05-37 821
05-37 821
| Board of Vet. App. | Feb 2, 2017Background
- Veteran served on active duty 1972–1975 and 1982–1988; claim originally denied by RO in 2004 and appealed through Board and Court remand proceedings.
- Veteran diagnosed with type II diabetes mellitus (confirmed by January 2016 VA exam).
- Veteran contends diabetes was caused by Celebrex and other medications he took to treat service-connected residuals of Ross River virus with multiple joint arthritis.
- Medical evidence in the record is mixed: some VA examiners and medical literature note a small reported incidence (0.1–2%) of hyperglycemia/diabetes with Celebrex; other opinions attribute diabetes to obesity and family history.
- The Board found the November 2012 VA opinion (which supported causation by Celebrex and provided specific rationale) entitled to substantial probative weight, and concluded the evidence was in approximate equipoise.
- Because reasonable doubt was resolved in the Veteran’s favor, service connection for Type II diabetes as secondary to medications for his service‑connected condition was granted.
Issues
| Issue | Veteran's Argument | VA's Argument | Held |
|---|---|---|---|
| Is the Veteran’s Type II diabetes service‑connected as secondary to medications (e.g., Celebrex) prescribed for service‑connected Ross River virus residuals? | Celebrex and other meds taken for service‑connected arthritis caused his diabetes. | Medical opinions and literature show diabetes is more likely due to obesity and family history; Celebrex association is unlikely. | Granted: evidence approximately evenly balanced; reasonable doubt resolved for Veteran; secondary service connection awarded. |
Key Cases Cited
- Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay evidence can be competent to identify medical conditions in specified circumstances)
- Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (Board cannot dismiss lay evidence solely for lack of contemporaneous medical records)
- Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (VA must give due consideration to all pertinent medical and lay evidence)
- Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App. 1990) (benefit of the doubt rule when evidence is approximately balanced)
- Allen v. Brown, 7 Vet. App. 439 (Vet. App. 1995) (service connection may be granted for disability proximately due to or the result of a service‑connected disability)
- Wanner v. Principi, 17 Vet. App. 4 (Vet. App. 2003) (recognizing secondary service connection based on treatment for a service‑connected condition)
- Velez v. West, 11 Vet. App. 148 (Vet. App. 1998) (discussing secondary service‑connection theories tied to medications taken for service‑connected conditions)
- Jones v. Brown, 7 Vet. App. 134 (Vet. App. 1994) (reviewing secondary service‑connection as result of treatment for a service‑connected condition)
- Wensch v. Principi, 15 Vet. App. 362 (Vet. App. 2001) (VCAA assistance not required when claim is already substantiated)
- Evans v. West, 12 Vet. App. 22 (Vet. App. 1998) (Board may weigh and favor one medical opinion over another)
- Gabrielson v. Brown, 7 Vet. App. 36 (Vet. App. 1994) (Board must address persuasive and unpersuasive material evidence)
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (Vet. App. 2008) (medical opinion must show the provider’s qualifications, review of the record, and rationale to be probative)