Citation Nr: 20049925 Decision Date: 07/27/20 Archive Date: 07/27/20 DOCKET NO. 15-11 308 DATE: July 27, 2020 REMANDED Entitlement to service connection for peripheral neuropathy, claimed as secondary to herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from August 1969 to April 1971. He served in the Republic of Vietnam (RVN) from June 24, 1970 to April 13, 1971. This matter is on appeal from an October 2012 rating decision. In July 2018, this matter was remanded by the Board for further development. The Veteran contends that he has peripheral neuropathy related herbicide agent exposure during service. Pursuant to the Board’s July 2018 remand, on May 2019 VA peripheral nerves condition Disability Benefits Questionnaire examination, the examining physician diagnosed bilateral upper and lower extremities peripheral neuropathy. In a May 2019 VA medical opinion in favor of the claim, the examining physician opined that the claimed peripheral neuropathy was at least as likely as not incurred in or caused by the claimed inservice injury, event, or illness. The rationale was that the Veteran’s examination revealed sensory deficits for all four extremities and that peripheral neuropathy is a recognized presumed disability for anyone in service in Vietnam. However, in a second VA medical opinion also issued in May 2019 the same VA examining physician opined that the claimed peripheral neuropathy was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale was that peripheral neuropathy was not manifested during the Veteran’s period of active service and medical records were silent for complaints of peripheral neuropathy during active service. Therefore, it is less likely than not that the Veteran’s peripheral neuropathy was manifested during service. In a third May 2019 VA medical opinion the VA examining physician opined that the claimed peripheral neuropathy was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale was that the Veteran’s disability did not manifest within one year of his separation from service. Since the VA examining physician offered seemingly contradictory medical opinions which in support of and against the claim, on remand an addendum VA medical opinion should be obtained to reconcile the record. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matters are REMANDED for the following action: Obtain an appropriate addendum from the May 2019 VA examiner (or to a VA examiner of appropriate expertise if the May 2019 examiner is no longer available) regarding the nature and etiology of the Veteran’s peripheral neuropathy. The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. The examiner must provide the following opinion(s): Is it at least as likely as not (50 percent probability or more) that the Veteran's currently diagnosed peripheral neuropathy had its onset in or is etiologically-related to the Veteran’s active duty service, to include herbicide agent exposure? The report of examination should include the complete rationale for all opinions expressed. The examiner should address, as appropriate, the pertinent evidence of record to include the Veteran’s lay statements and complaints concerning the onset of his peripheral neuropathy. The phrase “at least as likely as not” does not mean within the realm of medical possibility, but rather the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of that conclusion as it is to find against it. If an opinion cannot be rendered without resorting to speculation, the physician should explain why it would be speculative to respond. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Adams, 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.