Citation Nr: 20003334 Decision Date: 01/14/20 Archive Date: 01/14/20 DOCKET NO. 08-29 744A DATE: January 14, 2020 REMANDED Entitlement to service connection for a bilateral lower extremity disability manifested by weakness and/or numbness, other than already service-connected bilateral lumbar radiculopathy and/or a bilateral knee disability is remanded. Entitlement to service connection for a bilateral upper extremity disability manifested by weakness and/or numbness, other than already service-connected bilateral carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1997 to October 2006. 1. Entitlement to service connection for a bilateral lower extremity disability manifested by weakness and numbness, other than already service-connected bilateral lumbar radiculopathy and a bilateral knee disability is remanded. 2. Entitlement to service connection for a bilateral upper extremity disability manifested by weakness and numbness, other than already service-connected bilateral carpal tunnel syndrome is remanded. The Veteran seeks service connection for bilateral upper and lower extremity disabilities characterized by numbness and muscle weakness, other than her already service-connected bilateral carpal tunnel syndrome, bilateral lumbar radiculopathy, and bilateral knee patellofemoral pain syndrome and degenerative arthritis. The Veteran has been diagnosed with diabetic peripheral neuropathy, which she contends is related to an episode of gestational diabetes in service. Some treatment records have also suggested the Veteran may suffer from cervical radiculopathy or fibromyalgia. In May 2018, a VA examiner diagnosed the Veteran with peripheral neuropathy of the bilateral upper and lower extremities. He opined that this peripheral neuropathy is at least as likely as not related to service. Unfortunately, he failed to provide a rationale for his opinion, merely stating that “medically there is a pathophysiological relationship between chronic diabetes and peripheral neuropathy.” However, since the Veteran was not diagnosed with chronic diabetes in service or within one year of service and is not otherwise service connected for diabetes, the relevance of this statement to the issue of whether the Veteran's peripheral neuropathy is related to her active service is unclear. Additionally, the VA medical examiner concluded that the Veteran's neurological symptoms in her upper extremities were attributable to peripheral neuropathy, not cervical radiculopathy, but again failed to explain his conclusion. Because the VA examiner’s rationale for his conclusions is alternatively irrelevant or nonexistent, the Board finds that the May 2018 VA medical opinion is inadequate and a remand is required for a new opinion. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from October 2019 to the Present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any disability manifested by numbness and/or muscle weakness in the bilateral upper extremities, other than that attributable to already service-connected bilateral carpal tunnel syndrome (CTS). For each identified condition, the examiner must opine whether any disability found, other than CTS, is at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s in-service complaints of upper extremity pain and tingling and her gestational diabetes. The examiner should also opine whether any condition found, other than CTS, is at least as likely as not (1) proximately due to a service-connected disability, to include cervical degenerative disc disease or bilateral CTS or (2) aggravated beyond its natural progression by service-connected disability, to include cervical degenerative disc disease or bilateral CTS. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any disability manifested by numbness and/or muscle weakness in the bilateral lower extremities, other than that attributable to already service-connected lumbar radiculopathy or patellofemoral pain syndrome with degenerative arthritis of the knees. For each identified condition, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s in-service complaints of lower extremity pain and tingling and her gestational diabetes. The examiner should also opine whether any disability found is at least as likely as not (1) proximately due to a service-connected disability, to include lumbar radiculopathy or patellofemoral pain syndrome with arthritis of the knees or (2) aggravated beyond its natural progression by service-connected disability, to include lumbar radiculopathy or patellofemoral pain syndrome with degenerative arthritis of the knees. 3. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.D. Anderson, 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.