Citation Nr: 21066109 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 16-35 029 DATE: October 28, 2021 ORDER Service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy, is denied. Service connection for a left upper extremity disability, to include radiculopathy and peripheral neuropathy, is denied. Service connection for left lower extremity neurologic impairment is granted. REMANDED Entitlement to service connection for a right lower extremity disability, to include radiculopathy and peripheral neuropathy, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. FINDINGS OF FACT 1. The Veteran does not currently have a right upper extremity disability, to include radiculopathy and peripheral neuropathy. 2. The Veteran does not currently have a left upper extremity disability, to include radiculopathy and peripheral neuropathy. 3. The Veteran's left lower extremity neurologic impairment had its onset in service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy, have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1116, 1154(a), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for a left upper extremity disability, to include radiculopathy and peripheral neuropathy, have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1116, 1154(a), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for left lower extremity neurologic impairment have been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1116, 1154(a), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Air Force from February 1969 to September 1970, including service in the Republic of Vietnam. This matter is before the Board of Veterans' Appeals (Board) on appeal of an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), that denied service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy; a left upper extremity disability, to include radiculopathy and peripheral neuropathy; a right lower extremity disability, to include radiculopathy and peripheral neuropathy; and for a left lower extremity disability. The Board finds that it is appropriate to characterize the Veteran's claims more broadly, as listed above. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). By this decision, the RO also denied entitlement to a TDIU. In November 2018, the Board remanded the issues of entitlement to service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy; a left upper extremity disability, to include radiculopathy and peripheral neuropathy; a right lower extremity disability, to include radiculopathy and left lower extremity neurologic impairment, as well as the issue of entitlement to a TDIU, for further development. In May 2021, the Board also remanded the issues of entitlement to service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy; a left upper extremity disability, to include radiculopathy and peripheral neuropathy; a right lower extremity disability, to include radiculopathy and peripheral neuropathy; and for a left lower extremity disability, as well as the issue of entitlement to a TDIU, for further development. 1. Right Upper Extremity Disability, to include Radiculopathy and Peripheral Neuropathy, and Left Upper Extremity Disability, to include Radiculopathy and Peripheral Neuropathy Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table). Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA's policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a). A veteran who served in the Republic of Vietnam during the Vietnam era is presumed to have been exposed during such service to certain herbicide agents (e.g., Agent Orange). In the case of such a veteran, service incurrence for the following diseases will be presumed if they are manifest to a compensable degree within specified periods, even if there is no record of such disease during service: chloracne or other acneform diseases consistent with chloracne, type 2 diabetes, Hodgkin's disease, chronic lymphocytic leukemia, multiple myeloma, non-Hodgkin's lymphoma, acute and sub-acute peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, and trachea), and soft-tissue sarcomas. 38 U.S.C. § 1116; 38 C.F.R. § 3.307 (a)(6), 3.309(e). Effective August 31, 2010, ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina), is included as a disease associated with herbicide exposure under 38 C.F.R. § 3.309 (e). (Under 38 C.F.R. § 3.309 (e), the term ischemic heart disease does not include hypertension or peripheral manifestations of arteriosclerosis such as peripheral vascular disease or stroke, or any other condition that does not qualify within the generally accepted medical definition of Ischemic heart disease. 38 C.F.R. § 3.309 (e) (Note 3.). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and recurrence of symptoms. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence is competent the Board must determine, on a case by case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d at 1377 (Fed. Cir. 2007) (holding that "[w]hether lay evidence is competent and sufficient in a particular case is a factual issue to be addressed by the Board"). The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104(a) (West 2002). Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996). In determining the probative value to be assigned to a medical opinion, the Board must consider three factors. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The initial inquiry in determining probative value is to assess whether a medical expert was fully informed of the pertinent factual premises (i.e., medical history) of the case. A review of the claims file is not required, since a medical professional can also become aware of the relevant medical history by having treated a Veteran for a long period of time or through a factually accurate medical history reported by a Veteran. See Id. at 303-04. The second inquiry involves consideration of whether the medical expert provided a fully articulated opinion. See Id. A medical opinion that is equivocal in nature or expressed in speculative language does not provide the degree of certainty required for medical nexus evidence. