DIABETES MELLITUS

JENNIFER WHITE · 2026 · Case ID: A26040464

DENIED

Summary

The veteran, who served from March 1960 to March 1963, appeals the denial of service connection for diabetes mellitus, type 2, prostate cancer, ischemic heart disease, bilateral lower extremity peripheral artery disease, and hypertension. The veteran claimed these conditions were related to herbicide agent exposure, specifically Agent Orange, during service in Guam and the Philippines. The Board found no evidence to support herbicide exposure in service, either directly or presumptively. Military records indicated service in Kentucky, North Carolina, South Carolina, California, and the Philippines, but not Guam. While the veteran alleged exposure to herbicides from C-123 aircraft, personnel records showed no duties as flight, ground maintenance, or medical crew members on such aircraft, and the veteran's MOS was infantryman. The Board also noted that the Veteran's claims of exposure in the Philippines lacked specific details and corroboration. Service treatment records did not document complaints or diagnoses of the claimed conditions during service. The Board found that VA satisfied its duty to assist, and no VA examination was required as the evidence persuasively weighed against an in-service event. All claims were denied.

Rationale

No established in-service event (herbicide exposure); Service treatment records negative for diabetes; No VA examination required due to lack of in-service event

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250916-586763

Full Decision Text

Citation Nr: A26040464
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250916-586763
DATE: April 30, 2026

ORDER

Entitlement to service connection for diabetes mellitus, type 2 is denied.

Entitlement to service connection for prostate cancer is denied.

Entitlement to service connection for ischemic heart disease is denied.

Entitlement to service connection for right lower extremity peripheral artery disease is denied.

Entitlement to service connection for left lower extremity peripheral artery disease is denied.

Entitlement to service connection for hypertension is denied.

FINDINGS OF FACT

1. The evidence persuasively weighs against finding that the Veteran was exposed to herbicide agents during active service.

2. An April 7, 2025 TERA Memorandum indicates that the Veteran had no in-service toxic exposure.

3. The evidence of record persuasively weighs against finding that diabetes mellitus began during active service or is otherwise related to an in-service event.

4. The evidence of record persuasively weighs against finding that prostate cancer began during active service or is otherwise related to an in-service event.

5. The evidence of record persuasively weighs against finding that ischemic heart disease began during active service or is otherwise related to an in-service event.

6. The evidence of record persuasively weighs against finding that diabetes mellitus began during active service or is otherwise related to an in-service event.

7. The Veteran's bilateral peripheral artery disease is not secondary to a service-connected disability and is not otherwise related to an in-service event.

8. The evidence of record persuasively weighs against finding that hypertension began during active service or is otherwise related to an in-service event.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for diabetes mellitus, type 2 are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for prostate cancer are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for ischemic heart disease are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

4. The criteria for entitlement to service connection for right lower extremity peripheral artery disease to include as secondary to ischemic heart disease are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

5. The criteria for entitlement to service connection for left lower extremity peripheral artery disease as secondary to include as secondary to ischemic heart disease are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

6. The criteria for entitlement to service connection for hypertension are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had confirmed service from March 1960 to March 1963.

This case comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In the September 2025 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 April 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

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 notes that the AOJ requested the Veteran submit any relevant private treatment records or submit information with which VA can assist the Veteran in obtaining private treatment records. Required notice and information were provided in the claim form which the Veteran signed, certifying to the fact that such notice was received and further than they have included or identified relevant evidence. VA requested records for which the Veteran submitted a proper release and/or adequately identified. The duty to assist is not a one-way street. If a Veteran desires help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Thus, the Board finds that VA has satisfied the duty to assist. No further notice or assistance to the Veteran is required to fulfill VA's duty to assist in development. Smith v. Gober, 14 Vet. App. 227 (2000); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); Quartuccio v. Principi, 16 Vet. App. 183 (2002).

The standard set forth in 38 C.F.R. § 3.103(c)(2)(iii) only permits constructive receipt of Veterans Health Administration (VHA) records that not only existed prior to the issuance of the AOJ decision on appeal, but also for which the claimant furnished sufficient information to make the Veterans Benefits Administration (VBA) aware of the existence of those records. Thus, the Board's consideration of VHA records is limited to the same. Here, the Board finds that VA treatment records were obtained and reviewed consistent with 38 C.F.R. § 3.103(c)(2)(iii) and the AMA framework.

Legal Criteria

Generally, to establish a right to compensation for a present disability a veteran must show: (1) a present disability; (2) an 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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

1. Entitlement to service connection for diabetes mellitus, type 2 is denied.

The Veteran contends that he is entitled to service connection for diabetes mellitus because it developed as a result of herbicide agent exposure, specifically Agent Orange.

Evidence of record, including April 2014 private treatment records, establish that the Veteran has a current diagnosis of diabetes, initially diagnosed in or about September 2011.

Despite evidence of a current disability, the record does not establish an in-service event.

