Case A26023407

ERIC S. LEBOFF · 2026 · Case ID: A26023407

MIXED

Summary

The veteran, who served, appeals the denial of an earlier effective date for service connection for diabetes mellitus, type II, and an increased rating for this condition. The veteran also sought service connection for an eye disability, including cataracts, diabetic retinopathy, or glaucoma, claimed as secondary to diabetes mellitus, type II. The Board denied the earlier effective date claim, finding no evidence of a claim prior to April 27, 2010, and that the veteran's diabetes management (diet and oral medication) did not meet the criteria for a higher rating beyond the initial 20 percent. The Board also denied service connection for eye conditions, noting that while cataracts were diagnosed, they were considered age-related and not linked to service-connected diabetes, and no diagnosis of glaucoma or diabetic retinopathy was present. However, the Board granted service connection for diabetic peripheral neuropathy in all four extremities (right and left upper and lower) as secondary to the service-connected diabetes mellitus, type II. The Board found the evidence in approximate balance regarding the peripheral neuropathy claims, ultimately resolving the doubt in the veteran's favor, granting service connection for these conditions.

Rationale

No factual basis to establish entitlement to an effective date prior to April 27, 2010.; Weight of evidence against finding diabetes required regulation of activities or episodes of ketoacidosis/hypoglycemic reactions.; Diabetes managed by restricted diet and oral medication, not insulin or regulation of activities.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260218-632103

Full Decision Text

Citation Nr: A26023407
Decision Date: 03/16/26 Archive Date: 03/16/26

DOCKET NO. 260218-632103
DATE: March 16, 2026

ORDER

Entitlement to an effective date prior to April 27, 2010, for service connection for diabetes mellitus, type II is denied.

Entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II is denied.

Entitlement to service connection for an eye disability, to include cataracts, claimed as diabetic retinopathy and/or glaucoma, is denied.

Entitlement to service connection for diabetic peripheral neuropathy, right lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

Entitlement to service connection for diabetic peripheral neuropathy, left lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

Entitlement to service connection for diabetic peripheral neuropathy, right upper extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

Entitlement to service connection for diabetic peripheral neuropathy, left upper extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

FINDINGS OF FACT

1. A claim of service connection for diabetes mellitus was first received on April 27, 2010; this was more than a year following the Veteran's separation from active service.

2. The weight of the evidence is persuasively against a finding that the Veteran's diabetes mellitus, type II has required regulation of activities or has resulted in episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or visits to a diabetic care provider twice a month or more frequently.

3. The weight of the evidence is persuasively against a finding that the Veteran has an eye disability, to include cataracts, diabetic retinopathy, or glaucoma, which is proximately due to or aggravated by his service connected diabetes mellitus, type II.

4. The weight of the evidence is in at least approximate balance as to whether the Veteran has current diagnoses of right and left upper and lower extremity diabetic peripheral neuropathy that is proximately due to his service connected diabetes mellitus, type II.

CONCLUSIONS OF LAW

1. The criteria for an effective date prior to April 27, 2010, for service connection for diabetes mellitus are not met. 38 C.F.R. §§?3.400(b)(2)(i), 3.2501.

2. The criteria for entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.119.

3. The criteria for entitlement to service connection for an eye disability, to include cataracts, diabetic retinopathy, or glaucoma, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to right upper extremity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for entitlement to left upper extremity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

6. The criteria for entitlement to right lower extremity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

7. The criteria for entitlement to left upper extremity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

In October 2025,
ity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

In October 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of an October 2024 decision. In February 2026, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior October 2024 decision. Therefore, the Board may only consider the evidence of record at the time of the October 2024 decision [and any evidence submitted during an applicable evidentiary window].

In the February 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the October 2024 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

The Board notes that the Veteran, through counsel, has waived his right to modify his chosen Board appeal docket. 02/18/2026, VA Form 10182 Notice of Disagreement.

If the Veteran would like VA to consider any evidence that was submitted 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.

The Board remanded the Veteran's claims in January 2024 with remand directives to obtain a VA medical opinion as to the nature and etiology of the claimed peripheral neuropathy and to identify and obtain any medical records in the possession of the Social Security Administration (SSA). A remand by the Board confers on the Veteran, as a matter of law, the right to substantial compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998).