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The third and final factor in determining the probative value of an opinion involves consideration of whether the opinion is supported by a reasoned analysis. The most probative value of a medical opinion comes from its reasoning. Therefore, a medical opinion containing only data and conclusions is not entitled to any weight. In fact, a review of the claims file does not substitute for a lack of a reasoned analysis. See Nieves-Rodriguez, 22 Vet. App. at 304; see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions."). The Veteran contends that he has a right upper extremity disability, to include radiculopathy and peripheral neuropathy, and a left upper extremity disability, to include radiculopathy and peripheral neuropathy, that are related to service, to include as due to Agent Orange exposure. He specifically maintains that he was exposed to Agent Orange while serving in Vietnam. See Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015). The Veteran served on active duty in the Air Force from February 1969 to September 1970, including service in the Republic of Vietnam. Therefore, his exposure to Agent Orange is conceded. The Veteran's service treatment records do not show treatment for right upper extremity problems, to include radiculopathy and peripheral neuropathy, and/or for left upper extremity problems, to include radiculopathy and peripheral neuropathy. Post-service private and VA treatment records, including VA examination reports, also do not show treatment for any right upper extremity problems, to include radiculopathy and peripheral neuropathy, and/or for any left upper extremity problems, to include radiculopathy and peripheral neuropathy. A June 2021 VA peripheral nerves conditions examination report includes a notation that the Veteran's claims file was reviewed. The examiner reported that there were no diagnoses or evidence of the Veteran's claimed upper extremity radiculopathy and neuropathy. The examiner indicated that the Veteran did not have a peripheral nerve condition or peripheral neuropathy. The examiner stated that for the Veteran's claimed conditions of peripheral neuropathy of the right upper extremity, and peripheral neuropathy of the left upper extremity, there were no diagnoses, because there were no findings, signs, and/or symptoms to support such diagnoses. The examiner indicated that the claimed conditions were less likely than not (less than 50 percent probability) incurred in, or caused by, the claimed in-service injury, event, or illness. The examiner maintained that there were no current diagnoses of the claimed right upper extremity neuropathy, and the claimed left upper extremity neuropathy. The examiner stated that it was less likely than not that the claimed right upper extremity neuropathy, and the claimed left upper extremity neuropathy, were from service, or were incurred in, or caused by peripheral neuropathy of the bilateral upper extremities during service, including exposure to Agent Orange. In a July 2021 addendum opinion, the same examiner did not refer to the Veteran's claimed right upper extremity disability, to include radiculopathy and peripheral neuropathy, and left upper extremity disability, to include radiculopathy and peripheral neuropathy. The Board observes that the evidence affirmatively shows no current right upper extremity disability, to include radiculopathy and peripheral neuropathy, and no current left upper extremity disability, to include radiculopathy and peripheral neuropathy. A VA examiner, pursuant to a June 2021 peripheral nerves conditions examination report, specifically indicated that there were no diagnoses or evidence of the Veteran's claimed right upper extremity radiculopathy and neuropathy, and his claimed left upper extremity radiculopathy and neuropathy. The examiner also stated that for the Veteran's claimed conditions of peripheral neuropathy of the right upper extremity, and peripheral neuropathy of the left upper extremity, there were no diagnoses, because there were no findings, signs, and/or symptoms to support such diagnoses. The examiner further maintained that the claimed conditions were less likely than not incurred in, or caused by, the claimed in-service injury, event, or illness. The Board observes that the June 2021 VA peripheral nerves conditions examination report, essentially, refers to radiculopathy and peripheral neuropathy of the right upper extremity, and radiculopathy and peripheral neuropathy of the left upper extremity. The Board notes, however, that the evidence indicates that there is no presently diagnosed right upper extremity disability, to include radiculopathy and peripheral neuropathy, and no presently diagnosed left upper extremity disability, to includer radiculopathy and peripheral neuropathy. The Board observes that, to the extent that the Veteran does not have a diagnosable disability, the VA must consider whether he has functional impairment for which service connection may be granted. See Saunders v. Wilkie, 886 F.3d 1356, 1363-64 (Fed. Cir. 2018) (indicating that the term "disability" refers to the functional impairment of earning capacity, rather than the underlying cause of the impairment, and pain alone may be a functional impairment). The Board observes that the evidence indicates that the Veteran does not have any diagnosed right upper extremity