First, in his December 2024 Fully Developed Claim form, the Veteran contends that his diabetes mellitus is a result of exposure to Agent Orange while serving in Guam. Later, in a December 2024 statement in support of claim the Veteran contends that his Agent Orange exposure is a result of his service at Clark Airforce Base in the Philippines.

In regard to the Veteran's claim that his disabilities are a result of exposure to herbicide agents to include Agent Orange, generally, the Veteran must show the following in order to establish presumptive service connection for a disease associated with exposure to certain herbicide agents: (1) that he served in the Republic of Vietnam, including its territorial waters within 12 nautical miles from shore, during the period beginning on January 9, 1962 and ending on May 7, 1975, served between September 1, 1967, and August 31, 1971, in or near the Korean Demilitarized Zone (DMZ); or, pursuant to the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) served in Thailand at any US or Royal Thai base; Laos, certain provinces in Cambodia; Guam, or America Samoa or their territorial waters; or the Johnston Atoll or a ship that called there from January 9, 1962, to June 30, 1976; (2) that he currently suffers from a disease associated with exposure to certain herbicide agents enumerated under Section 3.309(e); and (3) that the current disease process manifested to a degree of 10 percent or more within the specific time period prescribed in section 3.307(a)(6)(ii). 38 U.S.C. § 1116; 38 C.F.R. § 3.307(a)(6), 3.309(e).

While the Veteran contends that his military service included service in Guam, this is not supported by evidence of record which shows service at military bases in Kentucky, New Jersey, North Carolina, South Carolina, California and the Philippines.

38 C.F.R. § 3.307a)(6)(v) provides that an individual who performed service in the Air Force or Air Force Reserve under circumstances in which the individual concerned regularly and repeatedly operated, maintained, or served onboard C-123 aircraft known to have been used to spray an herbicide agent during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent. "Regularly and repeatedly operated, maintained, or served onboard C-123 aircraft" means that the individual was assigned to an Air Force or Air Force Reserve squadron when the squadron was permanently assigned one of the affected aircraft and the individual had an Air Force Specialty Code indicating duties as a flight, ground maintenance, or medical crew member on such aircraft. Such exposure constitutes an injury under 38 U.S.C. § 101(24)(B) and (C).

Here, military personnel records show that the Veteran had several parachute jumps from C-123 planes in October 1960, February 1961, March 1961, and August 1961 while stationed in North Carolina, Kentucky, and California. However, the record does not show that the Veteran was permanently assigned to these planes. Further, the record shows that the Veteran's military occupational specialty was that of an infantryman, with no evidence of duties as flight, ground maintenance or medical crew member on such aircraft. Thus, the record does not establish an in-service injury of herbicide agent exposure on either a presumptive basis. See 38 C.F.R. § 3.307(a)(6)(iii)-(v), Honoring our PACT Act of 2022, Pub. L. 117-168 (2022).

Additionally, the record does not establish an in-service injury on a direct service basis. First, the Veteran has not alleged an in-service injury other than exposure to Agent Orange service in Guam and the Philippines. As discussed above, the evidence of record does not establish service in Guam. With respect to the Philippines, in a December 2024 development letter, the Veteran was asked to provide details about when where and how he was exposed. The Veteran only asserted service in the Philippines in February 1962 for training purposes, with no additional information. The duty to assist is not a one-way street. If a Veteran desires help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Here, there is no indication with which to verify herbicide exposure in the Philippines and the location is not on the presumed list for herbicide exposure. More specifically, the Veteran is not competent to attest that herbicides were used in the Philippines or that such location was contaminated with herbicide agents, or that herbicide agents were ever used or stored there. See Barr v. Nicholson, 21 Vet.
purposes, with no additional information. The duty to assist is not a one-way street. If a Veteran desires help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Here, there is no indication with which to verify herbicide exposure in the Philippines and the location is not on the presumed list for herbicide exposure. More specifically, the Veteran is not competent to attest that herbicides were used in the Philippines or that such location was contaminated with herbicide agents, or that herbicide agents were ever used or stored there. See Barr v. Nicholson, 21 Vet. App. 303 (2007); See also Layno v. Brown, 6 Vet. App. 465, 471 (1994) ("Competent testimony is thus limited to that which the witness has actually observed and is within the realm of his personal knowledge"). Accordingly, the Board must afford the Veteran's statements little probative weight.

Service treatment records do not note complaints of diabetes or symptoms of diabetes during the Veteran's March 1960 enlistment examination nor his March 1963 separation examination. Similarly, treatment records during service do not note complaints of or treatment for diabetes in service. Post service, the record shows a diagnosis of diabetes in or about September 2011 more than five decades post service.

The Board acknowledges that the Veteran has not been afforded a VA examination with respect to his claim for service connection for diabetes but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service as there is no verified in-service event. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event and thus, no VA examination and/or opinion would be required in any case.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure.

Entitlement to service connection for diabetes mellitus is denied.

2. Entitlement to service connection for prostate cancer is denied.

The Veteran contends that he is entitled to service connection for prostate cancer because it developed as a result of his herbicide agent exposure in service.

