10-49 395
10-49 395
| Board of Vet. App. | Jun 30, 2017Background
- Veteran served in the U.S. Army from Feb 1978 to Feb 2002 and appealed an Oct 2009 VA RO rating decision denying service connection for Type II diabetes mellitus (DM).
- STRs show in-service glucose readings generally between 86–104 mg/dL, including 104 mg/dL at separation (Oct 17, 2001).
- DM was first diagnosed and treated post-service in 2004, outside the one-year presumptive period for chronic diseases.
- VA provided VCAA notice and assisted development; the Board found development adequate and ordered a VA examination, which was completed in Jan 2017.
- The VA examiner confirmed current DM but opined DM was less likely than not related to service, citing normal in-service glucose and absence of glucosuria; the Board gave this opinion significant probative weight.
- The Board denied service connection, concluding DM was not manifest in service or within one year after separation and the evidence preponderates against service connection.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether DM is service-connected | Veteran contends DM should have been diagnosed in service or is related to service | VA/Board cites normal in‑service glucose readings and medical opinion finding no nexus | Denied — no in‑service manifestation or nexus to service |
| Whether DM is entitled to presumptive service connection under the one‑year rule | Veteran argues sequelae manifested close to separation | VA notes diagnosis occurred in 2004, outside one‑year presumptive period | Denied — not manifested to compensable degree within one year |
| Whether VA satisfied VCAA and duty to assist | Veteran raised no specific VCAA/development errors | VA furnished notice, obtained records, and provided VA exam and opinion | Held adequate — no VCAA or development deficiency found |
| Whether benefit‑of‑the‑doubt applies | Veteran claims lay evidence supports connection | Board finds medical evidence and VA examiner outweigh lay statements | Benefit‑of‑the‑doubt not applied; preponderance against claim |
Key Cases Cited
- Pelegrini v. Principi, 18 Vet. App. 112 (explaining VA notice requirements under VCAA)
- Prejean v. West, 13 Vet. App. 444 (factors for assessing probative value of medical opinions)
- Walker v. Shinseki, 708 F.3d 1331 (continuity of symptomatology as alternate route for chronic disease service connection)
- Shedden v. Principi, 381 F.3d 1163 (elements required to establish service connection)
- Jandreau v. Nicholson, 492 F.3d 1372 (limitations of lay evidence on medical issues)
- King v. Shinseki, 700 F.3d 1339 (upholding greater probative weight of medical expert over lay opinion)