disability, to include radiculopathy and peripheral neuropathy, and/or left upper extremity disability, to include radiculopathy and peripheral neuropathy, and that he has not been shown to have any functional impairment. The Veteran essentially asserts that he has a right upper extremity disability, to include radiculopathy and peripheral neuropathy, and a left upper extremity disability, to include radiculopathy and peripheral neuropathy, that had their onset in service, to include as due to Agent Orange exposure. However, while the Veteran is competent to report that he had right upper extremity problems and left upper extremity problems, and/or symptoms that he thought were due to a right upper extremity disability, to include radiculopathy and peripheral neuropathy, and a left upper extremity disability, to include radiculopathy and peripheral neuropathy, during service, or since service, he is not competent to diagnose his currently claimed right upper extremity disability, to include radiculopathy and peripheral neuropathy, and left upper extremity disability, to include radiculopathy and peripheral neuropathy, as related to service, to include as due to exposure to Agent Orange. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay evidence can be competent and sufficient to establish a diagnosis of a condition when a layperson is competent to identify the medical condition, or reporting a contemporaneous medical diagnosis, or the lay testimony describing symptoms at the time supports a later diagnosis by a medical professional); Buchanan v. Nicholson, 451 F.3d. 1331 (Fed. Cir. 2006) (lay evidence is one type of evidence that must be considered and competent lay evidence can be sufficient in and of itself). The Board notes that there is simply no evidence of an actually diagnosed right upper extremity disability, to include radiculopathy and peripheral neuropathy, and an actually diagnosed left upper extremity disability, to include radiculopathy and peripheral neuropathy. Here, the preponderance of the evidence is against the claims for service connection for a right upper extremity disability, to include radiculopathy and peripheral neuropathy, and for a left upper extremity disability, to include radiculopathy and peripheral neuropathy. As there is no doubt to be resolved, service connection is not warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Left Lower Extremity Disability, to include Radiculopathy and Peripheral Neuropathy The Veteran contends that he has a left lower extremity disability, to include radiculopathy and peripheral neuropathy, that is related to service, to include as due to Agent Orange exposure. He specifically maintains that he was exposed to Agent Orange while serving in Vietnam. See Scott, 789 F.3d at 1375. The Veteran served on active duty in the Air Force from February 1969 to September 1970, including service in the Republic of Vietnam. Therefore, his exposure to Agent Orange is conceded. The Veteran's service treatment records indicate that he was treated for low back problems on numerous occasions, with multiple treatment entries referring to probable left sciatica. A March 1970 treatment entry notes that the Veteran was seen for intermittent low back pain for several days. The Veteran reported that he had a throbbing ache into the left posterior thigh, with no paresis or paresthesias. The impression was low back pain, with probable left sciatica. An April 1970 clinical record cover sheet notes that the Veteran was on a two-month temporary profile, with restrictions of no stooping, bending, or lifting more than fifteen pounds, as well as no standing or sitting for longer than two hours. The diagnosis was back pain, with probable sciatica. An April 1970 physical profile serial report indicates that the Veteran had restrictions of no walking, standing, extensive sitting, bending, or lifting. The diagnosis was back pain, with probable sciatic. It was noted that the date of release of the temporary limitations was in June 1970. A June 1970 hospital discharge note indicates that the Veteran was hospitalized from March 24, 1970, to April 2, 1970. The diagnosis was back pain, with probable left sciatica. Post-service private and VA treatment records, including VA examination reports, show treatment for left lower extremity complaints, including radiculopathy and sciatica. A November 1970 VA general medical examination report, within two months of the Veteran's separation from service, does not specifically include a notation that the Veteran's claims file was reviewed. The Veteran reported that he had recurrent back pain that was aggravated by lifting. He stated that he was hospitalized at Luke Air Force Base in Arizona for about two weeks, as well as in Vietnam for about two weeks. He also stated that he had occasional low back and leg pain. The examiner reported, as to the Veteran's nervous system, that his cerebellar coordination and equilibrium tests were normal, and that a Romberg test was negative. The examiner stated that the Veteran had no sensory loss or motor deficits, and that deep tendon reflexes were equal and active. As to the Veteran's musculoskeletal system, the examiner reported that the Veteran had normal ranges of motion of the spine and all extremities. The diagnosis was lumbosacral strain, by history. A November 1970 VA orthopedic examination report does not specifically include a notation that the Veteran's claims file was reviewed. The Veteran reported that he injured his back while lifting a heavy object approximately five years earlier, and that the pain only listed a few days. He stated that, after the injury, he began having intermittent low back pain. The Veteran indicated that he re-injured his back while