DIABETES MELLITUS

Summary

The veteran, who served honorably in the U.S. Army from October 1989 to April 1992, appeals the denial of service connection for morbid obesity, difficulty walking, allergic rhinitis, and otitis media. The Board denied service connection for morbid obesity, citing VA policy that obesity is not a disability unless it impairs earning capacity, and finding no evidence of such impairment in this case. Difficulty walking was denied as it is considered a symptom of other diagnosed conditions, not a standalone disability. Service connection for allergic rhinitis and otitis media was denied because, despite current diagnoses and RO concessions, the service treatment records were silent for these conditions, and the VA examiner opined they were unrelated to service, with no competent medical nexus established. The Board found the evidence did not preponderate in favor of the veteran for these denied claims. Several other conditions, including gout, sleep apnea, hyperglycemia, kidney disease with diabetic nephropathy, polyneuropathy affecting all four extremities, tinea pedis, and tinea unguium (onychomycosis), were remanded for further development, including VA examinations to determine their nature, etiology, and relationship to service or other service-connected conditions, particularly diabetes.

Rationale

Obesity not considered a disability unless it impairs earning capacity per VA policy and Larson v. McDonough.; Record silent for evidence of impairment of earning capacity due to obesity.; Veteran clarified obesity was a linking condition, not a direct impairment.

Full Decision Text

Citation Nr: A26002645
Decision Date: 01/12/26	Archive Date: 01/12/26

DOCKET NO. 221220-307014
DATE: January 12, 2026

ORDER

Service connection for morbid obesity is denied.

Service connection for difficulty walking is denied.

Service connection for allergic rhinitis is denied.

Service connection for otitis media is denied.

REMANDED

Service connection for gout is remanded.

Service connection for sleep apnea is remanded.

Service connection for hyperglycemia is remanded.

Service connection for kidney disease to include diabetic nephropathy is remanded.

Service connection for polyneuropathy including diabetic peripheral neuropathy of the left upper extremity is remanded.

Service connection for polyneuropathy including diabetic peripheral neuropathy of the right upper extremity is remanded.

Service connection for polyneuropathy including diabetic peripheral neuropathy of the left lower extremity is remanded.

Service connection for polyneuropathy including diabetic peripheral neuropathy of the right lower extremity is remanded.

Service connection for tinea pedis is remanded.

Service connection for tinea unguium (onychomycosis) is remanded.

FINDINGS OF FACT

1. The record does not establish that the Veteran's obesity limits the Veteran's ability to work or otherwise results in a functional impairment of earning capacity.

2. Difficulty walking is not a disability for VA compensation purposes, because it is a symptom of a number of diagnosed conditions including a back disability, a bilateral knee disability, and pes planus.

3. A medical nexus has not been established between an in-service incurrence and a current diagnosis of allergic rhinitis.

4. A medical nexus has not been established between an in-service incurrence and a current diagnosis of otitis media.

CONCLUSIONS OF LAW

1. The criteria for service connection for morbid obesity have not been met.  38 U.S.C. §§ 1101, 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.

2. The criteria for service connection for difficulty walking have not been met.  38 U.S.C. §§ 1101, 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.

3. The criteria for service connection for allergic rhinitis have not been met.  38 U.S.C. §§ 1101, 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.

4. The criteria for service connection for otitis media have not been met.  38 U.S.C. §§ 1101, 1110, 1131; 38 C.F.R. §§ 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably in the United States Army from October 1989 to April 1992.

These matters come to the Board of Veterans' Appeals (Board) on appeal from a November 2022 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  This appeal is being adjudicated under the modern appellate framework.  In the December 2022 notice of disagreement (NOD) which commenced this appeal, the Veteran opted into the Hearing Docket.  The Veteran testified at a personal hearing before the Board in August 2025, and a transcript of the hearing is of record.

The Board may only consider the evidence of record before the agency of original jurisdiction (AOJ) at the time of its decision on the issue(s) on appeal, evidence submitted by the Veteran or his or her representative at the Board hearing, to include testimony provided at the hearing; and evidence submitted within 90 days following the Board hearing.  38 C.F.R. § 20.300(a), 302(a).  If additional evidence was submitted outside of these time periods, the Board will not consider.  If the Veteran would like VA to consider any evidence that was added to the claims file that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim(s), considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a supplemental claim are included with this decision.  See also Cook v. McDonough, 36 Vet. App. 175 (2023).

