DIABETES MELLITUS

HARVEY P. ROBERTS · 2026 · Case ID: A26022893

DENIED

Summary

The Veteran, a Veteran who served from October 1965 to October 1967, appeals the denial of service connection for diabetes mellitus. The Veteran claims the condition is due to toxic exposure from a ship fire on the USS Forrestal, herbicide exposure in Vietnam, or aggravation by service-connected hypertension. The Board reviewed the July 2023 TERA Memorandum, which conceded toxic exposure from the ship fire but denied herbicide exposure. While the Veteran received the Vietnam Service Medal, the Board found no evidence of qualifying duty in Vietnam or its territorial waters, and VA has not conceded herbicide exposure. The Board noted favorable findings from the RO regarding the Veteran's diabetes diagnosis and concession of toxic exposure from the ship fire. However, the Board found the October 2023 VA TERA opinion inadequate, deeming it speculative and inconsistent with the record, particularly regarding the lack of qualifying Vietnam service and conceded herbicide exposure. Subsequent VA opinions from October 2023, December 2023, and March 2024 consistently found diabetes mellitus less likely than not related to the ship fire exposure or hypertension. The Board concluded that the weight of the competent and credible evidence does not establish a service connection for diabetes mellitus, as no medical opinion supported a link to service or service-connected hypertension. The Board acknowledged the benefit of the doubt doctrine but found the evidence weighed against service connection, thus denying the claim.

Rationale

Weight of the evidence does not show diabetes mellitus is etiologically related to service.; No competent medical opinion supports a link between diabetes mellitus and service or service-connected hypertension.; VA opinions found diabetes mellitus less likely than not related to ship fire exposure or hypertension.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251217-625509

Full Decision Text

Citation Nr: A26022893
Decision Date: 03/13/26 Archive Date: 03/13/26

DOCKET NO. 251217-625509
DATE: March 13, 2026

ORDER

Entitlement to service connection for diabetes mellitus is denied.

FINDING OF FACT

The weight of the evidence is against a finding that any diabetes mellitus disability is etiologically related to service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for diabetes mellitus have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.104(c), 3.303, 3.304, 3.2501, 20.300.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from October 1965 to October 1967.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2025 Department of Veterans Affairs (VA) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO), which is the Agency of Original Jurisdiction (AOJ). In December 2025, the Veteran filed VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and elected the Direct Review docket. Under the Direct Review docket, the Board reviews the claims based on the evidence of record at the time of the appealed rating decision. 38 C.F.R. § 20.303.

Under the Direct Review option, evidence submitted after the date of notification of the rating decision is not reviewable by the Board. 38 C.F.R. § 20.301.

The Board cannot consider any evidence added to the claims file during a period of time when new evidence was not allowed for Board review under the Direct Review docket option. However, the Veteran may file a Supplemental Claim and submit or identify that evidence. If the evidence is new and relevant, VA will issue another decision on the claim considering the new evidence, in addition to the evidence previously considered. 38 C.F.R. §§ 3.2501, 20.300.

The Board generally must refrain from deciding a case until the case proceeds to the point where a docket change is no longer permitted under the terms of 38 C.F.R. § 20.202(c)(2). Williams v. McDonough, 37 Vet. App. 305 (2024). However, this appeal has been advanced on the Board docket, which the Board interprets as a request for expedited consideration and waiver of the remaining timeline to change dockets. Accordingly, the Board finds that the adjudication of the issue on appeal may proceed without further delay.

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c); 38 U.S.C. § 7107(b).

Entitlement to service connection for diabetes mellitus

The Veteran asserts that toxic exposure due to a fire on flight deck of the USS Forrestal caused diabetes mellitus that began during service and has continued to the present. In the alternative, the Veteran asserts that diabetes mellitus was caused or aggravated by exposure to herbicide agents while in active service in Vietnam or was caused or aggravated by service-connected hypertension.

As an initial matter, a July 2023 Toxic Exposure Risk Activity (TERA) Memorandum indicated that the Veteran participated in a TERA due to toxic exposure from a ship fire that occurred on the flight deck of the USS Forrestal. The memorandum also indicated that the Veteran was not exposed to herbicide agents. The Board notes that service personnel records show that the Veteran received the Vietnam Service Medal. However, receipt of the Vietnam Service Medal alone cannot be used to establish service in the Republic of Vietnam as it is undisputed that some service members who received the Vietnam Service Medal were not in Vietnam or its territorial waters. The deck logs and Blue Water Navy Ship Locator Dashboards for the USS Forrestal do not show that the ship entered within specified points within 12 nautical miles of the Republic of Vietnam during the Veteran's active service and herbicide agent exposure has not been conceded by VA. The Board finds that the record does not show that Veteran had qualifying duty or visitation in the Republic of Vietnam, or on its inland waterways, or nautical service in the offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23; Haas v. Peake, 525 F.3d 1168 (2008).

Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service.
for the USS Forrestal do not show that the ship entered within specified points within 12 nautical miles of the Republic of Vietnam during the Veteran's active service and herbicide agent exposure has not been conceded by VA. The Board finds that the record does not show that Veteran had qualifying duty or visitation in the Republic of Vietnam, or on its inland waterways, or nautical service in the offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23; Haas v. Peake, 525 F.3d 1168 (2008).

Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. To establish service connection for a current disability, a Veteran must show: (1) the existence of a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004).

The AOJ made favorable findings in the June 2025 rating decision on appeal that the evidence showed (1) the Veteran has been diagnosed with diabetes mellitus type II confirmed by an October 2023 VA examination, (2) participation in a toxic exposure risk activity was conceded by VA based on the Veteran's participation in the extinguishment of a ship fire that caused bombs and fuel cells to detonate in July 1967, and (3) diabetes mellitus type II is a known presumptive condition linked to herbicide exposure. The Board is bound by favorable findings by the AOJ. 38 C.F.R. § 3.104(c).

At an October 2023 VA diabetes mellitus examination, the examiner diagnosed diabetes mellitus type II. The examiner opined that diabetes mellitus was less likely than not proximately due to or the result of service-connected hypertension. The examiner also opined that it was at least as likely as not that diabetes mellitus was caused by herbicide agent exposure near the Vietnam coast. The rationale indicated that there was no medical evidence to suggest a relationship between the development of diabetes mellitus and hypertension, and diabetes was on the list of presumptive conditions due to herbicide exposure.

In a December 2023 VA addendum opinion, the same examiner indicated that the Veteran met the criteria for a diagnosis of chronic diabetes mellitus.

In March 2024 VA opinions, the same examiner opined that diabetes mellitus was less likely than not caused by the toxic risk exposure activity based on a ship fire on the USS Forrestal. The examiner also opined that diabetes mellitus was less likely than not proximately due to or the result of service-connected hypertension. The rationale indicated that there was no scientific or medical evidence available that provided any indication of a relationship between the development of diabetes mellitus and the toxic exposures from the ship fire and there was no medical or scientific evidence that indicated a relationship between the development of diabetes mellitus and hypertension.

In a December 2024 VA opinion, provided by the same examiner, the examiner opined that diabetes mellitus was not secondary to hypertension and was not aggravated by hypertension. The rationale indicated that there was no medical or scientific evidence to support a relationship between the development of diabetes mellitus and hypertension.

In a December 2024 VA addendum opinion, provided by the same examiner, the examiner opined that there was no medical or scientific evidence available that provided any indication of a relationship between diabetes mellitus and service-connected hypertension. The rational referred to a medical article submitted by the Veteran that indicated hypertension is common among patients with diabetes mellitus and diabetes mellitus is a risk factor for the development of hypertension. The examiner indicated that the medical and scientific evidence suggested diabetes mellitus may be a risk factor for the development of hypertension. However, the medical and scientific evidence did not show the opposite where hypertension caused the development of diabetes mellitus.

The Board notes that the October 2023, December 2023, March 2024, and December 2024 VA opinions are the only medical opinions of record during the period under review. The October 2023 VA TERA opinion indicated that diabetes mellitus type II was recognized as a presumptive condition, and it was as likely as not that that diabetes mellitus was caused by herbicide exposure while the Veteran served on the Vietnam coast. However, the Board finds that the October 2023 VA TERA opinion is inadequate. The opinion was speculative and inconsistent with the evidence of record. The record does not show that the Veteran had qualifying duty or visitation in the Republic of Vietnam, or on its inland waterways, or nautical service in the offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019 and VA has not conceded the Veteran's exposure to herbicide agents. Therefore, the Veteran's diabetes mellitus type II disability does not qualify for presumptive service connection due to herbicide agent exposure related to service in Vietnam. The other VA opinions of record did not establish a link between the diabetes mellitus disability and service.

The Board is not free to substitute its own judgment for a medical expert. Colvin v. Derwinski, 1 Vet. App. 171 (1991).

While the Veteran has asserted that a diabetes mellitus disability is related to service, the Board finds that the Veteran, as a lay person, is not competent to diagnose any disability or provide an opinion as to the etiology of any disability. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

After a review of the record, the Board finds that the weight of the competent and credible evidence does not show that any diabetes mellitus disability is etiologically related to service and service connection cannot be established. Brammer v. Derwinski, 3 Vet. App. 223 (1992).

The Board notes that the Veteran has not submitted, and the record does not show, a competent medical opinion that supports a finding that any diabetes mellitus is related to service or was caused or aggravated by service or a service-connected disability, to include hypertension. However, the Veteran may file a Supplemental Claim and submit or identify new and relevant evidence, to include the submission of a competent medical opinion in support of the claim for service connection for any diabetes mellitus disability. If the evidence submitted is new and relevant, VA will issue another decision on the claim considering that evidence, in addition to the evidence previously considered. 38 C.F.R. §§ 3.2501, 20.300.

The Board is appreciative of the Veteran's faithful and honorable service to our country. The Board acknowledges that VA is statutorily required to resolve reasonable doubt in favor of the Veteran when there is an approximate balance of positive and negative evidence regarding the merits of an outstanding issue. However, the Board finds that the weight of the evidence is against a finding that any diabetes mellitus disability is related to service. The Board finds that the evidence is not in approximate balance and there is no reasonable doubt to resolve in favor of the Veteran. Therefore, the claim for service connection for diabetes mellitus must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Harvey P. Roberts

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Malec, Jennifer L., 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.

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