Citation Nr: 20002597 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 17-07 180 DATE: January 14, 2020 REMANDED Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities, to include as secondary to herbicide agent exposure and/or the Veteran’s service-connected prostate cancer, is remanded. REASONS FOR REMAND The Veteran had active service from September 1967 to March 1971, to include service in the Republic of Vietnam. In connection with this appeal, the Veteran testified at a hearing before the undersigned in October 2019. The Veteran asserts that his peripheral neuropathy of the bilateral lower extremities is due to his presumed herbicide agent exposure. The Veteran’s treatment records show that he was first diagnosed with peripheral neuropathy of the bilateral lower extremities in February 2013. In March 2016, he was diagnosed with peripheral polyneuropathy. In December 2016, the Veteran reported that his peripheral neuropathy of the bilateral lower extremities had to be due to herbicide agent exposure as he had no other conditions that would result in peripheral neuropathy. He also submitted medical articles discussing the relationship between herbicide agent exposure and peripheral neuropathy. In February 2018, the Veteran’s physician reported that the most likely cause of the Veteran’s polyneuropathy was his history of prostate and kidney cancer. As such, a remand is necessary to adjudicate the service connection claim for peripheral neuropathy of the bilateral lower extremities. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to assist in determining the nature and etiology of the diagnosed peripheral neuropathy of the bilateral lower extremities. The examiner should offer the following opinions: a. Is it at least as likely as not (50 percent or greater probability) that the Veteran’s peripheral neuropathy of the bilateral lower extremities either began during or was otherwise caused by his active service? Why or why not? b. Is it at least as likely as not (50 percent or greater probability) that the Veteran’s peripheral neuropathy of the bilateral lower extremities was caused by his presumed exposure to herbicide agents, including Agent Orange, during active service? Why or why not? In answering this question, the VA examiner should note that the Veteran is presumed to have been exposed to herbicide agents during service. The examiner should discuss the findings of the Veteran’s physician regarding the etiology of his peripheral neuropathy, the medical articles discussing the relationship between herbicide agent exposure and peripheral neuropathy, and the lay statements of the Veteran. c. Is it at least as likely as not (50 percent or greater) that any peripheral neuropathy of the bilateral lower extremities was caused by a service-connected disability, such as his prostate cancer? Why or why not? d. Is it at least as likely as not (50 percent or greater) that any peripheral neuropathy of the bilateral lower extremities was aggravated (made worse) by a service-connected disability? Why or why not? If aggravation is found, the examiner should identify the baseline level of severity of the peripheral neuropathy of the bilateral lower extremities before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the peripheral neuropathy of the bilateral lower extremities. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berryman, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.