Citation Nr: 21064016 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 18-02 620 DATE: October 18, 2021 REMANDED 1. Entitlement to service connection for lower left peripheral neuropathy is remanded. 2. Entitlement to service connection for lower right peripheral neuropathy is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1969 to May 1971. The matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision of a Veterans Affairs (VA) Regional Office (RO). In July 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge; a transcript of the hearing is of record. Although the Board regrets the additional delay, a remand is necessary to ensure there is a complete record on which to decide the Veteran's claim. The Veteran contends that his disability is related to exposure to herbicide agents while serving in the Republic of Vietnam and that symptoms of the neuropathy manifested within two months of his return. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. See 38 U.S.C. § 1110 (2018); 38 C.F.R. § 3.303 (2020); see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The RO has found that Veteran is presumed to have been exposed to herbicide agents while in the Republic of Vietnam. See January 9, 2018 Statement of the Case. However, for service connection for peripheral neuropathy to be granted based on presumption to such exposure, the condition is required to have been diagnosed to a compensable degree within one year from last exposure to herbicide agents. 38 C.F.R. § 3.307. Likewise, service connection may be granted on a non-presumptive basis if the evidence otherwise demonstrates that the condition is related to exposure to herbicide agents. The Veteran has testified and presented additional lay statements that he has had neurological problems with his legs following his return from his second tour in Vietnam. Prior nerve studies and podiatry consults did not find evidence to render a functional diagnosis. During a May 2017 VA examination the examiner diagnosed neuropathy of the feet and remarked that a neurological referral was needed for definitive diagnosing to include repeat electromyography (EMG) testing, nerve, and skin biopsies to diagnose the underlying etiology of the Veteran's polyneuropathy. There is an indication that the Veteran's disability may be related to service, but there is insufficient competent evidence in the file to decide the claim. A VA examination is warranted to determine the nature and etiology of the Veteran's peripheral neuropathy of the bilateral lower extremities. The matters are REMANDED for the following action: 1. Obtain any outstanding medical records relevant to the Veteran's claim of peripheral neuropathy of the bilateral lower extremities. 2. Schedule the Veteran for a VA neurological examination by an appropriate clinician to determine the nature and etiology of his peripheral neuropathy of the bilateral lower extremities. The claims file should be reviewed by the examiner. Any necessary tests, specifically including EMG testing, nerve testing, and skin biopsies, should be conducted if the Veteran consents to such testing. a) The examiner should offer an opinion as to whether it is at least likely as not (50 percent probability or greater) that the Veteran's peripheral neuropathy arose during service or is otherwise related to service, to include as due to his acknowledged exposure to herbicide agents. In offering the opinion, the examiner is asked to consider whether the condition may be related to exposure to herbicide agents even though there is only a presumptive relationship when peripheral neuropathy manifests within one year of such exposure. The examiner must address the Veteran's lay statements regarding the onset of (Continued on the next page) symptoms. A complete medical rationale must be provided for any opinion expressed. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C.L. Hamilton, 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.