Service Connection

In seeking VA disability compensation, a Veteran generally seeks to establish that a current disability results from disease or injury
 like VA to consider any evidence that was added to the claims file that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim(s), considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a supplemental claim are included with this decision.  See also Cook v. McDonough, 36 Vet. App. 175 (2023).

Service Connection

In seeking VA disability compensation, a Veteran generally seeks to establish that a current disability results from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131. "Service connection" basically means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. 38 C.F.R. § 3.303.

1. Service connection for morbid obesity is denied.

At issue is whether the Veteran is entitled to service connection for morbid obesity.  Unfortunately, the Veteran's claim for service connection for obesity must be denied.

A current disability or a disability during the pendency of the appeal is the cornerstone for a claim for service connection, and, without one, the Veteran cannot prevail.  Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997).  Obesity is not listed as a disability on the rating schedule; 38 C.F.R. §§ 4.1-4.150; and VA's longstanding policy has always been that obesity is not considered a disability for VA compensation purposes.  VAOPGCPREC 1-2017 (January 6, 2017).  While the judiciary has declined to alter this determination, the judiciary has claimed the jurisdiction to review the policy, and - while declining to make a finding that obesity is a disability in the first instance - the judiciary has outlined the standard by which to evaluate whether or not obesity is a disability for VA compensation purposes; namely, whether or not obesity causes an impairment of earning capacity.  Larson v. McDonough, 10 F. 4th 1325 (Fed. Cir. 2021) (citing Saunders v. Wilkie, 886 F. 3d 1356 (Fed. Cir. 2018)).  

The Board is cognizant that, in November 2022, the RO conceded that the Veteran had a current diagnosis of obesity, and the Board is bound by such a favorable determination.  38 C.F.R. § 3.104.  Nevertheless, the Board must interpret this favorable finding in light of precedential guidance from the judiciary and the secretary, and, as described above, the Board is bound by the precedential opinion indicating that obesity is not a disability for VA compensation purposes on a direct basis.  

The Board also has a duty to make a finding on all material issues of fact presented by the record; 38 U.S.C. § 7104(d)(1); which in this case includes whether or not the Veteran's obesity causes an impairment of the Veteran's earning capacity.  In this particular case, the record is silent for any evidence that the Veteran's obesity directly causes an impairment of the Veteran's earning capacity.  In an August 2025 hearing before the Board moreover, the Veteran expressly clarified that obesity served as a linking condition between previously service-connected disabilities and disabilities that the Veteran was seeking service connection for on a secondary basis; rather than obesity serving as a direct impairment on earning capacity in and of itself.  See Transcript.

Here, the weight of the probative evidence of record does not demonstrate that the Veteran is entitled to service connection for obesity.  Therefore, the evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  As such, service connection for obesity is denied.     

2. Service connection for difficulty walking is denied. 

At issue is whether the Veteran is entitled to service connection for difficulty walking.  Unfortunately, difficulty walking is not a disability for VA compensation purposes.

As noted supra, a current disability or a disability during the pendency of the appeal is the cornerstone of a claim for service connection and without one, the Veteran cannot prevail.  See Degmetich.  As also noted supra, the standard for whether a disability that is not listed in the disability schedule (such as obesity or undiagnosed pain) is whether or not
 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  As such, service connection for obesity is denied.     

2. Service connection for difficulty walking is denied. 

At issue is whether the Veteran is entitled to service connection for difficulty walking.  Unfortunately, difficulty walking is not a disability for VA compensation purposes.

As noted supra, a current disability or a disability during the pendency of the appeal is the cornerstone of a claim for service connection and without one, the Veteran cannot prevail.  See Degmetich.  As also noted supra, the standard for whether a disability that is not listed in the disability schedule (such as obesity or undiagnosed pain) is whether or not the claimed disability causes an impairment of earning capacity.  See Larson; see also Saunders.  Nevertheless, this standard only applies to disabilities that are not listed in the rating schedule.  Martinez-Bodon v. McDonough, 38 F.4th 1241 (2022).  In this particular case, the Veteran's claimed difficulty walking is symptom of a number of different disabilities that the Veteran has been diagnosed with (some of which the Veteran has been granted service connection for and some of which the Veteran has not) including: a back disability, a bilateral knee disability, and pes planus.  See July 2025 Rating Decision Code Sheet.  As such, the Veteran's claimed difficulty walking is not a disability for VA compensation purposes.  

