DIABETES MELLITUS

A. ISHIZAWAR · 2026 · Case ID: A26040729

DENIED

Summary

The Veteran, who served and Air National Guard across multiple periods between June 1979 and June 2005, appeals the denial of service connection for diabetes mellitus, type II. The Veteran contended that his diabetes was diagnosed during service or within one year of separation, citing elevated glucose readings and subsequent treatment with Metformin. The Board reviewed the Veteran's service treatment records, which were silent regarding diabetes diagnosis or treatment. The Veteran's own statements and private treatment records indicated elevated blood sugar and monitoring for hyperglycemia, with the earliest prescription for diabetes medication noted in March 2013, well outside any presumptive period. The Board found that while the Veteran had elevated blood sugar, the evidence did not establish a diagnosis of diabetes mellitus type II during service or within the presumptive period. Two VA medical opinions concluded that the diabetes was less likely than not related to service, citing the lack of in-service diagnosis and the trajectory towards pre-diabetes. The Board gave more weight to these VA opinions, finding the Veteran's lay statements regarding an in-service diagnosis and immediate post-service treatment uncorroborated by the available medical evidence. Consequently, service connection for diabetes mellitus, type II, was denied.

Rationale

No in-service diagnosis or treatment for diabetes mellitus noted in service treatment records.; Available medical records do not reflect diagnosis or medication for diabetes mellitus until 2011/2013.; VA examiners opined diabetes mellitus, type II, was less likely than not incurred in or caused by service.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251103-592140

Full Decision Text

Citation Nr: A26040729
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 251103-592140
DATE: April 30, 2026

ORDER

Service connection for diabetes mellitus, type II, is denied.

FINDING OF FACT

The Veteran's diabetes mellitus, type II, was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease.

CONCLUSION OF LAW

The criteria for service connection for diabetes mellitus, type II, are not met. 38 U.S.C. §§ 1110, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from June 1979 to September 1979, May 1992 to September 1992, October 1992 to March 1993, and from March 2002 to June 2005. He had additional service in the Air National Guard.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2025 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Notably, this was a supplemental claim decision issued in response to an August 2025 VA Form 20-0995, Decision Review Request: Supplemental Claim, in which the Veteran requested readjudication of his diabetes mellitus, type II, claim most recently addressed in a May 2025 rating decision. In the September 2025 rating decision, the agency of original jurisdiction (AOJ) found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision.

In the November 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 14, 2026. Therefore, the Board may only consider the evidence of record at the time of the September 2025 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative at the 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 AOJ 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.

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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Entitlement to service connection for diabetes mellitus, type II

The Veteran contends that his diabetes mellitus type II warrants service connection because it was diagnosed within one year of his leaving active duty service. Specifically, he contends that he was diagnosed with diabetes mellitus type II at his retirement physical from a Title 10 active duty tour. He further contends that immediately after retirement, he started seeing doctors for diabetes and promptly stated Metformin medication. See February 2025 VA Form 21-10210.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

For certain chronic diseases, including diabetes mellitus, a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from service. 38 C.F.R. §§ 3
§§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

A Veteran exposed to herbicide agents may also be entitled to presumptive service connection for certain enumerated diseases, including diabetes mellitus, type II. 38 C.F.R. §§ 3.307(a)(6); 3.309(e). Here, however, the Veteran does not contend nor does the record show that he was exposed to herbicide agents while in service. Rather, the Veteran's service connection contentions have been limited to his being diagnosed with diabetes mellitus, type II while on active duty service or within one year of separation from active duty service.

For the reasons explained below, the Board concludes that, while the Veteran has a current diagnosis of diabetes mellitus, type II, the evidence weighs against finding that his diabetes mellitus began during service, manifested to a compensable degree within the applicable presumptive period, or is otherwise related to service.

The Veteran's service treatment records (STRs) are silent for complaints, diagnosis, or treatment of diabetes. The Veteran consistently denied a personal history of diabetes on periodic report of medical examinations conducted between June 1974 and February 1985. In December 1997, the Veteran was not noted to have diabetes diagnosis. At a September 2002 optometry appointment, the Veteran denied having diabetes.

The Veteran has consistently maintained that he immediately sought treatment for diabetes mellitus type II following March 2006 laboratory results showing elevated glucose. Specifically, the Veteran's glucose was reported to be 124 mg/dL, however, his urine sample was negative for urine glucose.

Likewise, in January 2026, the Veteran testified before the Board that he was told in March 2006 that his glucose reading was high and that he needed to get it checked out. However, the Veteran was in the process of moving and was told that he would never get VA benefits anyway, so he delayed pursuing filing a claim for compensation. He testified that he was put on Metformin in 2006 by a private treatment doctor, but those treatment records have been purged. Similarly, pharmacy records were reported to be unavailable as his prescriptions were filled at a local pharmacy that was now closed. He further claimed that during service, his glucose was never checked because the military did not want to know otherwise you could become undeployable.

