Citation Nr: 21066814 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 17-10 277 DATE: November 2, 2021 REMANDED Entitlement to service connection for left peroneal motor neuropathy is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to October 1982 and from December 2003 to February 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in July 2018 and was remanded for additional development. The Board again remanded the matter in March 2021 due to noncompliance with the July 2018 remand directives. The Veteran contends that his left peroneal motor neuropathy is related to his military service, to include injury to his left knee in service, or alternatively secondary to his service-connected low back disability or his service-connected bilateral lower extremity radiculopathy. While further delay is regrettable, the Board finds that another remand is warranted to obtain adequate medical opinions. The Veteran was provided a VA examination and medical opinion in March 2020. The examiner opined that the Veteran's peroneal motor neuropathy was not related to service, instead finding that it was secondary to his diabetes mellitus. In addressing the Veteran's military service, the examiner noted there was no evidence in medical literature that being an infantryman, or a parachutist increased the risk to develop peripheral neuropathy. While the opinion stated the Veteran's peroneal motor neuropathy was not related to his military service as an infantryman or parachutist, the examiner did not address whether the peroneal motor neuropathy was related to his January 1998 knee injury or the reoccurrence of pain noted during service in August 2004. In addition, the examiner did not address the Veteran's report in a September 2009 VA examination report which noted the pain in his knee had become progressively worse since the injury. See September 2009 VA Knee Examination Report. Therefore, on remand the examiner should clarify whether the left peroneal motor neuropathy is related to his January 1998 injury. In the same vein, the examiner should provide an opinion as to whether the Veteran's left peroneal motor neuropathy is secondary to his service-connected left knee degenerative joint disease. Therefore, a remand is necessary for addendum medical opinions. The matters are REMANDED for the following action: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Thereafter, forward the Veteran's claim file to the clinician who conducted the March 2020 medical opinion, if available, for the purpose of obtaining an addendum medical opinion as to the nature and etiology of the Veteran's current left peroneal motor neuropathy. If the same examiner is unavailable, request an addendum opinion from an appropriately qualified VA clinician. The claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. After a review of the claims file, the examiner is asked to respond to the following: (a) Provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the currently diagnosed left peroneal neuropathy is caused by or related to service, to include the Veteran's left knee injury in January 1998 which appears to have been exacerbated in April 2004. (b) It is at least as likely as not (a 50 percent or greater probability) that the peroneal motor neuropathy was caused by the left knee degenerative joint disease? (c) It is at least as likely as not (a 50 percent or greater probability) that the peroneal motor neuropathy was aggravated (worsened beyond normal progression) by the left knee degenerative joint disease? *In doing so, specifically consider the January 1998 injury during a physical training run where his left knee jerked and hit his knee on a rock while crawling or the August 2004 reoccurrence of the pain. See January 1998 Statement of Medical Examination and Duty Status; January 1998 Individual Sick Slip; January 1998 Chronological Record of Medical Care; August 2004 Consultation Sheet; August 2004 Chronological Record of Medical Care; September 2009 VA Knee Examination Report; October 2012 Correspondence to VA. ***Any increase/aggravation is sufficient, permanent aggravation is NOT required. See Ward v. Wilkie, 31 Vet. App. 233, 239 (2019) (permanent worsening is not a requirement for secondary service connection of a non-service-connected injury or disease) A complete rationale for all opinions must be provided. 5. Thereafter, readjudicate the remanded claim. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Moldawer, 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.