Citation Nr: 21061501 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 11-15 227 DATE: October 4, 2021 REMANDED Entitlement to service connection for peripheral neuropathy, right upper extremity, to include as secondary to degenerative disc disease (DDD) of the lumbar spine is remanded. Entitlement to service connection for peripheral neuropathy, left upper extremity, to include as secondary to DDD of the lumbar spine, is remanded. Entitlement to service connection for peripheral neuropathy, right lower extremity, to include as secondary to DDD of the lumbar spine, is remanded. Entitlement to service connection for peripheral neuropathy, left lower extremity, to include as secondary to DDD of the lumbar spine, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1967 to December 1969. He served in the Republic of Vietnam during the Vietnam War. These matters are before the Board of Veterans' Appeals (Board) on appeal from a May 2010 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). In June 2018 and August 2020, the Board remanded these claims for additional development. The Veteran asserts that he experiences peripheral neuropathy of the bilateral upper and lower extremities, and these conditions arose as due to his active service. In its August 2020 remand, the Board requested that the Veteran be scheduled for a VA examination for peripheral nerve conditions. The examiner was asked to identify all peripheral nerve conditions present during the period on appeal and to provide an etiology opinion for the Veteran's claimed conditions. During the Veteran's January 2021 VA examination for peripheral nerve conditions and the accompanying June 2021 VA medical opinions, the VA examiner did not address which conditions were present during the period on appeal and did not provide adequate rationales for their etiology opinions. The examiner found no symptoms of peripheral neuropathy of the upper extremities, but they did not discuss the November 2019 VA examination, which found the Veteran's left upper extremity exhibited symptoms of peripheral neuropathy but required further testing to determine the cause. The 2021 examiner did find the Veteran was positive for bilateral peripheral neuropathy of the lower extremities. However, they found these conditions were less likely than not due to service, as they were diagnosed in 2013. The examiner's rationale does not consider the Veteran's exposure to herbicides during service or provide a medical foundation for their conclusions. Based on these facts, the Board finds the 2021 VA examination report and medical opinions to be inadequate for adjudication purposes. Accordingly, these matters must be remanded so that the Veteran can be afforded an adequate VA examination. The matters are REMANDED for the following action: Schedule the Veteran for an appropriate VA examination by a qualified examiner to determine the nature and etiology of the Veteran's claimed bilateral upper and lower extremity peripheral nerve conditions. The entire claims folder should be made available to and reviewed by the examiner. All necessary tests should be performed, all findings should be reported in detail, and all opinions must be supported by a rationale. The examiner must comment upon the following: (a) The examiner is asked to identify all peripheral nerve conditions of the upper or lower extremities present during the period on appeal, even if currently resolved. If no condition is found during the period on appeal, the examiner should explain the reasoning for this conclusion, in light of the November 2019 examination findings as to the upper extremities. (b) An opinion must be provided as to whether it is at least as likely as not (i.e. a 50 percent or greater probability) that the Veteran's bilateral peripheral neuropathy of the upper and lower extremities is otherwise etiologically related to service, including herbicide exposure. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Hicks, 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.