Citation Nr: 20003995 Decision Date: 01/16/20 Archive Date: 01/16/20 DOCKET NO. 19-08 048 DATE: January 16, 2020 REMANDED The claim of entitlement to service connection for peripheral neuropathy, right upper extremity (hereinafter RUE) is remanded. The claim of entitlement to service connection for peripheral neuropathy, left lower extremity (hereinafter LLE) is remanded. REASONS FOR REMAND The Veteran had honorable active duty service with the United States Army from December 1989 to November 1993, to April 1995 to May 1995. These matters are before the Board of Veteran’s Appeals (Board) from an October 2013 and November 2014 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee, that denied service connection for peripheral neuropathy for RUE and LLE. The Board notes that the Veteran’s claims above were previously claimed as secondary to a thoracolumbar and/or cervical spine condition, however the Board decision issued in December 2018 denied reopening the Veteran’s claims for service connection for either spinal condition. The Board finds that the Board’s December 2018 decision is final and therefore is not on appeal. The Veteran does a have a right to refile for service connection for a spinal condition if deemed warranted. The Board’s decision issued December 2018 remanded the above issues to have the RO issue a Statement of the Case (SOC) which was issued January 2019. Entitlement to service connection for peripheral neuropathy, RUE See below. Entitlement to service connection for peripheral neuropathy LLE The Veteran contends that he is entitled to service connection for peripheral neuropathy RUE and LLE. To date the Veteran has not had a VA examination for his peripheral neuropathy. The Veteran has been diagnosed with upper extremity peripheral neuropathy and his VA treatment records noted median motor compression in his wrists in December 2007, and in September 2009 and confirmed in May 2018 he was found to have a moderate ulnar conduction block both above and below the right elbow along with prolonged ulnar sensory peak latency with reduced sensory nerve action. In August 2010 the Veteran was noted as having moderate right ulnar neuropathy and in December 2010 the Veteran complained of persistent numbness with possible decrease in grip strength. The Board notes that the Veteran has consistent complaints and treatment of neuropathic pain. The Veteran’s service treatment records indicated a broken right wrist of which the Veteran is service connected at 10 percent disabling as of May 2003. The Veteran’s VA spinal examination in November 2014 indicated LLE radiculopathy with sciatic nerve involvement with moderate pain, mild parasthesia and mild numbness. The Veteran is also noted in his VA treatment records as having reports of neuropathic pain in his legs associated with back pain as indicated in December 2006 which were noted as possible neuropathies and March 2015 noted as neuropathic pain. However, in July 2006, the Veteran’s correspondence indicated that his left leg numbness, pain, and tingling was due to a motor vehicle accident in July 1992 in service. Additionally, the Board notes that the Veteran was treated in service for left knee pain which caused pain while standing, with noted popping and crepitus, diagnosed as strained ligaments in March 1992. The Board notes there is no competent medical opinion as to whether the Veteran’s RUE and LLE peripheral neuropathy are due to or caused by his active duty service as the Veteran alleges - as such there is insufficient competent medical evidence of record to make a determination of the Veteran’s claims. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159 (c)(4)(i) (2018). The Board further notes that the Veteran’s representative requested that the Veteran receive a VA examination for his claims. See Appellate Brief submitted October 2019. Although further delay is regrettable, the Board finds that a remand is necessary in this case to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claims so that he is afforded every possible consideration. 38 U.S.C. § 5103(A) (2012); 38 C.F.R. § 3.159 (2018). These matters are REMANDED for the following actions: 1. The Veteran should be scheduled for a VA examination regarding his peripheral neuropathy. Have the examining physician/specialist provide information to demonstrate that they are qualified to offer the above requested opinion (such as a curriculum vitae or similar demonstrable documentation). This information is to be associated with the Veteran’s claims file. The Veteran’s claims file and a copy of this remand must be provided to the examiner for review and the examination report should reflect that these items were available for review. After performing all indicated tests and studies, the examiner should address the following: (a.) For each identified RUE and LLE peripheral neuropathy opine as to whether it is at least as likely as not that this disability manifested during, or as a result of, active military service. The examiner should consider the Veteran’s motor vehicle accident in July 1992. (b.) The examiner should also provide an opinion as to whether it is at least as likely as not that any currently RUE and LLE peripheral neuropathy was either (1) caused by, or (2) aggravated by, a service-connected disability. An opinion should be provided for each. The term “aggravation” in the above context refers to a permanent worsening of the underlying condition, beyond its natural progression, as contrasted to temporary or intermittent flare-ups of symptomatology which resolve with return to the baseline level of disability. In formulating the above opinions, the examiner must consider and discuss all lay statements and assertions provided by the Veteran. A complete rationale must be provided for any and all opinions offered. If any requested opinion cannot be provided without resorting to mere speculation, the examiner must fully explain why this is the case and identify what, if any, additional evidence or information might allow for a more definitive opinion. (CONTINUED NEXT PAGE) 2. Following completion of the foregoing, the Agency of Original Jurisdiction (AOJ) should review the record, perform any necessary development, and readjudicate the claim on appeal. If the appeal is denied, the AOJ should issue an appropriate Supplemental Statement of the Case (SSOC), afford the Appellant and his representative an opportunity to respond, and return the case to the Board. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C.A. Teich, 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.