Citation Nr: 18143454 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 15-19 587 DATE: October 19, 2018 REMANDED Entitlement to service connection for degenerative arthritis is remanded. Entitlement to service connection for diabetic retinopathy is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for poor blood circulation is remanded. Entitlement to service connection for diabetes mellitus, type II is remanded. Entitlement to service connection for bilateral peripheral neuropathy of the upper extremities is remanded. Entitlement to service connection for bilateral peripheral neuropathy of the lower extremities is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from June 1973 to May 1975. These matters are before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was scheduled to appear at a hearing before the Board in August 2018. However, in an August 2018 VA Form 21-4138, Statement in Support of Claim, the Veteran’s representative requested that the hearing be cancelled. As such, the Board considers the hearing request to be withdrawn. Entitlement to service connection for degenerative arthritis, diabetic retinopathy, hypertensive vascular disease, arteriosclerosis obliterans (claimed as poor blood circulation), diabetes mellitus type II, bilateral peripheral neuropathy of the upper extremities (paralysis of the median nerve), and bilateral peripheral neuropathy of the lower extremities (paralysis of the sciatic nerve) is remanded. A December 2012 Notice of Award from the Social Security Administration (SSA) indicates that there may be outstanding and relevant SSA records. As such records may be pertinent to the Veteran’s claim, a remand is required to allow VA to request these records. The Board cannot make a fully-informed decision on the issue of secondary service connection for peripheral neuropathy of the upper extremities because no VA examiner has opined whether this condition has been caused by or is otherwise related to the Veteran’s military service, or whether it is secondary to the Veteran’s service-connected intervertebral osteochondrosis. Additionally, regarding the claim for bilateral peripheral neuropathy of the lower extremities, a November 2017 examination report reflected findings of hypoactive deep tendon reflexes and reduced sensation to touch in his ankles and feet. The examiner concluded that pedal edema caused him to have numbness in his legs and that there was no evidence of radiculopathy from the service-connected intervertebral osteochondrosis. However, the examination report did not give a clear rationale for this conclusion. As such, a further opinion is needed. The matters are REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from May 2016 to the present. 2. Obtain the Veteran’s federal records from the Social Security Administration. Document all requests for information as well as all responses in the claims file. 3. After obtaining any additional records, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral upper extremity neuropathy. The examiner must provide opinions on the following questions: (a.) Is it at least as likely as not that any peripheral neuropathy of the upper extremities is related to an in-service injury, event, or disease? (b.) Is it at least as likely as not that any peripheral neuropathy of the upper extremities is at least as likely as not (1) caused by the Veteran’s service-connected intervertebral osteochondrosis, or (2) aggravated beyond its natural progression (i.e., any increase in severity beyond the natural progression) by service-connected osteochondrosis? 4. After obtaining any additional records, obtain an addendum opinion from the VA clinician who performed the November 2017 VA examination for peripheral neuropathy of the lower extremities. (a.) A second examination should not be scheduled unless the clinician determines that it is necessary. (b.) The examiner should provide a rationale for his conclusion that the Veteran’s hypoactive deep tendon reflexes and reduced sensation in the Veteran’s ankles and feet are symptoms of pedal edema and are not secondary to his service connected intervertebral osteochondrosis. (c.) If the November 2017 clinician is not available, please obtain an opinion from an appropriate clinician as to whether the Veteran has peripheral neuropathy of the bilateral lower extremities that is at least as likely as not (1) caused by the Veteran’s service-connected intervertebral osteochondrosis, or (2) aggravated beyond its natural progression (i.e., any increase in severity beyond the natural progression) by service-connected osteochondrosis. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Dean, Associate Counsel