Citation Nr: 18139661
Decision Date: 09/28/18	Archive Date: 09/28/18

DOCKET NO. 16-27 821
DATE:	September 28, 2018
Entitlement to an evaluation in excess of 20 percent for diabetes mellitus II is remanded.
The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of the Department of Veterans Affairs (VA) Regional office (RO).
1. Entitlement to an evaluation, in excess of 20 percent, for diabetes mellitus II is remanded.
The Veteran contends that his diabetes disability is more severe than the 20 percent evaluation he is currently assigned. Since the June 2015 rating decision, he has submitted several correspondences indicating that his diabetes requires him to take insulin, abide by a restricted diet, and regulate his activities due his diabetes mellitus disability.
The Veteran submitted a correspondence from his private physician. Dr. L endorsed that the he has treated the Veteran for diabetes and other cardiovascular conditions. See November 2017 Correspondence. The examiner noted, as part of his comprehensive diabetic management, that the Veteran was advised to continue with his activities of daily living. Also, he was advised to “continue with his restrictions on strenuous physical activity in the effort to prevent and control diabetic complications and injuries.”
The Veteran was afforded a VA examination in March 2015 to assess his diabetes disability. The examiner confirmed a diagnosis of diabetes mellitus II. The Veteran was noted to take insulin and restrict diet as part of his management of his diabetes. Additionally, the examiner endorsed that the Veteran was not required to regulate his activities as part of medical management of diabetes mellitus.
In light of the above, the Board finds that a new VA examination is warranted.  
The matter is REMANDED for the following action:
Schedule the Veteran for a new VA examination by an appropriate clinician to determine the current nature and severity of the Veteran’s service-connected diabetes mellitus II disability. 
The examiner should make findings responsive to the criteria for rating diabetes mellitus, to include whether the condition requires insulin, restricted diet, or regulation of activities (avoidance of strenuous occupational and recreational activities). If regulation of activities is necessary, please state whether that is due to diabetes mellitus. 
In providing this opinion, the examiner should address the November 2017 private correspondence from the Veteran’s private physician, and describe the quality and nature of the “regulation of activities” associated with his diabetes mellitus II disability.

The examiner should also state whether the Veteran has been hospitalized for episodes of ketoacidosis or hypoglycemic reactions; whether he requires visits to a diabetic care provider either weekly or twice per month; whether he has complications and, if so, the severity thereof; and whether he has had a progressive loss of weight and strength due solely to service-connected diabetes mellitus.
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. A. Macek, Associate Counsel

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