Diabetes denial contained legal error by the Board

Summary

The Veteran served on active duty in the United States Air Force from 1975 to 1979.  She initially applied for disability compensation for her anxiety disorder in March of 2008.  She was denied compensation in an October 2009 rating decision, and submitted an appeal to the VA which was also denied.  Later, she applied for compensation for diabetes. The Veteran then appealed her case to the Board of Veterans Appeals.  Her separation exam noted anxiety and depression and the Veteran was later granted service connection at 50% effective back to the date of her initial claim in March of 2008.  The decision granted benefits for her anxiety disorder with depression, but continued the denial of compensation for her diabetes secondary to her anxiety.

Board denies service-connection for diabetes secondary to anxiety

The Board continued the denial of benefits for the Veteran’s diabetes as secondary to her anxiety disorder with depression.  The Veteran stated that she believed her diabetes to be secondary to her anxiety, as she had a tendency to over-eat in response to her anxiety symptoms. The Board held that the Veteran’s assertion that her diabetes was connected to her anxiety was not probative since she lacked the medical expertise to give an opinion on the cause of her diabetes.

CCK appeals to the Court

However CCK argued, and the Court agreed, that the Veteran did not need such medical expertise in order to provide testimony about her conditions and symptoms.  Her credible testimony should be enough to trigger a Compensation and Pension examination.  Citing VA regulations, the Court emphasized that the VA must provide an examination if the evidence of record satisfies a “low threshold” to indicate a connection between current symptoms and a claimant’s period of service.  The Court also asserted that medical nexus is not required to trigger a VA examination, but rather, the VA examination is what would establish the medical nexus.

The Court ruled that the Board erred when it refused to acknowledge the Veteran’s statements that her service-connected anxiety disorder caused her to over-eat, which lead to her diagnosis of diabetes. The Veteran supplied the Board with testimony regarding her service-connected anxiety disorder and her diabetes, which should have triggered the duty to provide a medical examination. The Court ruled that the Board provided insufficient reasoning in its decision to issue a decision without first requesting that a medical opinion be completed.

CAVC remands the case to reevaluate the need for a medical opinion

The Court agreed that the Veteran could provide a competent statement that her anxiety caused her to overeat and that this may have caused or aggravated the diabetes.  Accordingly, the Court vacated the Board’s decision and remanded the case back to the Board to determine whether the Veteran should receive a medical opinion concerning the potential link between her diabetes and her anxiety.