Evidence of record establishes a diagnosis of prostate cancer, diagnosed in or about January 2012. However, as discussed above, the record does not establish an in-service injury of herbicide exposure on either a direct or presumptive basis. Further, the Veteran's service treatment records, including his March 1960 enlistment examination, March 1963 separation examination, and treatment records during service do not note complaints, treatment or diagnosis of prostate cancer. Post service the Veteran was diagnosed with prostate cancer in 2012, more than five decades post service. Ultimately, the evidence of record does not establish an in-service event.

The Board acknowledges that the Veteran has not been afforded a VA examination with respect to his claim for service connection for prostate cancer but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event
, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event and thus, no VA examination and/or opinion would be required in any case.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure.

Entitlement to service connection for prostate cancer is denied.

3. Entitlement to service connection for ischemic heart disease is denied.

The Veteran contends that he is entitled to service connection for ischemic heart disease based on herbicide agent (specifically Agent Orange) exposure in service.

Evidence of record, including July 2013 private treatment records, establishes a current diagnosis of coronary artery disease (CAD). However, similar to his other claims, the record does not establish an in-service event. The Veteran has alleged entitlement to service connection based solely on herbicide exposure which is not established on either a direct or presumptive basis, as discussed above. Service treatment records, March 1963 separation examination, and treatment records during service do not note complaints, treatment or diagnosis of a heart disability.

The Board acknowledges that the Veteran has not been afforded a VA examination with respect to his claim for service connection for CAD but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event and thus, no VA examination and/or opinion would be required in any case.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure.

Entitlement to service connection for ischemic heart disease is denied.

4. Entitlement to service connection for bilateral lower extremity peripheral artery disease is denied.

The Veteran contends that he is entitled to service connection for bilateral lower extremity peripheral artery disease secondary to his ischemic heart disease.

At the outset, the Board notes that the record does not establish service connection for peripheral artery disease on a direct basis.

First, July 2019 private treatment records establish a diagnosis of atherosclerosis of the right lower extremity artery. There is no diagnosis of left lower extremity peripheral artery disease. The Veteran contends an in-service injury of herbicide exposure which has not been established by the record on a direct or presumptive basis (see discussion of entitlement to service connection for diabetes above). The record contains no other evidence of an in-service injury with no complaints related to peripheral artery disease during service or in his March 1963 separation examination.

For secondary service connection, it must be shown that the disability for which the claim is made is proximately due to or the result of service-connected disease or injury, or that service-connected disease or injury has aggravated (increased in severity) the nonservice-connected disability for which service connection is sought. 38 C.F.R. § 3.310. Here, as discussed above, entitlement to service connection for ischemic heart disease has not been established, accordingly, secondary service connection is not warranted.

The Board acknowledges that the Veteran has not been afforded a VA examination with respect to his claim for service connection for bilateral lower extremity peripheral artery disease but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, there is no established in-service event and the secondary claim fails on the basis of the primary disability not being related to service.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure, and the secondary claim is not based on a service-connected primary disability.

Entitlement to service connection for bilateral lower extremity peripheral artery disease is denied.

5. Entitlement to service connection for hypertension is denied.

The Veteran contends that he is entitled to service connection for hypertension because it developed as a result of herbicide agent exposure in service.

July 2013 private treatment records note a diagnosis of hypertension.

However, evidence of record does not establish an in-service event. The Veteran has alleged herbicide agent exposure. As discussed above the record does not establish herbicide agent exposure.

Similarly, service treatment records do not note a diagnosis of or symptoms related to hypertension in service. Hypertension for VA purposes means that the diastolic blood pressure is predominantly 90 or more, or systolic blood pressure is predominantly 160 or more. Hypertension must be confirmed by readings taken two or more times on three different days. 38 C.F.R. § 4.104 Diagnostic Code 7101, Note (1). The Veteran's March 1960 enlistment examination notes systolic pressure of 120 and diastolic pressure of 70. The Veteran's March 1963 separation examination notes systolic pressure of 120 and diastolic pressure of 62. Similarly, an August 1960 airborne training examination notes systolic pressure of 120 and diastolic pressure of 70. Treatment records in service do not note diastolic blood pressure is predominantly 90 or more, or systolic blood pressure is predominantly 160 or more or a diagnosis of hypertension by a medical professional. Based on the evidence of record, an in-service treatment or diagnosis is not established.

The Board acknowledges that the Veteran has not been afforded a VA examination with respect to his claim for service connection for hypertension but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran's active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Under McLendon, VA is obligated to provide an examination when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event and thus, no VA examination and/or opinion would be required in any case.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure.

Entitlement to service connection for hypertension is denied.

in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Here, the disability is presumptive of the alleged in-service event and thus, no VA examination and/or opinion would be required in any case.

To summarize, the Board finds that the evidence of record is persuasively against a finding of an in-service event, namely herbicide exposure.

Entitlement to service connection for hypertension is denied.

Jennifer White

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Wimbish, Alicia

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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