In making this determination, the Board is cognizant that, in November 2022, the RO conceded that the Veteran had a current diagnosis of difficulty walking, and the Board is bound by such a favorable determination.  38 C.F.R. § 3.104.  Nevertheless, the Board must interpret this favorable finding in light of precedential guidance from the judiciary and the secretary, and, as described above, the Veteran's difficulty walking is a symptoms of a number of diagnosable conditions.  Thus while the Board may, and indeed must, acknowledge the factual determination that the Veteran has difficulty walking, this is not a valid basis for declaring difficulty walking a disability for VA compensation purposes

The weight of the probative evidence of record demonstrates that the Veteran is not entitled to service connection for difficulty walking.  Therefore, the evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  As such, service connection for difficulty walking is denied.  

3. Service connection for allergic rhinitis is denied. 

At issue is whether the Veteran is entitled to service connection for allergic rhinitis.  The weight of the evidence indicates that the Veteran is not entitled to service connection.

In November 2022, the RO conceded that the Veteran had a current diagnosis of allergic rhinitis.  The Board is bound by this determination.  38 C.F.R. § 3.104.

The Veteran's service treatment records are silent for a diagnosis of or treatment for allergic rhinitis.

The record is silent for over a decade thereafter until the Veteran sought treatment for allergic rhinitis in August 2008.  The Veteran continued to report the condition thereafter.

The Veteran underwent a VA examination in October 2022.  The Veteran reported that his allergic rhinitis began during basic training and continued to manifest in an increasing severe degree thereafter.  The examiner diagnosed the Veteran with allergic rhinitis dating back to August 2008.  The examiner opined that a medical nexus could not be established between the Veteran's allergic rhinitis and an in-service incurrence, because the Veteran's allergic rhinitis was more likely than not a series of acute responses to specific allergic exposures that occurred after the Veteran's period of service.

The Veteran testified at a personal hearing before the Board in August 2025, but did not provide pertinent testimony regarding the etiology of his allergic rhinitis.  See Transcript.

The weight of the evidence indicates that the Veteran is not entitled to service connection for allergic rhinitis.  The Veteran clearly has a current diagnosis of allergic rhinitis.  Nevertheless, contemporaneous medical records do not memorialize allergic rhinitis until over a decade after separation from service.  A competent VA examiner opined that the Veteran's allergic rhinitis was unrelated to service, and the record is silent for a competent medical opinion establishing a medical nexus between a current diagnosis and an in-service incurrence.

The weight of the probative evidence of record demonstrates that the Veteran is not entitled to service connection for allergic rhinitis.  Therefore, the evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law
 not entitled to service connection for allergic rhinitis.  The Veteran clearly has a current diagnosis of allergic rhinitis.  Nevertheless, contemporaneous medical records do not memorialize allergic rhinitis until over a decade after separation from service.  A competent VA examiner opined that the Veteran's allergic rhinitis was unrelated to service, and the record is silent for a competent medical opinion establishing a medical nexus between a current diagnosis and an in-service incurrence.

The weight of the probative evidence of record demonstrates that the Veteran is not entitled to service connection for allergic rhinitis.  Therefore, the evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  As such, service connection for allergic rhinitis is denied.

4. Service connection for otitis media is denied. 

At issue is whether the Veteran is entitled to service connection for otitis media.  The weight of the evidence indicates that the Veteran is not entitled to service connection.

In November 2022, the RO conceded that the Veteran had a current diagnosis of otitis media.  The Board is bound by this determination.  38 C.F.R. § 3.104.

The Veteran's service treatment records are silent for a diagnosis of or treatment for otitis media.

The record is silent for decades thereafter until the Veteran sought treatment for otitis media in 2021.  The Veteran continued to report the condition thereafter.

The Veteran underwent a VA examination in October 2022.  The Veteran reported that he first began manifesting ear symptomology in 1989 during a period of service.  The examiner opined that the Veteran may have had acute instances of otitis media in the past, but that the Veteran had not manifested such a condition during the examination.  The examiner opined that a medical nexus did not exist between the Veteran's claimed otitis media and an in-service incurrence, because the Veteran's otitis media was more likely than not a series of acute responses to specific allergic exposures that occurred after the Veteran's period of service.  

The Veteran testified at a personal hearing before the Board in August 2025 that he continued to manifest otitis media due to ear infections.  While the Veteran continued to suggest that his otitis media began during a period of service, the Veteran did indicate that his current manifestations of otitis media were caused by getting his ears wet when he would go swimming.  See Transcript.