lifting some heavy objects, and that the frequency of his low back pain had increased. He denied that he had any weakness or numbness in the lower extremities, as well as any bowel or bladder problems. It was noted that the Veteran's back pain was localized to the low back, and that it did not radiate into his extremities. The examiner reported that the neurological examination of the Veteran's lower extremities was completely within normal limits. The examiner stated that straight leg raising was negative bilaterally, but that there was a marked tightness of the hamstrings on the left. The diagnosis was lumbosacral strain, by history. A November 1989 VA hospital discharge examination report notes that the Veteran presented with complaints of low back pain and bilateral leg pain, with numbness, left greater than the right, for four months. The examiner reported that the Veteran began experiencing lower back pain and alternating episodes of pain and numbness near the buttocks, as well as down the posterior thighs and, predominantly, the left calf. It was noted that the Veteran also stated that he had pain in the right lower extremity, but that he had no numbness on that side. The examiner reported that the Veteran underwent a L5-S1 discectomy. The diagnosis was a herniated nucleus pulposus, L5-S1. An April 1990 statement from a VA physician indicates that the Veteran reported that he did not lift in 1989. The physician stated that the Veteran indicated that he lifted heavy stock and started having leg pain in 1987. The examiner maintained that the Veteran's problem progressed, from 1987 on until October 1989, when he underwent surgery. A February 2015 VA back conditions examination report includes a notation that the Veteran's claims file was reviewed. The Veteran reported that he suffered lumbar strain during service. He stated that he was treated with traction, for another injury while performing a civilian job, resulting in a disc herniation and discectomy. The Veteran maintained that he had continued to have pain intermittently, with no radicular pain, and no weakness. He related that he did have decreased sensation in his low back. The diagnosis was lumbosacral strain and degenerative disc disease. The examiner reported that the Veteran had radicular pain, or other signs or symptoms due to radiculopathy. The examiner stated that the Veteran did not have constant pain (which may be excruciating at times); intermittent pain (usually dull); or paresthesias and/or dysesthesias of the left lower extremity. The examiner indicated that the Veteran did have mild numbness in the left lower extremity. The examiner maintained that the Veteran had involvement of the L4/L5/S1/S2/S3 nerve roots (sciatic nerve) on the left side. The examiner stated that the severity of the radiculopathy was mild. The examiner indicated that a claimed condition was less likely than not (less than 50 percent probability) incurred in, or caused by, the claimed in-service injury, event, or illness. The examiner maintained that it was less than 50 percent likely that the Veteran's back pain was due to his injury in service, and that it was more likely due to his lifting injury out of service that resulted in a discectomy. The examiner did not address the Veteran's radiculopathy (and sciatica) of the left lower extremity. Multiple recent VA treatment records show that the Veteran was treated for sciatica. A July 2016 VA primary care nursing note indicates that the Veteran complained of cramps, tingling, numbness, and foot cramping. He reported that he sometimes had to stand up for the cramps to stop, and that they had a duration of over two years off an on. The examiner stated that the Veteran had a history of sciatica. A March 2018 VA hypertension clinic note reflects that the Veteran reported that he had chronic sciatica. The assessment solely referred to hypertension. A June 2021 VA nerve conditions examination report includes a notation that the Veteran's claims file was reviewed. The examiner reported that there was no evidence of any lower extremity radiculopathy. The examiner indicated that the Veteran did not have a peripheral nerve condition or peripheral neuropathy. The examiner stated that for the Veteran's claimed condition of peripheral neuropathy of the left lower extremity, there was no diagnosis, because the condition had resolved. The examiner maintained that the claimed condition was less likely than not (less than 50 percent probability) incurred in, or caused by, the claimed in-service injury, event, or illness. The examiner reported that there was no current diagnosis of the claimed left lower extremity neuropathy. The examiner indicated that it was less likely than not that the claimed left lower extremity neuropathy was from service, or was incurred in, or caused by, peripheral neuropathy of the bilateral lower extremities during service, including exposure to herbicide agents. In a July 2021 addendum, the same examiner stated that the Veteran had right sciatic nerve involvement from a herniated nucleus pulposus that was noted by a computed tomography scan in 1989. The examiner indicated that such condition was treated with a discectomy, with subsequent relief of symptoms and no further recurrence or residuals. The examiner maintained that the diagnosis of sciatic had been carried through. The Board observes that the Veteran's service treatment records indicate that he was treated for probable left sciatica on multiple occasions. Additionally, at the time of a November 1970 VA general medical examination report, within two months of the Veteran's separation from service, he reported that he had occasional low back and leg pain. The Board notes, however, that the November 1970 VA