a "continuity of symptomatology" basis.

Further, the disorder did not manifest to a degree of 10 percent or more within one year from the date of separation of service. The Veteran separated from service in 1988, but he did not note symptoms of DM until 2001. This evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. Therefore, the medical evidence does not support presumptive service connection on any basis. In sum, the medical evidence does not support service connection for DM under any theory of entitlement.

Vision Disorder

The Veteran contends that a vision disorder is secondary to the DM. As to the first element of direct service connection, he has been diagnosed as advanced macular degeneration and diabetic retinopathy. As such, a current disorder is shown.

As to in-service incurrence, the STRs are silent as to any complaints of, treatment for, a diagnosis of, or symptoms reasonably associated with a vision disorder. Further, the separation examination is negative for complaints related to a vision disorder, and the clinical evaluation was normal. Therefore, the evidence does not support an in-service incurrence of a vision disorder, and the second element of direct service connection has not been met.

As there is no competent evidence in the record of an in-service event, injury, or disease, VA was not required to schedule an examination, as noted in the DM analysis. Without evidence of in-service incurrence or a nexus, the medical evidence persuasively weights against direct service connection.

As to secondary service connection, although the Veteran has a current diagnosis of a vision disorder, there is no underlying service-connected disability upon which secondary service connection may be granted since service connection for DM has been denied in this decision. As such, the claim for secondary service connection for a vision disorder must be denied as a matter of law. See 38 C.F.R. § 3.310(a).

The Board has considered the Veteran's lay statements that DM and a vision disorder were caused by service. While he is competent to report symptoms as this requires only personal knowledge as it comes through the senses, he is not competent to offer an opinion as to the etiology of the current disorders due to the medical complexity of the matters involved. Specifically, the lay statements about the DM and vision problems do not describe symptoms of a particular disorder or suggest a particular etiology of any such disorder.

In sum, after a careful review of the record, the evidence weighs persuasively against the claims for service connection, and
for a vision disorder must be denied as a matter of law. See 38 C.F.R. § 3.310(a).

In sum, after a careful review of the record, the evidence weighs persuasively against the claims for service connection, and there is no doubt to be resolved. As such, the appeals are denied.

Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not

required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board B. J. Ferguson, Associate 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.

Analyze in VA Law Explorer