Citation Nr: 21004333 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 17-15 218 DATE: January 26, 2021 REMANDED The claim of entitlement to service connection for neuropathy of the right lower extremity is remanded. The claim of entitlement to service connection for neuropathy of the left lower extremity is remanded. The claim of entitlement to service connection for gastritis, to include as secondary to service-connected disabilities and/or the medication taken therefor, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to October 1981 and from November 1987 to November 1991. His claims come before the Board of Veterans' Appeals (Board) on appeal of a December 2015 Department of Veterans Affairs (VA) rating decision. In October 2019, the Board denied this claim. The Veteran then appealed the Board's decision to the United States Court of Appeals for Veterans Claims. In August 2020, based on a Joint Motion For Partial Remand (joint motion), the Court, in pertinent part, remanded these claims to the Board for action consistent with the terms of the joint motion.   Entitlement to service connection for neuropathy of the right lower extremity Entitlement to service connection for neuropathy of the left lower extremity The Board initially denied these claims on the basis that there is no lower extremity neuropathy diagnosis of record or evidence indicating persistent or recurrent symptoms of a neurologic or nerve condition affecting the Veteran’s lower extremities. In their joint motion, the parties to this appeal agree that, in so finding, the Board failed to consider the Veteran’s reports of leg complaints made during an August 2010 VA back examination and March 2016, April 2016 and February 2017 primary care treatment visits. As these reports refer to lay-observable lower extremity symptoms and are therefore competent, an examination is needed to address whether these symptoms are attributable to a neurological disability or the Veteran’s service-connected back disability. In addition, in a January 2021 rating decision, the Agency of Original Jurisdiction (AOJ) granted the Veteran service connection for radiculopathy of the right lower extremity. It is unclear whether the AOJ’s decision in this regard satisfies the Veteran’s claim for service connection for neuropathy in the right lower extremity. Radiculopathy results from the pinching of root nerves of the spinal column while neuropathy results from peripheral nerve damage and encompasses a wider array of issues. https://go-imaging.com/blog/mri/the-difference-between-radiculopathy-and-neuropathy/. Additional medical guidance is therefore needed. Entitlement to service connection for gastritis, to include as secondary to service-connected disabilities and/or the medication taken therefor The Board initially denied this claim on the basis that there is no gastritis diagnosis of record. As the parties to this appeal have pointed out, however, the Veteran is claiming entitlement to service connection for a digestive system disability, however diagnosed, including as gastritis, gastroesophageal reflux disease (GERD) and/or dyspepsia. He claims that this disability developed secondary to medication taken for his service-connected disabilities. As the Veteran sought treatment and underwent testing for digestive system complaints during the course of this appeal, an examination is needed to address whether any digestive system disability is related his service-connected disabilities, to include the medication taken therefor. These matters are REMANDED for the following action: 1. Afford the Veteran a VA neurological disability examination for the purpose of addressing the etiology of his lower extremity complaints. The examiner should review all pertinent evidence of record, including: rating decisions showing the Veteran is service connected for a back disability, residuals of cold exposure affecting both lower extremities and radiculopathy of the right lower extremity; service and post-service treatment records showing lower extremity complaints, including aching, tingling and painful legs; the Veteran’s statements describing these symptoms; the October 2020 VA back examination referring to right lower extremity complaints; and the parties’ joint motion. The examiner should record in detail the Veteran's history of lower extremity complaints, including since service. The examiner should list all lower extremity neurological symptoms shown to exist on examination and/or which were reported or noted during the course of this appeal. The examiner should indicate which of the findings are attributable to the Veteran’s service-connected cold exposure disability and which are attributable to his service-connected right lower extremity radiculopathy. The examiner should indicate whether the Veteran has neuropathy in either lower extremity, including separate and distinct from the radiculopathy in the right lower extremity. The examiner should also indicate whether the Veteran has any other neurological disability in his left lower extremity. Accepting as competent any reports of lay-observable neurological symptoms, the examiner should opine whether any lower extremity neurological disability is at least as likely as not (50 percent or greater probability) related to the Veteran’s service or initially manifested therein. If not, the examiner should opine whether such disability, including symptoms thereof, is due to, the result of, or aggravated by, the Veteran’s service-connected back disability, cold exposure residuals and/or right lower extremity radiculopathy. The examiner should provide rationale for each opinion. 2. Afford the Veteran a VA digestive system disability examination for the purpose of addressing the etiology of his digestive system complaints. The examiner should review all pertinent evidence of record, including post-service treatment records showing complaints of and testing for digestive system complaints and the parties’ joint motion. The examiner should record in detail the Veteran's history of digestive system complaints, including in relation to when he started taking medication for his service-connected disabilities. The examiner should diagnose any digestive system disability shown on examination or which was diagnosed during the course of this appeal, including GERD and dyspepsia. Accepting as competent any reports of lay-observable digestive system symptoms, the examiner should opine whether such disability is at least as likely as not (50 percent or greater probability) related to the Veteran’s service or initially manifested therein. If not, the examiner should opine whether such disability is due to, the result of, or aggravated by, the Veteran’s service-connected disabilities, including the medication taken therefor. The examiner should provide rationale for each opinion. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. N. 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.