DIABETES MELLITUS
J. T. HUTCHESON · 2026 · Case ID: A26036320
Summary
The Veteran served from November 1965 to November 1969 and again from September 1972 to September 1976. The Veteran appeals the denial of service connection for Type II diabetes mellitus and diabetic retinopathy. Service connection for PTSD, major depressive disorder, recurrent unspecified anxiety disorder, tinnitus, and left ear hearing loss was previously established. The Veteran contends that Type II diabetes mellitus is related to the service-connected psychiatric conditions. Evidence includes a January 2014 VA diagnosis of diabetes mellitus and a May 2024 VA examination report stating no objective evidence linked contaminated water at Camp Lejeune to the diabetes. However, a January 2026 private evaluation by J. Gold, Ph.D., concluded it was at least as likely as not that the Veteran's diabetes was caused by and aggravated by PTSD, citing neuroendocrine dysregulation and temporal relationship. The Board found the evidence in equipoise, resolving doubt in the Veteran's favor to grant service connection for Type II diabetes mellitus. Diabetic retinopathy was diagnosed in January 2014 and found by a January 2025 VA eye examination to be related to the Type II diabetes mellitus. Service connection for diabetic retinopathy was therefore granted. The Board granted service connection for Type II diabetes mellitus and diabetic retinopathy.
Rationale
Private evaluation found diabetes at least as likely as not caused/aggravated by PTSD; PTSD causes neuroendocrine dysregulation and impaired glucose metabolism; Temporal relationship between PTSD and diabetes onset supports PTSD as etiological factor; Evidence in equipoise, doubt resolved in Veteran's favor
Full Decision Text
Citation Nr: A26036320 Decision Date: 04/20/26 Archive Date: 04/20/26 DOCKET NO. 250412-530168 DATE: April 20, 2026 ORDER Entitlement to service connection for Type II diabetes mellitus is granted. Entitlement to service connection for diabetic retinopathy is granted. FINDINGS OF FACT 1. Service connection has been established for posttraumatic stress disorder (PTSD) with major depressive disorder and recurrent unspecified anxiety disorder; tinnitus; and left ear hearing loss. 2. Type II diabetes mellitus has been shown to be related to the service-connected PTSD with major depressive disorder and recurrent unspecified anxiety disorder 3. Diabetic retinopathy has been shown to be related to the diagnosed Type II diabetes mellitus. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for Type II diabetes mellitus have been met. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a). 2. The criteria for entitlement to service connection for diabetic retinopathy have been met. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran active service from November 1965 to November 1969 and from September 1972 to September 1976. The Veteran appeared at a January 2026 virtual hearing before the undersigned Veterans Law Judge. The hearing transcript is of record. In April 2025, the Agency of Original Jurisdiction denied service connection for diabetes mellitus and diabetic retinopathy. In April 2025, the Appellant submitted Decision Review Request: Board Appeal (Notice of Disagreement), VA Form 10182, and elected the Hearing docket. Therefore, the Board of Veterans' Appeals (Board) may only consider the evidence of record at the time of the April 2025 Agency of Original Jurisdiction decision on appeal, as well as any evidence submitted by the Veteran at the Board hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the Agency of Original Jurisdiction issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. Service Connection Service connection may be granted for recurrent disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Service connection shall be granted on a secondary basis under the provisions of 38 C.F.R. § 3.310(a) where it is demonstrated that a service-connected disorder has aggravated a nonservice connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). Service connection has been established for PTSD with major depressive disorder, recurrent unspecified anxiety disorder, tinnitus, and left ear hearing loss. Diabetes Mellitus The Veteran contends that service connection for diabetes mellitus is warranted as the diagnosed disability is related to the service-connected psychiatric disability. Department of Veterans Affairs (VA) clinical documentation dated in January 2014 indicates that the Veteran was diagnosed with diabetes mellitus. The report of a May 2024 diabetes mellitus examination conducted for VA states that the Veteran was initially diagnosed with Type II diabetes mellitus in the "2010s." The examiner concluded that "there is no objective evidence that contaminated water at Camp LeJeune caused this Veteran's diabetes." A January 2026 evaluation from J. Gold, Ph.D., concludes that "[i]t is at least as likely as not that the Veteran's diabetes was caused by and aggravated by the Veteran's service connected PTSD." The psychologist commented that: "PTSD is medically recognized as a condition that causes persistent dysregulation of the neuroendocrine system including prolonged elevation of cortisol and catecholamines, chronic activation of the hypothalamic pituitary-adrenal axis, increased insulin resistance, impaired glucose, metabolism, and chronic systemic inflammation in the body" and "[t]he absence of a familial predisposition, combined with the temporal relationship between PTSD and diabetes onset supports PTSD as the most likely etiological factor." The evidence is in at least equipoise as to whether the diagnosed Type II diabetes mellitus is related to the service-connected psychiatric disabilities. The Veteran was initially diagnosed with Type II diabetes mellitus in the "2010s." Dr. The psychologist commented that: "PTSD is medically recognized as a condition that causes persistent dysregulation of the neuroendocrine system including prolonged elevation of cortisol and catecholamines, chronic activation of the hypothalamic pituitary-adrenal axis, increased insulin resistance, impaired glucose, metabolism, and chronic systemic inflammation in the body" and "[t]he absence of a familial predisposition, combined with the temporal relationship between PTSD and diabetes onset supports PTSD as the most likely etiological factor." The evidence is in at least equipoise as to whether the diagnosed Type II diabetes mellitus is related to the service-connected psychiatric disabilities. The Veteran was initially diagnosed with Type II diabetes mellitus in the "2010s." Dr. Gold determined that the Type II diabetes mellitus is related to the service-connected PTSD. Upon resolution of all reasonable doubt in the Veteran's favor, the Board finds that service connection for Type II diabetes mellitus is warranted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a). Diabetic Retinopathy A January 2014 VA treatment record states that the Veteran was diagnosed with diabetic retinopathy. The report of a January 2025 eye examination conducted for VA states that the diagnosed diabetic retinopathy is related to the diagnosed Type II diabetes mellitus. The Veteran has been diagnosed with diabetic retinopathy related to the service connected Type II diabetes mellitus. Accordingly, service connection for diabetic retinopathy is granted. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Colicelli, Marcus 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.