However, while the Veteran may have sought treatment or monitoring for elevated blood sugar, his available medical records do not reflect that he was diagnosed with or prescribed medication for diabetes mellitus until at earliest 2011 or 2013, respectively. Significantly, at the January 2026 Board hearing, the Veteran testified that after being treated by a private doctor who put him on Metformin in 2006, he continued to be treated by that individual until he switched over his medical care to Dr. D.N. in 2011, who continued him on Metformin and also added Januvia and Lantus. The claims file contains private treatment records from Dr. D.N. These include treatment records from the Veteran's initial office visit with Dr. D.N. in April 2011. At this initial visit, the Veteran was noted to have had some elevated blood sugar in the past, but he watched his diet and the blood sugar improved. Metformin or other diabetes mellitus medication were not included on the list of Veteran's medications. His past medical history diagnoses included hyperglycemia but not diabetes mellitus. Hyperglycemia means high blood sugar or glucose and is often associated with diabetes mellitus. See U.S. National Library of Medicine, "Hyperglycemia," available at https://medlineplus.gov/hyperglycemia.html. However, hyperglycemia is a laboratory finding, and not a disease or disability for VA purposes. Review of the Veteran's medications reflects that the first notation of a Glucophage prescription was not until March 2013.

The Board also acknowledges that in August 2025 the Veteran submitted a letter dated July 2025 from Dr. D.N. who noted that he had been the Veteran
medications. His past medical history diagnoses included hyperglycemia but not diabetes mellitus. Hyperglycemia means high blood sugar or glucose and is often associated with diabetes mellitus. See U.S. National Library of Medicine, "Hyperglycemia," available at https://medlineplus.gov/hyperglycemia.html. However, hyperglycemia is a laboratory finding, and not a disease or disability for VA purposes. Review of the Veteran's medications reflects that the first notation of a Glucophage prescription was not until March 2013.

The Board also acknowledges that in August 2025 the Veteran submitted a letter dated July 2025 from Dr. D.N. who noted that he had been the Veteran's primary care provider since April 2011. Dr. D.N. stated that at the time the Veteran came into his care, the Veteran had been watching his blood sugars which were elevated prior to his initial visit. Dr. D.N. further stated that at the Veteran's initial April 2011 visit, his A1c was elevated with a measurement of 6.5. Dr. D.N. opined that "based on [the Veteran's] blood sugars during that visit, [he could] ascertain that [the Veteran's] blood sugars were most likely elevated during his retirement in 2005." The Board has considered this statement, however, Dr. D.N. did not state in his letter that the Veteran had been diagnosed with diabetes mellitus type II while on active duty orders or within one year of leaving active duty orders. Rather, he stated the Veteran had elevated blood sugars and was being monitored for such. This is consistent with the treatment records, which show that in 2011, the Veteran was noted to have hyperglycemia.

The record also contains two VA medical opinions from May 2025 and September 2025. Both VA examiners opined that the Veteran's diabetes mellitus, type II, was less likely than not incurred in or caused by his military service. The May 2025 VA examiner's rationale was that after a review of STRs, no diagnosis of diabetes mellitus, type II, was noted in active duty service. The September 2025 VA examiner's rationale was that the Veteran was not diagnosed with diabetes mellitus until after military service. The September 2025 VA examiner further explained that although the Veteran's 2006 submitted record showed an elevated blood glucose, the value of 124 was evidence of pre-diabetes rather than diabetes. The examiner concluded that "technically the Veteran had evidence of prediabetes starting in between periods of active duty. Those values appear to have been following an expected trajectory toward development of diabetes. There is no evidence that the Veteran's elevated blood glucoses were significantly impacted by military service, nor did they have onset while in military service."

Based on the aforementioned evidence, there is no evidence that the Veteran's current diabetes manifested in service or to a compensable degree in the first year following his separation from active duty service. Although the Veteran reported in his February 2025 VA Form 21-526 that his diabetes was diagnosed in June 2005 on an active duty retirement physical, the Veteran's medical records do not corroborate his contentions. Rather, as explained above, the earliest diagnosis or medication for diabetes mellitus was not until 2011 or 2013. Likewise, while the Veteran's March 2006 laboratory results showed elevated glucose levels, the Veteran's glucose was not measured to be 126 mg/dL.

Accordingly, the Board finds that the Veteran's current diabetes mellitus, type II, did not manifest in service or to a compensable degree in the first year following separation from active duty service. Consequently, service connection for diabetes on the basis that such became manifest in service and persisted, or on a presumptive basis (as a chronic disease under 38 U.S.C. § 1112), is not warranted.

Service connection for diabetes may still be granted on a direct basis, however, there is no evidence that a medical nexus exists between the Veteran's diabetes and his military service. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d).

The Board acknowledges the Veteran's lay statements relating his current diabetes to his military service. However, he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex and outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson,
nexus exists between the Veteran's diabetes and his military service. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d).

The Board acknowledges the Veteran's lay statements relating his current diabetes to his military service. However, he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex and outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight particularly to the competent medical evidence of record, including the September 2025 VA examiner's opinion.

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Upon review of the foregoing, the Board concludes that the evidence persuasively weighs against finding that the Veteran's current diabetes mellitus, type II, was caused by or incurred during his active military service, nor does the evidence show that the Veteran's diabetes manifested to a compensable degree within one year of separation from service. As the evidence persuasively weighs against the claim, there is no benefit of the doubt to resolve in the Veteran's favor. Accordingly, service connection for diabetes mellitus, type II, must be denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

A. ISHIZAWAR

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. Coburn

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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