Citation Nr: 18141335 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 16-22 474 DATE: October 10, 2018 ORDER Entitlement to service connection for peripheral neuropathy to the bilateral upper extremities is denied. REMANDED Entitlement to service connection for the residuals of an inguinal hernia is remanded. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of peripheral neuropathy of the bilateral upper extremities. CONCLUSION OF LAW The criteria for service connection for peripheral neuropathy of the bilateral upper extremities are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1968 to February 1988. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision. Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303. Service connection may also be granted when a claimed disability is found to be proximately due to or the result of a service-connected disability, or when any increase in severity (aggravation) of a nonservice-connected disease or injury is found to be proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310. VA shall give the benefit of the doubt to the claimant when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran asserts that he has peripheral neuropathy in his bilateral upper extremities, presenting as tingling and numbness of the fingers, associated with his service-connected diabetes mellitus. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of peripheral neuropathy and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The March 2016 VA examiner evaluated the Veteran and determined that, while he had been diagnosed with diabetes mellitus and occasionally experienced subjective symptoms of numbness in the tips of his fingers, the Veteran did not have a diagnosis of peripheral neuropathy. Further, the examiner noted the Veteran’s treatment records do not contain a diagnosis of peripheral neuropathy despite additional testing as part of his treatment. An earlier October 2014 VA examination for the Veteran’s diabetes mellitus noted that the Veteran had normal sensation to touch in feet and hands by monofilament testing. The examiner, in describing physical findings and functional impacts related to the Veteran’s condition, did not describe any peripheral neuropathy symptoms. The examiners’ reports are competent and credible, as the reports were based on reviews of the Veteran’s medical records and in-person examinations of the Veteran, and are therefore entitled to significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). As noted by the most recent VA examiner, the Veteran’s treatment records do not indicate a diagnosis or other indications of peripheral neuropathy. These records include several years of treatment for his diabetes mellitus, including occasional testing for relevant neuropathy symptoms in the upper and lower extremities. In these reports, the records indicate that the Veteran has denied numbness or pain in his extremities upon examination. The Veteran has stated that he has occasional symptoms of peripheral neuropathy of the upper extremities, but he has not been prescribed any treatment or medication for the condition. While the Veteran is competent report symptoms of numbness and tingling in his fingers, he is not competent to provide a diagnosis of peripheral neuropathy, a medically complex condition requiring specialized knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence of record. Based on this evidence, the Board concludes that the Veteran has not had a current diagnosis of a peripheral neuropathy condition during the period on appeal. Therefore, the benefit-of-the-doubt doctrine does not apply, and service connection for the peripheral neuropathy of the bilateral upper extremities is not warranted. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND The duty to assist requires VA to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with military service, and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The claimant’s reports of a continuity of symptomatology can satisfy the requirement for evidence that the claimed disability may be related to service. Id. In the current case, the Veteran’s medical records indicate a recent history of inguinal pain without a clear diagnosis or etiology. The Veteran has provided competent and credible statements indicating he was diagnosed with an inguinal hernia two months after discharge, an injury that the Veteran attributes to heavy lifting during active service. The Veteran has not been provided a VA examination to obtain a medical opinion addressing these claims, and the record does not contain sufficient information for the Board to come to a decision on this issue. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the Veteran’s file. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any residuals of an inguinal hernia. The examiner must opine whether the Veteran’s condition is at least as likely as not related to an in-service injury, event, or disease. The Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered by the examiner. The examination report must include a complete rationale for the opinion provided. If the examiner cannot provide the requested opinion without resorting to speculation, he or she should so state and explain why an opinion cannot be provided without resorting to speculation. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Pitman, Associate Counsel