Citation Nr: 20003503 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 16-31 087 DATE: January 16, 2020 REMANDED Entitlement to service connection for peripheral neuropathy, left upper extremity, is remanded. Entitlement to service connection for peripheral neuropathy, right upper extremity, is remanded. REASONS FOR REMAND The Veteran had active military service, including from April 1969 to April 1973 and from December 1990 to May 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of a VA Regional Office (RO). In October 2018, the Board remanded the claims. In the Board’s October 2018 remand, the Board instructed the RO to afford the Veteran a new VA examination on the nature and etiology of his claimed peripheral neuropathy of the upper and lower extremities. The VA examiner was instructed to indicate whether the Veteran had peripheral neuropathy in his upper extremities and, if not, to reconcile the finding with prior medical records. During the Veteran’s May 2019 VA examination for peripheral neuropathy, the VA examiner found that the Veteran did not have peripheral neuropathy in his upper extremities and noted that the Veteran’s carpal tunnel syndrome of the right upper extremity was not likely related to his diabetes. The examiner did find that the Veteran suffered from mild intermittent pain, paresthesias and/or dysesthesias, and numbness in both upper extremities; however, they did not offer an etiological opinion or explanation for these symptoms. Accordingly, the Board finds that an additional remand is necessary so that an addendum opinion can be obtained to clarify whether the symptoms noted by the May 2019 examiner are due to peripheral neuropathy or a service-connected disability. Additionally, there has not been substantial compliance with the Board’s previous remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Make efforts to obtain all outstanding medical records in accordance with the duties set forth in 38 C.F.R. § 3.159(c). 2. Obtain an addendum opinion from the May 2019 examiner, or another appropriate clinician, to determine the nature and etiology of the Veteran’s upper extremity symptoms, including numbness, pain, and paresthesias and/or dysesthesias. The claims folder must be reviewed by the examiner. The need for a physical examination is left to the discretion of the clinician providing the opinion. The examiner must state whether the Veteran’s upper extremity symptoms are due to peripheral neuropathy or another condition and should provide an explanation for their conclusions. Additionally, the examiner must opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s symptoms are caused or aggravated by his service-connected diabetes or are otherwise causally related to any event or circumstance of his service. A fully-explained rationale for the requested opinion should be provided. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Hicks, Associate 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.