The weight of the evidence indicates that the Veteran is not entitled to service connection for otitis media.  The Veteran clearly has recurring instances of otitis media.  Nevertheless, contemporaneous medical records do not memorialize otitis media for decades after separation from service.  A competent VA examiner opined that the Veteran's otitis media was unrelated to service, and the record is silent for a competent medical opinion establishing a medical nexus between a current diagnosis and an in-service incurrence.  Finally, the Veteran testified that the most recent instances of otitis media were caused by getting his ears wet while swimming.

The weight of the probative evidence of record demonstrates that the Veteran is not entitled to service connection for otitis media.  Therefore, the evidence in this case is not so evenly balanced so as to allow application of the benefit-of-the-doubt rule as required by law and VA regulations.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  As such, service connection for otitis media is denied

REASONS FOR REMAND

1. Service connection for gout is remanded.

At issue is whether the Veteran is entitled to service connection for gout.  In November 2022, the RO conceded that the Veteran had a current diagnosis of gout.  The Board is bound by this determination.  38 C.F.R. § 3.104.  In an August 2022 claim for service connection, the Veteran made the lay report that the rigors of physical training during a period of service led to his gout.  This is sufficient to trigger VA's duty to assist and to provide the Veteran with a VA examination evaluating the nature and etiology of the Veteran's gout.  Unfortunately, the record is silent for such an examination.  This constitutes a violation of VA's duty to assist.  McLendon v. Nicholson, 20 Vet. App. 79 (2006).  Unfortunately, the Board cannot grant the Veteran's entire prayer of relief at this time, and the Board must remand this matter for a VA examination.  38 C.F.R. § 20.802.   

2. Service connection for sleep apnea is remanded.


 the rigors of physical training during a period of service led to his gout.  This is sufficient to trigger VA's duty to assist and to provide the Veteran with a VA examination evaluating the nature and etiology of the Veteran's gout.  Unfortunately, the record is silent for such an examination.  This constitutes a violation of VA's duty to assist.  McLendon v. Nicholson, 20 Vet. App. 79 (2006).  Unfortunately, the Board cannot grant the Veteran's entire prayer of relief at this time, and the Board must remand this matter for a VA examination.  38 C.F.R. § 20.802.   

2. Service connection for sleep apnea is remanded.

3. Service connection for hyperglycemia is remanded.

4. Service connection for kidney disease to include diabetic nephropathy is remanded.

5. Service connection for polyneuropathy including diabetic peripheral neuropathy of the left upper extremity is remanded.

6. Service connection for polyneuropathy including diabetic peripheral neuropathy of the right upper extremity is remanded.

7. Service connection for polyneuropathy including diabetic peripheral neuropathy of the left lower extremity is remanded.

8. Service connection for polyneuropathy including diabetic peripheral neuropathy of the right lower extremity is remanded.

9. Service connection for tinea pedis is remanded.

10. Service connection for tinea unguium (onychomycosis) is remanded.

In an August 2022 claim for service connection, the Veteran alleged that the Veteran's obstructive sleep apnea was caused by an acquired psychiatric disorder. The Veteran's treatment records indicate a diagnosis of sleep apnea.  In an August 2025 hearing before the Board, the Veteran alleged that his tinea pedis and tinea unguium (onychomycosis) were caused by his claimed diabetes.  The RO found that the Veteran has diagnosis of onychomycosis and a diagnosis of tinea pedis.  Additionally, the remaining issues, listed supra, are all intertwined with the Veteran's claim for service connection for diabetes.  As discussed in a separate Board decision, the issues of service connection for diabetes and an acquired psychiatric disorder other than posttraumatic stress disorder (PTSD) are being remanded.  As such, these matters must be remanded as well in order to avoid piecemeal appellate litigation.  Harris v. Derwinski, 1 Vet. App. 180 (1991).

The matters are REMANDED for the following action:

1. Arrange to provide a VA examination in order to determine the nature and etiology of the Veteran's gout. The examiner should opine whether it is at least as likely as not that the Veteran's gout is related to a period of service.

2. Arrange to provide the Veteran with a VA examination in order to address the following:  Is it at least as likely as not that the Veteran's tinea pedis, tinea unguium (onychomycosis,) and kidney condition are due to or aggravated by the Veteran's diabetes?  Why or why not?

 

 

Ann K. Minami

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	David R. Seaton, 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.