Citation Nr: 21000091 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 20-10 909 DATE: January 4, 2021 REMANDED Entitlement to service connection for a bilateral tibial nerve condition is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1968 to January 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied the Veteran service connection for a bilateral tibial nerve condition. The Veteran requested a hearing before the Board. See February 2020 VA Form 9. However, in June 2020, the Veteran submitted a statement indicating he wished to withdraw his hearing request. Accordingly, the Veteran’s hearing request is withdrawn. 38 C.F.R. § 20.702(d). The Board notes that the Veteran is service connected for bilateral lower extremity diabetic neuropathy affecting his sciatic nerve. The Veteran asserts that he has a “compromise of the tibial nerve” that had its onset in service. See November 2017 VA Form 21-526, January 2019 Notice of Disagreement. In support of his claim, he submitted private medical records wherein a physician found “evidence of a compromise of the tibial nerve at or about the tarsal.” See November 2017 private medical records. Additionally, service treatment records show treatment for intermittent numbness in the Veteran’s left lower extremity. See STRs. The Veteran was afforded VA examinations as to his diabetic neuropathy affecting his sciatic nerve. However, none of the examiners have found a tibial nerve condition, provided an opinion as to the presence of a “compromise of the tibial nerve,” or have otherwise provided an opinion as to its etiology. Indeed, the record shows that the Veteran’s alleged tibial nerve condition could potentially be related to his service-connected diabetes mellitus or active duty service. There is no competent medical evidence of record for the Board to determine whether the Veteran’s alleged compromise of the tibial nerve is related to either his service-connected diabetes or active duty service. See McClendon v. Nicholson, 20 Vet. App. 79, 84 (2006). Thus, a remand is necessary for a medical opinion as to these raised etiological theories. The matter is REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his bilateral tibial nerve condition that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative should be notified, and the record clearly documented. 2. After the above development is completed, obtain an opinion from an appropriately qualified clinician to determine the nature and etiology of the Veteran’s claimed tibial nerve condition. The evidentiary record, including a copy of this remand, must be made available and reviewed by the clinician. The opinion should include a notation that this record review took place. It is up to the discretion of the reviewing clinician as to whether a new examination is necessary to provide an adequate opinion. After the record review, and examination if deemed necessary, the reviewing clinician is asked to respond to the following inquiries: A. Is it at least as likely as not that the Veteran’s bilateral tibial nerve condition was incurred in, or is otherwise related to, his time on active service, to include documented numbness therein? B. Is it at least as likely as not that the Veteran’s tibial nerve condition was (a.) caused or (b.) aggravated by his service-connected disabilities, to include diabetes mellitus? The reviewing clinician should consider the October 2017 private medical record finding that the Veteran has a compromise of the tibial nerve. See November 2017 private medical records. The reviewing clinician should also consider an October 1969 service treatment record showing treatment for the Veteran’s left lower extremity intermittently falling asleep. In rendering this opinion, the reviewing clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the reviewing clinician rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The reviewing clinician is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 3. After the above has been completed to the extent possible, readjudicate the claims. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Strickland 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.