Citation Nr: 18160852 Decision Date: 12/27/18 Archive Date: 12/27/18 DOCKET NO. 16-61 241 DATE: December 27, 2018 REMANDED Issue of entitlement to service connection for peripheral neuropathy of the left lower extremity peroneal nerve is remanded. Issue of entitlement to service connection for peripheral neuropathy of the left lower extremity tibial nerve is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1970 to May 1974, and from May 1975 to August 1976. This appeal to the Board of Veterans’ Appeals (Board) arose from a December 2014 rating decision issued by the Department of Veterans Affairs (VA). See February 2015 Notice of Disagreement (NOD); September 2016 Statement of the Case (SOC); November 2016 Substantive Appeal (VA Form 9). Issues of entitlement to service connection for peripheral neuropathy of the left lower extremity peroneal nerve and tibial nerve. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for peripheral neuropathy of the left lower extremity peroneal nerve or tibial nerve because no VA examiner has opined whether there is a direct service connection for either asserted impairment. The Veteran asserts to having neuropathy due to Agent Orange exposure during service. See March 2014 VA Form 21-4138; September 2014 VA Form 27-0820. The evidence contains an abnormal nerve conduction study showing acquired axonal and demyelinating neuropathy affecting the left peroneal and left tibial nerves, and shows that the Veteran has a diagnosis of idiopathic peripheral neuropathy of the left leg. See May 2013 and October 2013 VA treatment records. The evidence also shows that the Veteran served in the Republic of Vietnam sometime between January 9, 1962, and May 7, 1975. See February 1971 Airman Performance Report; May 1974 DD Form 214. The Board finds that a VA examination is necessary to determine whether the evidence shows the Veteran had early-onset peripheral neuropathy that manifested to a degree of 10 percent or more within a year after the last date on which he was exposed to an herbicide agent during active duty. See 38 C.F.R. § 3.307(a)(6). If the VA examiner finds the evidence does not show early-onset peripheral neuropathy that manifested to a degree of 10 percent or more within a year after the last date the Veteran was exposed to an herbicide agent, then the VA examiner should consider whether there is a medical nexus between the Veteran’s current peripheral neuropathy and service. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran’s peripheral neuropathy of the left lower extremity peroneal nerve or tibial nerve, diagnosed as idiopathic peripheral neuropathy of the lower left extremity. The examiner should respond to the follow: (a) Whether the evidence shows the Veteran had early onset peripheral neuropathy that manifested to a degree of 10 percent or more within a year after the last date on which he was exposed to an herbicide agent during active duty. The Board notes that the Veteran indicated in his June 2009 application for compensation that he served in Vietnam through 1972. (b) If the examiner finds that the evidence does not show the Veteran had early onset peripheral neuropathy that manifested to a degree of 10 percent or more within a year after the last date on which he was exposed to an herbicide agent during active duty, then is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s peripheral neuropathy of the left lower extremity peroneal nerve or tibial nerve began in or is otherwise related to the Veteran’s service? The examiner should specifically consider and discuss the Veteran’s lay assertions that his neuropathy is due to Agent Orange herbicide exposure. The examiner should also specifically consider and discuss the May 2013 VA neurological consultant’s finding of an abnormal nerve conduction study showing acquired axonal and demyelinating neuropathy affecting the left peroneal and left tibial nerves, and that the Veteran has a diagnosis of idiopathic peripheral neuropathy of the left leg. A detailed explanation (rationale) is requested, including citing to supporting clinical data (and/or medical literature), as appropriate. (c) If peripheral neuropathy of the left lower extremity peroneal nerve or tibial nerve is deemed unrelated to service, the examiner should, if possible, identify the cause considered more likely and explain why that is so. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Lin, Associate Counsel