Citation Nr: 18146111 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 15-04 843 DATE: October 30, 2018 REMANDED Entitlement to service connection for left foot peripheral neuropathy, to include as secondary to service-connected bilateral pes planus, is remanded. Entitlement to service connection for right foot peripheral neuropathy, to include as secondary to service-connected bilateral pes planus, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1968 to March 1970. In October 2018, a videoconference hearing was held before the undersigned. As an initial matter, the Board acknowledges that the Veteran has submitted a timely August 2018 notice of disagreement (NOD) to an October 2017 rating decision that denied entitlement to a higher rating for his service-connected bilateral pes planus. While a statement of the case (SOC) has not yet been provided, the Agency of Original Jurisdiction (AOJ) has acknowledged receipt of this NOD. See October 2018 DRO Process Explanation Letter. Therefore, this situation differs from the situation in Manlincon v. West, 12 Vet. App. 238 (1999), where VA had not acknowledged the NOD. As such, a remand for this issue is not warranted at this time. Entitlement to service connection for left and right foot peripheral neuropathy, to include as secondary service-connected bilateral pes planus, is remanded. In December 2014, the AOJ procured a VA medical opinion regarding the Veteran’s left and right foot peripheral neuropathy. The examiner opined that pes planus was less likely as not a condition that would cause peripheral neuropathy. The examiner noted that it would also be speculation on her part to determine whether the Veteran had peripheral neuropathy because she was unable to locate an EMG/NCV study. Thereafter, in March 2015, after receiving the report from a February 2014 nerve conduction test, the same VA examiner who provided the December 2014 medical opinion provided a second opinion. She again opined that the Veteran’s claimed condition was less likely than not proximately due to or the result of the service-connected condition (bilateral pes planus). She explained that the Veteran had a pattern which suggested a severe mixed degenerative sensorimotor peripheral neuropathy, and that she was not aware of pes planus causing a mixed degenerative sensorimotor peripheral neuropathy. Despite the VA medical opinions provided above, the Board finds that the evidence of record remains insufficient to properly adjudicate the Veteran’s claims. In relevant part, although the December 2014 VA examiner addressed the causation aspect of a secondary service connection claim, she did not address whether the Veteran’s service-connected bilateral pes planus aggravated his left and/or right foot peripheral neuropathy. Additionally, at the October 2018 videoconference hearing, the Veteran raised a new theory of entitlement that his bilateral peripheral neuropathy may be directly related to his military service, and that must now be developed as well. Accordingly, the Board finds that remand is warranted for a new VA examination consistent with the directives herein. The matters are REMANDED for the following actions: 1. With the Veteran’s assistance, obtain any outstanding records of pertinent medical treatment from VA or private health care providers. All reasonable attempts to obtain such records should be made and documented. 2. After the above records request has been completed, schedule the Veteran for a VA examination with an appropriate examiner to determine the nature and etiology of his left and right foot peripheral neuropathy. The examiner must review pertinent documents in the Veteran’s claims file in conjunction with the examination. All indicated studies should be completed. All findings must be fully reported. a) The examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran’s left and/or right foot peripheral neuropathy had its onset in, or is otherwise related to, the Veteran’s active duty service. In rendering this opinion, the VA examiner must specifically consider and discuss the Veteran’s statements at the October 2018 videoconference hearing that he was exposed to cold weather while serving in Germany and that, while he was on guard duty, he had to stand in snow that went up to his knees. He also helped German civilians shovel snow. b) The examiner must also provide an opinion regarding whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran’s left and/or right foot peripheral neuropathy was aggravated by his service-connected bilateral pes planus. Aggravation in this context is defined as “any increase in disability.” See Allen v. Brown, 7 Vet. App. 439, 448 (1995). The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. E. Metzner, Associate Counsel