Citation Nr: A20008699 Decision Date: 05/15/20 Archive Date: 05/15/20 DOCKET NO. 191009-37493 DATE: May 15, 2020 REMANDED Entitlement to service connection for bilateral lower extremity disabilities, to include peripheral neuropathy, varicose veins and a left leg and ankle condition, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1964 to November 1968, including over three years of foreign service. A brief recitation of this case’s procedural history is instructive. A Department of Veterans Affairs (VA) Regional Office (RO) initially denied the claim at bar in an August 2014 rating decision. The Veteran later perfected his appeal under the legacy system by filing a substantive appeal in May 2016. In March 2018, the Veteran withdrew his appeal from the legacy system and opted into the modernized review system (known by the Board as the AMA) by electing to participate in the Rapid Appeals Modernization Program (RAMP); the Veteran selected the higher-level review lane. Pursuant to that election, the Veteran agreed that the evidence window for his appeal would close as of the date of his election (March 12, 2018). In September 2018, the RO issued a RAMP higher-level rating decision that continued his denial. In response, in October 2018, the Veteran submitted a RAMP review request under the supplemental claim lane. In January 2019, the RO again denied the Veteran’s claim for service connection. In October 2019, the Veteran filed a notice of disagreement to the Board of Veterans’ Appeals (Board); the Veteran selected the direct review docket. As a result of the Veteran’s election, the Board may analyze all evidence in the Veteran’s file at the time of the January 2019 supplemental claim rating decision. The Veteran seeks service connection for peripheral neuropathy of the bilateral lower extremities. He contends that his disability relates to an in-service injury he suffered to his left ankle. In support of his contention, the Veteran has submitted opinions from his private doctor which diagnose him as suffering from peripheral neuropathy of the bilateral lower extremities that is related to the Veteran’s in-service injury. These opinions, however, are inadequate. For instance, the private doctor states that neuropathy can result from injuries, but he has never explained why the Veteran would have bilateral neuropathy when only his left ankle was injured in service. VA examinations and opinions are similarly unavailing. They have determined that the Veteran suffers from peripheral neuropathy, but they attribute it to his long, post-service career as a postal worker, resulting in varicose veins and peripheral neuropathy. None of these examinations, however, have sufficiently addressed the Veteran’s in-service injury or stated whether any of his subsequent conditions may be related to that injury. At this point, given the number of diagnoses present, the Board has broadened the Veteran’s claim to include all possible claims for his bilateral lower extremities, to include orthopedic residuals of his in-service injury, peripheral neuropathy, and bilateral varicose veins. Given the insufficiencies of the various opinions of record, the Board remands the issue for an adequate opinion. The matters are REMANDED for the following action: Obtain a VA opinion responsive to the Board’s questions below. If the reviewing examiner determines that an opinion may not be offered without first examining the Veteran, then schedule the Veteran for an appropriate examination. Regardless of whether an examination is performed, the examiner is to review the Veteran’s claims file – including this remand – before answering the Board’s questions below. (a) From what current disabilities of the bilateral lower extremities does the Veteran suffer? Is there evidence of any orthopedic disability of the left lower extremity? (b) For all identified disabilities, state whether it is at least as likely as not that any such disabilities are related to the Veteran’s in-service left ankle injury. In answering this question, the examiner is to acknowledge and discuss the in-service treatment records, the Veteran’s statements, and the statements from his private physician. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. K. Hall, 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.