Citation Nr: 21064606
Decision Date: 10/21/21	Archive Date: 10/21/21

DOCKET NO. 16-31 732
DATE: October 21, 2021

REMANDED

The claim for service connection for peripheral poly neuropathy secondary to herbicide exposure is remanded.

REASONS FOR REMAND

The Veteran had active service from September 1961 to June 1965.

The Veteran seeks service connection for peripheral polyneuropathy that he believes is the result of his herbicide exposure during military service.  The Veteran concedes that his diagnosis is outside the presumptive period since he received his first diagnosis in 1990; however, the Veteran may still establish service connection on a direct basis for this condition.

In support of his claim, the Veteran has provided extensive private treatment records confirming his diagnosis of very severe axonal sensorimotor polyneuropathy and IgG Kappa Monoclonal Gammopathy. See Medical Treatment Records  Non-Government Facility received December 5, 2014.

In a June 2013 private treatment note, the Veteran's physician Dr. Cline indicated the likelihood that his neuropathy was a consequence of his IgG kappa monoclonal gammopathy, which is similar to multiple myeloma "just without the neoplastic cells although presumably there is a clone of plasma cells inappropriately generating the excess IgG kappa. One could make an argument then that exposure to Agent Orange has a causal connection with the monoclonal gammopathy, and therefore causal connection to his neuropathy."  While this opinion is speculative, it raises a potential connection between these conditions and herbicide exposure.  

The Board cannot make a fully-informed decision on the issue service connection for peripheral polyneuropathy because no VA examiner has opined whether there is a conection between peripheral polyneuropathy and IgG kappa monoclonal gammopathy and Agent Orange.  A VA examination is warranted in this case.  

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination to assist in determining the nature and etiology of the diagnosed peripheral polyneuropathy and IgG kappa monoclonal gammopathy.  The examiner should offer the following opinions:

(a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's peripheral polyneuropathy is the result of his military service, to include as a result of his presumed herbicide exposure therein?  Why or why not?

(b.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's IgG kappa monoclonal gammopathy is the result of his military service, to include as a result of his presumed herbicide exposure therein?  Why or why not?

The examiner should discuss the Veteran's private physician's statements regarding the connection between Agent Orange and IgG kappa and neuropathy.  See 12/5/2014 Medical Treatment Records  Non-Government Facility (page 18 of 36).

The examiner is advised that a negative opinion cannot be based solely on the fact that the IgG kappa monoclonal gammopathy is not on the list of diseases that are presumptively associated with exposure to herbicide agents.

 

 

MATTHEW W. BLACKWELDER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Jennifer M. Narvaez, 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.