Citation Nr: 1329208 Decision Date: 09/12/13 Archive Date: 09/20/13 DOCKET NO. 10-25 761 ) DATE ) ) Received from the Department of Veterans Affairs Regional Office in Indianapolis, Indiana THE ISSUES 1. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities or other neurological disability of the upper extremities manifested by tingling and weakness. 2. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities or other neurological disability of the lower extremities manifested by tingling and weakness. REPRESENTATION Veteran represented by: Andrew R. Rutz, Attorney ATTORNEY FOR THE BOARD Michael J. Adams, Associate Counsel INTRODUCTION The Veteran reported active duty from January 1982 to January 1988 and from March 1989 to July 2003. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Togus, Maine on behalf of the VA RO in Indianapolis, Indiana. In Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009), the Court held that, in determining the scope of a claim, the Board must consider the claimant's description of the claim; symptoms described; and the information submitted or developed in support of the claim. In light of the Court's decision in Clemons, the Board will consider all disabilities that would be described by the Veteran's symptoms. The appeal is REMANDED to the RO. VA will notify the Veteran if further action is required. REMAND Remand is required to obtain a VA examination in order to diagnose the Veteran's current symptoms and if a disability is found, determine the etiology. Service treatment records (STRs) indicate that the Veteran was involved in a motor vehicle accident in November 1984 and was diagnosed with head trauma. STRs also demonstrate that the Veteran experienced a muscle strain in his upper back in May 1985. In August 2001 the Veteran was seen in the emergency room for complaints of neck pain, upset stomach and tingling/numbness in his 4th and 5th digits. The Veteran also reported at this visit that he had experienced neck pain since a motor vehicle accident (although it is not clear if this is the same accident experienced in November 1984). The Veteran has asserted that this visit to the emergency room was prompted by weakness in his legs so severe that he could not extricate himself from his bathtub. The Veteran asserts that he has experienced symptoms of peripheral neuropathy, including weakness in both legs and numbness and tingling in both hands and arms since service separation. He also asserts that during periods of illness these symptoms are magnified and as of late, have become more severe, resulting in falls. The Board notes that the Veteran is competent to report that he has had symptoms of tingling, numbness, and weakness in his extremities since service. See Layno v. Brown, 6 Vet. App. 465, 469-70 (1994). Private treatment records from February 2009 and June 2008 indicate that the Veteran is diagnosed with chronic paraparesis with proximal weakness of bilateral lower extremities as well as multi-focal motor neuropathy. However, no opinion as to the etiology of the Veteran's current symptomatology is of record. Because a VA examination is needed to address the Veteran's contentions of peripheral neuropathy and provide an opinion as to the etiology of his claimed symptoms in his legs, arms, hands, and feet, a VA examination is warranted to address the specific allegations of the Veteran. See 38 U.S.C.A. § 5103A (West 2002); 38 C.F.R. § 3.159; McLendon v. Nicholson, 20 Vet. App. 79 (2006). Accordingly, the case is REMANDED for the following action: 1. The RO should schedule the Veteran for an appropriate VA examination to determine the current nature and etiology of the Veteran's symptoms. The claims file must be made available to the examiner for review prior to the examination. All necessary tests should be performed. The examiner should determine a diagnosis (or diagnoses) for the Veteran's symptoms of weakness, numbness, and tingling in all four extremities. Based on the examination and review of the record, the examiner should address whether it is at least as likely as not (a 50 percent or greater probability) that any diagnosed disability (to include peripheral neuropathy, multi-focal motor neuropathy, and chronic paraparesis) is related to service. The examiner should address that the Veteran experienced a motor vehicle accident in November 1984 resulting in head trauma; he experienced a back strain in May 1985; was treated for neck pain and numbness/tingling in his hands in August 2001 and reports that he also experienced severe weakness in his legs at this time. A complete rationale for any opinion offered must be provided. 2. After completion of the foregoing and all other necessary development, the RO should re- adjudicate the claim for service connection for bilateral peripheral neuropathy (or other neurologic disability) of the upper and lower extremities. If any benefit sought remains denied, the Veteran and his representative should be furnished a supplemental statement of the case, and should be given an opportunity to submit written or other argument in response before the claims file is returned to the Board for further appellate consideration. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ ROBERT C. SCHARNBERGER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).