joevet

UPDATE: We hope to submit the final FDC plus a TDIU claim early next month. In the process of gathering evidence, we uncovered a five year study that coincidentally was funded in part by the VA and used VA patients as study subjects. [The rating officer says, "D'Oh!".

I'll post a link to that one for anyone pursuing this etiology. In my favor is the fact that in addition to sleep apnea, I had other factors of metabolic syndrome (other than diabetes itself) in service. Once Dr. Bash has finished his letter, I'll post the relevant sections showing the etiology of sleep apnea -->> diabetes. This will be a fully developed claim, so hopefully we'll know before Jesus comes back whether this approach works -- and I'm hoping many other veterans will benefit from this research/claim process.

VA Funded study identifying sleep apnea as a serious risk factor/cause of diabetes here.

Good points, John.... Dr. Bash's approach is to demonstrate that a combination of stress, anxiety and my SC physical issues caused weight gain leading to Diabetes II -- OR -- as secondary to hypertension and sleep apnea. Most of the etiology and evidence he's providing supports his "OR" conclusion. His etiology is VERY similar to that used in two cases that were won at the BVA showing diabetes was caused or aggrivated by sleep apnea.

It should be interesting.

"There is one thing  I am sure of, the VA is not in the business of helping veterans. They will do everything possible against a veteran to deny a claim and never advise, or assist, in obtaining what needs to be done to help a veteran."
You are absolutely right.
Although things seem to be changing at VA with the new VA Secretary, what you said is something Every claimant should realize.
It often takes a real doctor ( non VA doctor) with expertise in the field of the specific disability(s) the vet has, to provide an IMO/IME that follows the IMO/IME guidelines here in that forum, to properly obtain direct and secondary SC ratings.
Within the next two weeks the WH and/or the Sec's office will give me feedback on 2 letters I sent already with ways to reduce the backlog and other stuff the Secretary didnt know of  and also this is something, if I did not mention in my letters,
I will add that ....
the BVA holds proof of the incompetence of C & P doctors-forcing many vets and widows to pay high fees for IMOs from real doctors, whose pay check is not from VA or a contractor with VA....solely to obtain what the RO could have awarded. I see that in many cases---I think I DID mention that.maybe when the WH Hot line called me...my only BVA case was an award and then a remand. It could have been awarded many years sooner, but I guess the VA hoped I would croak before that happened.
This is why Tbird started this great web site and why hardcore claimants like me here have practically had to become lawyers and doctors to deal with the ludicrous war of the words VA plays on us, in order to deny claims that are fully supported by documented medical evidence.
Some of the best people I ever met ,since 1984 , work for VA .I did as a VA volunteer and my husband also worked for them. But these good and smart dedicated people work side by side with idiots or those who are lazy , even watching porn on VA PCS as Shulkin refered to on TV, per a whistleblowers complaint, or are  just waiting for their retirement date for their FERS check, while they spin on their thumbs at a raters desk....not interested in properly adjudicating their workload.
If this was the way SSA ran their show, the grateful nation would be in an uproar.
Our grateful nation continues to remain long overdue in paying their debt of gratitude for the sacrifices all of you men and women have paid. That isnt the fault of veterans. The VA caused all the problems we have.
 
 
 
 

You need to obtain, and read your medical file and cfile.  As always, it takes 3 Caluza elements for Service connection.  If you dont have all 3 of these, it will be denied.  
1.  Current diagnosis.  
2.  In service event or aggravation.
3.  Nexus or medical link between number one and 2.  You need a doctor to say that your medical condition is "at least as likely as not" due to x event(s) in medical service.  
Now for secondary service connection.  You need only 2 elements for that, since your "in service event" is already documented with the primary condition.
1.  Current diagnosis.
2.  Nexus, or doctors statement that your high blood pressure is "at least as likely as not" related to your diabetes.  
Now I will mention "presumptive" service connection.  There are certain conditions that are "presumptive".  For example, if you served "in Country" Vietnam, then you will be presumptive for certain conditons, such as those related to Agent Orange.  
Get your service records and medical records and read for yourself it the above is DOCUMENTED.  If its not documented, it does not exist.  
There are 3 possibilities here:
1.  You actually had the applicable evidence in your cfile and VA never bothered to read it.  (highly possible).  I think your claim turns on the "nexus" especially since you are already service connected and seeking secondary conditions, and you apparently have the applicable diagnosis of hbp.  If you lack the nexus documented, you need to obtain said nexus, it will be fruitless to appeal, absent a nexus. In this case, you appeal and cite the doctors report in your appeal.  For example, you state something like this:  While the VARO decision stated " (copy the part of the denial)", Dr. xx on a medical exam dated August 3,  2005, stated, "The Veterans high blood pressure is at least as likely as not the result of his diabetes."   
2.  Your file does not contain the evidence, but you have it, in a docs report, but that report  is NOT in your Cfile.    In this case submit or resubmit the doctors report containing your nexus as New and material evidenece, 39 CFR 3.156.  B or C.  
3.156 C is for Service records, and 3.156 b.  is if you have a pending claim, which apparently you do.  
3.  You do not have documentation of a nexus, that is, there is nothing in your file where a doc says your high blood pressure is secondary to diabetes.  In this case you will need a nexus statement added to your file from either a VA doctor (sometimes they do that, but often they wont), or an IMO/IME.  After you get the applicable nexus, submit it as "new and material evidence" 38 CFR 3.156b. 
 

The Original VA diabetes training letter (1997) on the older forum board, clearly states that those secondarys you mentioned are more than likely due to DMII...
I used that training letter to prove my husband had been undiagnosed and untreated for DMII and that contributed to his death.
If I can find that TL I will post some of it here, it was a very long TL.
But the problem is that it usually takes a IMO doctor ( I mean a real doctor-non VA doctor) to prepare an IME/IMO to get SC for secondarys.VA went against my DMII death claim twice with an Endocrinologist. By then I knew more about endocrinology than she did.
Dr. Bash agreed with my lay medical opinion and evidence and his IMOs were ignored by my RO but I knew the BVA  would read them. Award 2009 SC death due to DMII from the AO in NAM.
A VA Neuro whose DMII diagnosis was crossed out ( I managed to read it) because another VAMC was trying to cover up the malpractice from the local VAMC-had gone into private practice and he gave me a freebee IMO  too to support he DMII claim. He was the only VA doctor who treated my husband who knew what he was doing.No wonder he left VA. He saw too much negligence  and cover ups I think.