Citation Nr: 21003910 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 18-42 784A DATE: January 25, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the right lower extremity as secondary to service-connected coronary artery disease/ischemic heart disease is remanded. Entitlement to service connection for peripheral neuropathy of the left lower extremity as secondary to service-connected coronary artery disease/ischemic heart disease is remanded. Entitlement to service connection for peripheral neuropathy of the right upper extremity as secondary to service-connected coronary artery disease/ischemic heart disease is remanded. Entitlement to service connection for peripheral neuropathy of the left upper extremity as secondary to service-connected coronary artery disease/ischemic heart disease is remanded. Entitlement to an evaluation in excess of 10 percent for service-connected asbestosis is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1965 to September 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2020, the Veteran testified at a Board video conference hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.902(c) (2019). 38 U.S.C. § 7107(a)(2) (2012). 1-2. Entitlement to service connection for peripheral neuropathy of bilateral lower extremities to include as secondary to service-connected coronary artery disease/ischemic heart disease 3-4. Entitlement to service connection for peripheral neuropathy of bilateral upper extremities to include as secondary to service-connected coronary artery disease/ischemic heart disease Veteran contends peripheral neuropathy of the upper and lower extremities are secondary to service connected coronary artery disease/ischemic heart disease. Alternatively, he contends peripheral neuropathy of the upper and lower extremities is due to agent orange exposure. A July 2015 nerve conduction velocity studies revealed mild peripheral neuropathy with paresthesias. The examiner noted agent orange as potential etiology. The Board notes that the Veteran failed to attend his VA examination scheduled in May 2015. In November 2020, the Veteran testified that that he did not receive timely notice for the VA examination. A remand is warranted to afford the Veteran a VA examination. 5. Entitlement to an evaluation in excess of 10 percent for service-connected asbestosis The most recent VA examination to assess the Veteran’s asbestosis was in November 2016. In November 2020, the Veteran testified that his symptoms have worsened since last examination. Thus, a remand for a VA examination is necessary to determine the current severity of his asbestosis. Updated treatment records should also be requested. The matters are REMANDED for the following action: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated his peripheral neuropathy and asbestosis. After securing any necessary releases, request any relevant records identified that are not duplicates of those in the record. Updated VA treatment records should also be obtained. If any requested records are unavailable or do not exist, the claims file should be annotated to reflect such and the Veteran should be notified of such. 2. Schedule the Veteran for a VA examination to determine the nature of any currently present peripheral neuropathy disability and to obtain an opinion as to whether such is related to service. The claims file should be reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted, and the results reported. After examining the Veteran and reviewing the claims file, the examiner should respond to the following: (a.) Does the Veteran have a current diagnosis of peripheral neuropathy of the bilateral upper extremities and/or bilateral lower extremities? (b.) If so, is it at least as likely as not (50 percent probability or greater) that the condition is related to service, to include the Veteran’s conceded exposure to herbicide agents such as agent orange? The examiner should explain why or why not. (c.) If not related to service, is it at least as likely as not that peripheral neuropathy of the bilateral upper extremities and/or bilateral lower extremities was caused by the service-connected coronary artery disease/ischemic heart disease? The examiner is asked to explain why or why not. (d.) If not caused by the service-connected coronary artery disease/ischemic heart disease, is it at least as likely as not that peripheral neuropathy of the bilateral upper extremities and/or bilateral lower extremities was worsened (aggravated) beyond natural progression by the service-connected coronary artery disease/ischemic heart disease? The examiner is asked to explain why or why not. (e.) If the examiner finds that peripheral neuropathy of the bilateral upper extremities and/or bilateral lower extremities was worsened (aggravated) by the service-connected coronary artery disease/ischemic heart disease, the examiner should attempt to quantify the level of aggravation beyond the baseline level of the peripheral neuropathy of the bilateral upper extremities and/or bilateral lower extremities. (f.) The examiner should provide a rationale for all opinions expressed. 3. Thereafter, schedule the Veteran for a VA examination to address the current severity of his asbestosis. The electronic claims file must be reviewed by the examiner. Any indicated tests and studies must be accomplished and the results reported. If the Veteran’s symptoms are due to a disability other than asbestosis, the examiner should attempt to distinguish between the symptoms related to asbestosis and those from other diagnosed disability. If the examiner is unable to distinguish the symptoms attributable to asbestosis from those attributable to a nonservice-connected disability, the examiner should so state. 4. If the claims remain denied, issue a supplemental statement of the case. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Asare, 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.