As the Veteran's peripheral neuropathy claims are being granted in full, discussion of the matter of compliance with the January 2024 remand directives in relation to those claims may be omitted without prejudice to the Veteran. The record reflects that the AOJ made appropriate attempts to obtain medical records from the SSA and received notification from the SSA that no such records existed. 01/10/2024, Correspondence. The Board finds there has been substantial compliance with the January 2024 remand directives and adjudication of the Veteran's claim on the merits is appropriate.

Earlier Effective Date

1. Entitlement to an effective date prior to April 27, 2010, for service connection for diabetes mellitus, type II is denied.

In October 2022 the AOJ granted service connection for diabetes mellitus, type II, effective April 27, 2010. 10/19/2022, Rating Decision - Narrative. The Veteran appealed, seeking an earlier effective date for the grant of service connection. 10/12/2023, VA Form 10182 Notice of Disagreement.

For claims of entitlement to service connection, the effective date will be the day following separation from active service or the date entitlement arose if the claim is filed within one year of discharge; otherwise, the effective date is the date of receipt of claim or date entitlement arose, whichever is later. 38 C.F.R. §§?3.400(b)(2)(i), 3.2501.

VA received the Veteran's claim of service connection on April 27, 2010. 04/27/2010, VA 21-526 Veterans Application for Compensation or
, seeking an earlier effective date for the grant of service connection. 10/12/2023, VA Form 10182 Notice of Disagreement.

VA received the Veteran's claim of service connection on April 27, 2010. 04/27/2010, VA 21-526 Veterans Application for Compensation or Pension. The record does not reflect receipt of any claims for any disability, diabetes mellitus or otherwise, prior to that date. Moreover, the claim was received more than a year after the Veteran's discharge from active service. Accordingly, there is no factual basis to establish entitlement to an effective date prior to April 27, 2010, for service connection for diabetes mellitus, type II.

The criteria for entitlement to an effective date prior to April 27, 2010, for service connection for diabetes mellitus, type II are not met. 38 C.F.R. § 3.400.

Increased Rating

1. Entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, is denied.

As discussed above, in October 2022 the AOJ granted service connection for diabetes mellitus, type II, effective April 2010 and assigned an initial disability rating of 20 percent. The Veteran seeks a higher initial disability rating.

Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating many accurately reflect the elements of disability; resolving any reasonable doubt regarding the degree of disability in favor of the claimant; where there is a questions as to which of two evaluations apply, assigning a higher of the two where the disability pictures more nearly approximates the criteria for the next higher rating; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disability upon the person's ordinary activity. See 38 C.F.R. §§ 4.2, 4.3, 4.7, 4.10; see also Schafrath v. Derwinski, 1 Vet. App. 589 (1991).

The Veteran's diabetes mellitus, type II, is rated under 38 C.F.R. § 4.119, diagnostic code 7913.

A disability rating of 20 percent is warranted where the claimant's diabetes mellitus requires one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet. The next higher rating of 40 percent is warranted where the claimant's diabetes mellitus requires one or more daily injection of insulin, restricted diet, and regulation of activities.

VA examinations performed in October 2022 and September 2024 reflect that the Veteran's diabetes has been managed by restricted diet and prescribed oral medication. Neither the VA examinations nor the Veteran's VA and non-VA medical treatment records reflect that the injection of insulin and/or regulation of activities have been required to manage his diabetes.

The Board acknowledges that the criteria for ratings of 60 and 100 percent include the presence of complications that would be compensable if separately evaluated. As discussed below, the Board finds that the Veteran has peripheral neuropathy of the upper and lower extremities attributable to his diabetes mellitus, type II. However, the presence of such complications alone does not satisfy all the criteria for entitlement to either a 60 or 100 percent rating, which include episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or visits to a diabetic care provider twice a month or more frequently.

The weight of the evidence is persuasively against a finding that the Veteran's diabetes mellitus, type II has required regulation of activities or has resulted in episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or visits to a diabetic care provider twice a month or more frequently.

Given the above, the criteria for entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, are not met.
. However, the presence of such complications alone does not satisfy all the criteria for entitlement to either a 60 or 100 percent rating, which include episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or visits to a diabetic care provider twice a month or more frequently.

