Citation Nr: 18145473
Decision Date: 10/29/18	Archive Date: 10/29/18

DOCKET NO. 16-36 882
DATE:	October 29, 2018
REMANDED
Entitlement to service connection for bilateral peripheral neuropathy of the upper extremities, to include as due to herbicide exposure is remanded.
Entitlement to service connection for bilateral peripheral neuropathy of the lower extremities, to include as due to herbicide exposure is remanded.
REASONS FOR REMAND
The Veteran served in the U.S. Army as a medic from July 1969 to July 1971 with service in the Republic of Vietnam. The Veteran testified at a video conference hearing in September 2017. 
1. Entitlement to service connection for bilateral peripheral neuropathy of the upper extremities, to include as due to herbicide exposure is remanded.
2. Entitlement to service connection for bilateral peripheral neuropathy of the lower extremities, to include as due to herbicide exposure is remanded.
The Veteran contends that service connection is warranted for bilateral peripheral neuropathy of the upper and lower extremities. The Veteran contends that his current leg pain, numbness and tingling in his extremities is due to his service in Vietnam and exposure to herbicides. The Board cannot make a fully-informed decision on the issue of service connection for upper and lower extremity peripheral neuropathy because no VA examiner has opined whether direct service connection, to include as due to herbicide exposure is warranted. As such remand is warranted for a VA examination. 
The matters are REMANDED for the following action:
Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral upper and lower extremity peripheral neuropathy.  The examiner must opine whether:
(a.) Does the Veteran have peripheral neuropathy of the upper and lower extremities?
(b.) Is it at least as likely as not (a 50 percent probability or greater) that the upper and lower extremity peripheral neuropathy is caused by service, to include herbicide exposure?
Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. The Veteran served in Vietnam during the applicable presumptive period and exposure to herbicides is presumed. 
In addition, the Veteran testified to first experiencing ongoing symptoms of burning, stinging and numbness in his toes and feet which began in-service and has continued since. Attention is invited VA treatment records reports of numbness through June 2017 and an undated letter from his attending physician received in November 2017 that diagnosed idiopathic peripheral neuropathy and suggested that exposure to Agent Orange in Vietnam may be contributing to his current neuropathic pain. Further, July 2012 correspondence from the Veteran’s primary care physician notes that his peripheral neuropathy was precipitated by his exposure to Agent Orange while serving in Vietnam. 
 
J.W. FRANCIS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Kardian