general medical examination report, and a November 1970 VA orthopedic examination report, were negative for any diagnosed left leg disability, to include radiculopathy and peripheral neuropathy. The Board observes that post-service private and VA treatment records show treatment for left lower extremity complaints, including radiculopathy and sciatica. The Board notes that a February 2015 VA back conditions examination report indicates that the Veteran had radicular pain, or other signs or symptoms due to radiculopathy. The examiner, following a review of the claims file, stated that Veteran had mild numbness in the left lower extremity. The examiner maintained that the Veteran had involvement of the L4/L5/S1/S2/S3 nerve roots (sciatic nerve) on the left side. The examiner indicated that the severity of the radiculopathy was mild. The Board notes that the examiner provided a negative opinion, as to the etiology of a low back disability, but that the Veteran's radiculopathy (and sciatica) of the left lower extremity was not addressed at that time. Therefore, the examiner's opinion, pursuant to the February 2015 VA back conditions examination report, is not probative in this matter. The Board observes that a June 2021 VA nerve conditions examination report relates that there was no evidence of any lower extremity radiculopathy. The examiner, following a review of the claims file, stated that the Veteran did not have a peripheral nerve condition or peripheral neuropathy. The examiner maintained that for the Veteran's claimed condition of peripheral neuropathy of the left lower extremity, there was no diagnosis, because the condition had resolved. The examiner also indicated that the claimed condition was less likely than not incurred in, or caused by, the claimed in-service injury, event, or illness. The examiner reported that there was no current diagnosis of the claimed left lower extremity neuropathy. Additionally, in a July 2021 addendum, the same examiner stated that the Veteran had right sciatic nerve involvement from a herniated nucleus pulposus that was noted by a computed tomography scan in 1989. The examiner indicated that such condition was treated with a discectomy, with subsequent relief of symptoms and no further recurrence or residuals. The examiner maintained that the diagnosis of sciatic had been carried through. The Board observes that the examiner found that there was no evidence of left lower extremity neurologic impairment. The Board notes, however, that a February 2015 VA back conditions examination report specifically indicates that the Veteran had radicular pain, or other signs or symptoms due to radiculopathy, that he had mild numbness in the left lower extremity, that he had involvement of the L4/L5/S1/S2/S3 nerve roots (sciatic nerve) on the left side, and that the severity of his radiculopathy was mild. The Board also notes that the examiner, in a July 2021 addendum, states that the Veteran had right sciatic nerve involvement from a herniated nucleus pulposus that was noted by a computed tomography scan in 1989, and that such condition was treated with a discectomy, with subsequent relief of symptoms and no further recurrence or residuals. The Board notes, however, that recent VA treatment records show numerous diagnoses of left lower extremity neurologic impairment. Additionally, the Board observes that the examiner did not address any reports by the Veteran of left lower extremity problems, during service or since service. The Veteran is competent to report left lower extremity problems during service and since service. See Davidson, 581 F.3d at 1313. Thus, the Board finds that the opinions provided by the examiner, pursuant to the June 2021 VA peripheral nerves conditions examination report, with the July 2021 addendum, are not probative. The Board notes that the Veteran is presently diagnosed with a left lower extremity disability, diagnosed as radiculopathy and sciatica. The Veteran was treated for probable left sciatica during service, and he has been currently diagnosed with radiculopathy and sciatica of the left lower extremity. The Veteran has reported left leg problems during service, and at times since service, and the Board finds those reports to be credible. See Jandreau v. Nicholson, 492 F.3d 1372 (2007) (holding that lay evidence can be competent and sufficient to establish a diagnosis of a condition when a lay person is competent to identify the medical condition, or reporting a contemporaneous medical diagnosis, or the lay testimony describing symptoms at the time supports a later diagnosis by a medical professional). Resolving any doubt in the Veteran's favor, the Board finds that the evidence is at least in equipoise as to whether his left lower extremity disability commenced during service. In light of the evidence, the Board cannot conclude that the preponderance of the evidence is against granting service connection for a left lower extremity disability. Therefore, service connection for left lower extremity neurologic impairment is warranted. As the Board has granted direct service connection in this matter, it need not address other theories of service connection. REASONS FOR REMAND The remaining issues on appeal are entitlement to service connection for a right lower extremity disability, to include radiculopathy and peripheral neuropathy, and entitlement to a TDIU. As discussed above, the Board has granted service connection for a left lower extremity disability, diagnosed as radiculopathy and sciatica. Given this change in circumstances, and to accord the Veteran due process, the RO must now readjudicate the issue of entitlement to service connection for a right lower extremity disability, to include radiculopathy and