Given the above, the criteria for entitlement to an initial disability rating in excess of 20 percent for diabetes mellitus, type II, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.119.

Service Connection

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a).

Entitlement to service connection may be established on a secondary basis where there is evidence of (1) a current, non-service-connected disability, (2) a current service-connected disability, and (3) evidence that the non-service-connected disability is either (i) proximately due to or the result of a service-connected disability or (ii) aggravated (increased in severity) beyond its natural progression by a service-connected disability. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310.

With respect to the Veteran's eye disability and peripheral neuropathy claims, he has not contended or presented any evidence that his claimed disabilities had their onset in service or otherwise directly related to such service. Rather, the Veteran contends that his claimed disabilities are proximately due to his service connected diabetes mellitus, type II. See e.g., 04/30/2010, VA 21-526 Veterans Application for Compensation or Pension.

1. Entitlement to service connection for an eye disability, to include cataracts, claimed as diabetic retinopathy and/or glaucoma, is denied.

A May 2019 VA treatment note reflects that providers considered him suspect for glaucoma. However, the record, to include subsequent VA examinations performed in November 2022 and September 2024, reflect no diagnosis of glaucoma. Similarly, there is no evidence to reflect a medical diagnosis of diabetic retinopathy. The Board notes that the November 2022 and September 2024 VA examinations and medical opinions were based on in-person examinations and are thus considered highly probative of whether the Veteran has manifested either diabetic retinopathy or glaucoma.

Both the November 2022 and September 2024 VA examinations reflect a diagnosis of bilateral cataracts. However, both VA examiners opined that the Veteran's bilateral cataracts are age related and not proximately due to or aggravated by his service connected diabetes mellitus, type II.

There are currently no medical opinions of record reflecting either a diagnosis of diabetic retinopathy or glaucoma, or that the Veteran's cataracts are at least as likely as not proximately due to or aggravated by his service connected diabetes mellitus, type II.

Thus, the weight of the evidence is persuasively against a finding that the Veteran has an eye disability, to include cataracts, diabetic retinopathy, or glaucoma, which is proximately due to or aggravated by his service connected diabetes mellitus, type II.

In sum, the criteria for entitlement to service connection for an eye disability, to include cataracts, diabetic retinopathy, or glaucoma, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. Entitlement to service connection for diabetic peripheral neuropathy, right lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

3. Entitlement to service connection for diabetic peripheral neuropathy, left lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

4. Entitlement to service connection for diabetic peripheral neuropathy, right upper extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

5. Entitlement to service connection for diabetic peripheral neuropathy, left upper extremity, as
); 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. Entitlement to service connection for diabetic peripheral neuropathy, right lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

3. Entitlement to service connection for diabetic peripheral neuropathy, left lower extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

4. Entitlement to service connection for diabetic peripheral neuropathy, right upper extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

5. Entitlement to service connection for diabetic peripheral neuropathy, left upper extremity, as proximately due to service connected diabetes mellitus, type II, is granted.

The Veteran's VA treatment records reflect that he has been assessed with diabetic peripheral neuropathy; i.e., peripheral neuropathy that is a complication of his service connected diabetes mellitus, type II. See e.g., 03/13/2017, CAPRI at 26.

In September 2024 a VA examiner opined that the Veteran has diabetic peripheral neuropathy of the right and left upper extremities and the right and left lower extremities. The examiner's opinion was based on an in person examination and a review of the lay and medical evidence of record.

The Board acknowledges that VA obtained a subsequent VA medical opinion from a different provider who stated that the Veteran's claimed neuropathy was neither proximately due to nor aggravated by his service connected diabetics mellitus, type II. However, the provider who offered this opinion did not perform an in person examination of the Veteran.

Further, in evaluating a claim for disability benefits, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107.

Given the above, the weight of the evidence is in at least approximate balance as to whether the Veteran has current diagnoses of right and left upper and lower extremity diabetic peripheral neuropathy that is proximately due to his service connected diabetes mellitus, type II.

In sum, the criteria for entitlement to right and left upper and lower extremity diabetic peripheral neuropathy as proximately due to service connected diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sametshaw, Eric C.

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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