Citation Nr: 18153548 Decision Date: 11/28/18 Archive Date: 11/27/18 DOCKET NO. 16-52 435 DATE: November 28, 2018 ORDER Entitlement to service connection for peripheral neuropathy of the bilateral feet, due to exposure to herbicide agents, is granted. FINDING OF FACT 1. The Veteran served in Vietnam and his exposure to herbicide agents is presumed. 2. The Veteran’s peripheral neuropathy of the bilateral feet is related to his exposure to herbicide agents in service. CONCLUSION OF LAW The criteria for service connection for peripheral neuropathy of the bilateral feet, due to exposure to herbicide agents, have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1968 to May 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Winston Salem, North Carolina. Legal Criteria Service connection may be granted for a disability due to disease or injury incurred in or aggravated by military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. §3.303 (d). Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303 (b); see also Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed.Cir.2013) (holding that only conditions listed as chronic diseases in 38 C.F.R. § 3.309 (a) may be considered for service connection under 38 C.F.R. § 3.303 (b)). Where the evidence shows a chronic disease in service or continuity of symptoms after service, the disease shall be presumed to have been incurred in service. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With a chronic disease in service, subsequent manifestations of the same chronic disease, at any later date, however remote, is service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303 (b). Certain enumerated diseases (including early-onset peripheral neuropathy) may be service connected on a presumptive basis as due to exposure to herbicides in service. Veterans who served in Vietnam during the Vietnam Era are presumed to have been exposed to herbicides in service. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309(e). Peripheral neuropathy must become manifest to a degree of 10 percent or more within one year after the date of last exposure to herbicides in order to qualify for the presumption of service connection. 38 C.F.R. § 3.307 (a)(6)(ii). The Board has reviewed all the evidence in the record. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Analysis The Veteran asserts that his peripheral neuropathy of the bilateral feet is due to Agent Orange exposure during military service. As an initial matter, the Board notes that the Veteran has been diagnosed with peripheral neuropathy of the bilateral feet. Accordingly, the first element for establishing service connection has been met. Turning to the second element for service connection, the Board initially notes that the Veteran is a combat Veteran of the Vietnam War. As such, his exposure to herbicide agents is conceded. Although his service treatment records (STRs) do not contain any mention of neurological problems, to include of the bilateral feet, and his medical history at separation is silent for neurological complaints, the Veteran has consistently maintained that he started feeling numbness, pain, and increased sensitivity in both of his feet while in Vietnam and soon after returning from Vietnam. In a September 2015 statement, the Veteran reported that he sought medical attention in the 1970s and early 1980s but was told by his doctors there was nothing that could be done for his bilateral foot condition. In a December 2015 VA Agent Orange program note, the Veteran reported significant bilateral lower extremity peripheral neuropathy since, and even during his time in Vietnam. A February 2016 medical examination from the Durham VAMC confirmed the Veteran had a diagnosis of peripheral neuropathy. In a February 2016 statement, the Veteran again stated that he experienced bilateral foot and ankle numbness during his service in Vietnam, and when he returned in 1970 he experienced bilateral foot pain. The Veteran further stated that around 1976 and 1981 he visited multiple physicians, and a podiatrist, for foot pain and numbness but the doctors were unable to help him. The Veteran’s wife also submitted a statement in October 2016. She indicated that she first met the Veteran in January 1967, prior to him entering service, and she reconnected with him in May 1970 after his return from Vietnam. She corroborated the Veteran’s statements, noting that the Veteran began to complain of numbness, foot pain, and extra sensitivity in his feet upon his return from Vietnam in 1970. She also noted that the Veteran had seen a couple of doctors about his feet but he “was told the condition was caused by peripheral neuropathy and that there was nothing that could be done.” The Veteran competently reports continuous symptoms of pain and numbness in his bilateral feet. He has also provided credible testimony that his symptoms of numbness, pain, and increased sensitivity in his feet began while still in service and have continued and increased in severity since that time. His testimony is also corroborated by his wife’s credible testimony regarding her observation of him experiencing these symptoms. 38 C.F.R. §§ 3.307, 3.309(a). Since the Veteran has reported that the numbness, pain, and increased sensitivity started while he was still in Vietnam in 1969, he meets the criteria for service connection for early onset peripheral neuropathy of the bilateral feet based on exposure to herbicide agents The Veteran’s competent and credible statements that he has experienced numbness, pain, and increased sensitivity in both his feet since service are sufficient to establish the continuity of symptomatology of his current peripheral neuropathy of the bilateral feet. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465, 470-71 (1994). (Continued on the next page)   The Board notes that there are no negative nexus opinions contained in the record. Therefore, in light of the evidence of record, including the Veteran and his wife’s credible statements, the Board finds that the evidence is at least in equipoise that the Veteran’s peripheral neuropathy of the bilateral feet arose within the presumptive period for the chronic disease presumption of one year after service. Therefore, all reasonable doubt is resolved in favor of the Veteran and the Veteran’s claim of entitlement to service connection for peripheral neuropathy of the bilateral feet is granted. See 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 3.307, 3.309(a). T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Gresham