Citation Nr: 18147639 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 17-41 191 DATE: November 6, 2018 REMANDED The issue of service connection for bilateral upper neuropathy is remanded. The issue of service connection for bilateral lower neuropathy is remanded. REASONS FOR REMAND The Veteran had active service from December 1966 to March 1974. Entitlement to service connection for bilateral upper and lower neuropathy is remanded. At the November 2015 VA medical examination for diabetes, the examiner did not indicate a current diagnosis of bilateral upper or lower neuropathy secondary to diabetes. In September 2016 the Veteran submitted medical evidence indicating findings consistent with a diagnosis of bilateral lower neuropathy secondary to diabetes. A VA medical examination is needed to fully and fairly adjudicate the Veteran’s claims. In August 2017, the Veteran requested a hearing with a Decision Review Officer (DRO). The requested DRO hearing has not been scheduled. The matters are REMANDED for the following action: 1. Request the Veteran identify and secure any relevant private medical records that are not in the claims file. If the Veteran identifies private records, following the securing of the appropriate waivers, make all appropriate attempts to locate such records and to associate them with the claims file. If the Veteran has no further evidence to submit, or, if after exhaustive efforts have been made, no records can be identified, so annotate the record. 2. Obtain any outstanding VA medical records and associate them with the claims file. 3. Schedule the Veteran for an appropriate VA examination, consistent with VA rating protocols, to determine the nature and etiology of his current diabetic neuropathy diagnoses. The entire claims file, including a copy of the Remand, should be made available to, and be reviewed by, the VA examiner. All appropriate tests, studies, and consultations should be accomplished and all clinical findings should be reported in detail. An explanation should be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner should provide the following opinions: Does the Veteran have current diagnoses of upper and/or lower neuropathy that are secondary to his service-connected diabetes mellitus type II? The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED AS A RESULT OF THIS REMAND, the VA examiner’s attention is drawn to the following: * The November 2015 VA medical examination for diabetes mellitus type II. * The September 2016 electromyography study indicating findings consistent with diabetic neuropathy. See “Medical Treatment Record – Non-Government Facility,” received September 12, 2016. * Service connection is in effect for diabetes mellitus type II with nephropathy and bilateral hearing loss. A thorough explanation must be provided for the opinion rendered. If the examiner cannot provide the requested opinion without resorting to speculation, s/he should expressly indicate this and provide supporting rationale as to why the opinion cannot be made without resorting to speculation. The examiner should schedule a new examination only if necessary to provide an adequate opinion. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 4. Clarify whether the Veteran desires review before a Decision Review Officer and undertake all appropriate actions towards that end. (In August 2017, the Veteran requested a hearing with a Decision Review Officer (DRO). The requested DRO hearing has not been scheduled.) 5. Following the review and any additional development deemed necessary, re-adjudicate the claims. Should the claims not be granted in its entirety, issue an appropriate supplemental statement of the case (SSOC) and forward the claims to the Board for adjudication. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). These claims must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112 (West 2014). Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Anwar, Associate Counsel