Citation Nr: 18155303
Decision Date: 12/04/18	Archive Date: 12/03/18

DOCKET NO. 17-02 108
DATE:	December 4, 2018
REMANDED
Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to service-connected diabetes, is remanded.
Entitlement to service connection for peripheral neuropathy right lower extremity, to include as secondary to service-connected diabetes, is remanded.
REASONS FOR REMAND
The Veteran served active duty in the United States Army from December 1967 to July 1970.
1. Service connection for peripheral neuropathy of the left lower extremity, to include as secondary to service-connected diabetes, is remanded.
2. Service connection for peripheral neuropathy right lower extremity, to include as secondary to service-connected diabetes, is remanded.
The Veteran contends that he has peripheral neuropathy due to his service-connected diabetes.
In November 2016, the Veteran was afforded a VA examination.  The examiner determined that the Veteran did not have a generalized peripheral neuropathy due to, caused by, or aggravated by his service-connected diabetes mellitus.  The examiner stated that the Veteran's issues are entirely explainable by his fracture and surgeries.  The examiner noted that the study was most consistent with local entrapments of the left sided sensory and left peroneal motor nerves from the Veteran’s past left ankle fracture surgery post open reduction and internal fixation, and later left knee arthroscopy and total knee arthroplasty.
The Board finds the opinion to be inadequate.  While the opinion provided a negative nexus, the explanation lacked sufficient reasons and bases for reaching the conclusion.  Specifically, the examiner did not discuss how the Veteran’s past left knee surgery would create sensory the issues noted in the right knee.  The examiner also noted the Veteran has a history of peripheral nerve disease, but denied such disease within the opinion.  For these reasons, a remand is necessary.
The matters are REMANDED for the following action:
Send the Veteran’s claims file to an appropriate examiner.  The examiner shall consider all other medical records associated with this file during review.  Schedule the Veteran for examination only if the examiner determines that the examination of the Veteran is necessary.  The examiner is asked to offer an opinion on the following:
Whether it is at least as likely as not (50 percent or greater probability) that the Veteran has peripheral neuropath of the lower left extremity and/or the lower right extremity which is due to or aggravated by the Veteran’s service-connected diabetes.
In rendering the requested opinion, the examiner must consider and discuss all pertinent medical and other objective evidence, as well as all lay assertions, to include any assertions as to onset and continuity of symptoms.  The examiner should explain the medical basis for the conclusions reached.
 
JENNIFER HWA
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Ford, Associate Counsel