Citation Nr: 21062345
Decision Date: 10/07/21	Archive Date: 10/07/21

DOCKET NO. 17-44 383
DATE: October 7, 2021

REMANDED

Entitlement to service connection for peripheral neuropathy is remanded.

REASONS FOR REMAND

The Veteran had active duty service from October 1966 to October 1968.

This matter comes before the Board of Veterans' Appeals (Board) from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

The Board remanded the Veteran's claim in March 2020 to obtain an addendum opinion addressing the nature and etiology of the claimed for condition. For reasons discussed at greater length below, the Board does not find there has been substantial compliance with its March 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order).

Entitlement to service connection for peripheral neuropathy is remanded.

In remanding the Veteran's claim, the Board requested that a VA medical examiner provide an additional medical opinion if it was found that the claimed for peripheral neuropathy condition is not at least as likely as not related to herbicide exposure. See March 2020 Board remand. Specifically, the Board requested that the VA examiner opine as to the etiology of the Veteran's claimed condition, to include identifying other known risk factors, other than herbicide exposure, for the development of his condition. Id. While the Veteran suggested that his condition may be caused by either his diabetes mellitus, seizure disorder, or hypokalemia, neither VA medical examiner addressed the aforesaid statements or opined as to the etiology of the Veteran's condition as requested in the March 2020 remand directives. See December 2020 VA medical opinion; April 2021 VA medical opinion. While the December 2020 examination confirmed a diagnosis, the April 2021 opinion appears to suggest that there is no diagnosis. Accordingly, the Board ultimately finds that its March 2020 remand directives have not been substantially complied with, requiring an additional remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998).

The matters are REMANDED for the following action:

1. Obtain an addendum medical opinion from an appropriate clinician, addressing the nature and etiology of the Veteran's peripheral neuropathy. 

Upon review of the pertinent evidence of record, to include this remand, the VA medical examiner is requested to opine as to all of the following:

a.) Identify the etiology of the Veteran's claimed for peripheral neuropathy condition.  Special attention is invited to the August 2014 compensation examination in which several other causes are ruled out (i.e., no evidence of radiculopathy due to his back condition, the lack of a diabetes diagnosis). See VBMS, document labeled, C&P Exam, receipt date September 10, 2014, page 12. 

b.) Opine as to whether the determined etiology for the Veteran's claimed for peripheral neuropathy condition is at least as likely as not (50 percent probability or greater) directly related to the Veteran's active duty military service. 

The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. 

 

Bethany L. Buck

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S.R. Fey, 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.