peripheral neuropathy, and entitlement to a TDIU. This case was last remanded in May 2021, partly to schedule the Veteran for VA examination to determine the etiology of his diagnosed sciatica and his neuropathy. The examiner was to provide an opinion, as to whether it was at least as likely as not, that any sciatica and/or peripheral neuropathy was related to the Veteran's military service, to include his presumed exposure to Agent Orange. Pursuant to the May 2021 Board remand, the Veteran was afforded a VA peripheral nerves conditions examination in June 2021. The examiner reported that there was no evidence of any lower extremity radiculopathy. The examiner indicated that the Veteran did not have a peripheral nerve condition or peripheral neuropathy. The examiner stated that for the Veteran's claimed condition of peripheral neuropathy of the right lower extremity, there was no diagnosis, because the condition had resolved. The examiner maintained that the claimed condition was less likely than not (less than 50 percent probability) incurred in, or caused by, the claimed in-service injury, event, or illness. The examiner reported that there was no current diagnosis of the claimed right lower extremity neuropathy. The examiner indicated that it was less likely than not that the claimed right lower extremity neuropathy was from service, or was incurred in, or caused by, peripheral neuropathy of the bilateral lower extremities during service, including exposure to herbicide agents. In a July 2021 addendum, the same examiner stated that the Veteran had right sciatic nerve involvement from a herniated nucleus pulposus that was noted by a computed tomography scan in 1989. The examiner indicated that such condition was treated with a discectomy, with subsequent relief of symptoms and no further recurrence or residuals. The examiner maintained that the diagnosis of sciatic had been carried through. The Board observes that the examiner found that there was no evidence of any lower extremity radiculopathy. The Board observes however, that a February 2015 VA back conditions reports clearly shows that the Veteran had radiculopathy of the left lower extremity. The Board also notes that the examiner, in the July 2021 addendum, stated that the Veteran had right sciatic nerve involvement that had resolved. The Board observes, however, that recent VA treatment records contain numerous diagnoses of sciatica, with reports by the Veteran of chronic sciatica. Additionally, the Board observes that the examiner did not address any reports by the Veteran of right lower extremity problems, to include symptoms he thought were due to radiculopathy or peripheral neuropathy, during service or since service. See Davidson, 581 F.3d at 1313. The Board further notes that the examiner did not address the fact that the Veteran was treated for probable sciatica, albeit left sciatica, during service, and that he reported leg pain (with back pain) at the time of a November 1970 VA general medical examination. In light of the above, the Board finds that the Veteran should be afforded a VA examination with the opportunity to obtain responsive etiological opinions, following a thorough review of the record, as to his claim for service connection for a right lower extremity disability, to include radiculopathy and peripheral neuropathy. Such an examination must be accomplished on remand. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006); Stefl v. Nicholson, 21 Vet. App. 120, 125 (2007); see also Stegall v. West, 11 Vet. App. 268, 271 (1998). Finally, as the Veteran's claim for a TDIU rating is inextricably intertwined with his claim for service connection, those matters must be addressed together on remand. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Ask the Veteran to identify all medical providers who have treated him for a right lower extremity disability, to include radiculopathy and peripheral neuropathy, since April 2021. After receiving this information and any necessary releases, obtain copies of the related medical records which are not already in the claims folder. Document any unsuccessful efforts to obtain the records, inform the Veteran of such, and advise him that he may obtain and submit those records himself. 2. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge, and/or were contemporaneously informed of his in-service and post-service right lower extremity neurologic impairment. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 3. Schedule the Veteran for an appropriate VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to determine the onset and/or etiology of his claimed right lower extremity neurologic impairment. The examiner must diagnose all right lower extremity impairment. Then the examiner must opine as to whether it is at least as likely as not that any right lower extremity neurologic impairment had its onset during service, to include presumed exposure to Agent Orange during service. The examiner must specifically acknowledge and discuss the Veteran's treatment for low back problems during service, with diagnoses of probable left sciatica, and any reports by the Veteran of right lower extremity problems, to include symptoms he thought were due to radiculopathy and/or peripheral neuropathy, during and since service. The examiner must further opine as to whether the Veteran's service-connected disabilities, to include his service connected left lower extremity disability, diagnosed as radiculopathy and sciatica, caused or aggravated any currently diagnosed right lower extremity disabilities, to include radiculopathy and peripheral neuropathy. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. D. Regan, 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.