Citation Nr: 21068400 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 15-43 254 DATE: November 10, 2021 ORDER Entitlement to service connection for right upper extremity peripheral neuropathy is granted. Entitlement to service connection for left upper extremity peripheral neuropathy is granted. Entitlement to service connection for right lower extremity peripheral neuropathy is granted. Entitlement to service connection for left lower extremity peripheral neuropathy is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran's favor, his bilateral upper extremity peripheral neuropathy is at least as likely as not related to Agent Orange exposure. 2. Resolving reasonable doubt in the Veteran's favor, his bilateral lower extremity peripheral neuropathy is at least as likely as not related to Agent Orange exposure. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral upper extremity peripheral neuropathy are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for bilateral lower extremity peripheral neuropathy are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1970 to December 1973 and from September 1982 to October 1983. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The appeal was before the Board in July 2019, October 2020, and August 2021. The appeal was remanded for additional development to include obtaining a new VA medical opinion. There has been substantial compliance with previous remand directives. Service Connection for Bilateral Upper and Lower Extremities The Veteran contends his bilateral upper and lower extremities are due to his conceded exposure to herbicide agents during service. The Board concludes that the Veteran has a current disability that is related to conceded exposure to Agent Orange. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A March 2020 VA examination report shows the Veteran has current diagnoses of peripheral neuropathy of the bilateral upper and lower extremities. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes March and November 2020 VA medical opinions. In March 2020, the examiner opined that the Veteran's peripheral neuropathy in the upper and lower extremities were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that there was insufficient documented evidence to find a link between the Veteran's bilateral upper and lower extremity peripheral neuropathy and his service. The Board, in its October 2020 decision, found this opinion to be inadequate as the examiner failed to consider the Veteran's statements that he had a delayed onset of these conditions because herbicides can lay dormant for 30 to 40 years and then become active. In the November 2020 opinion, the examiner concluded that the Veteran's peripheral neuropathy is less likely than not due to his exposure to herbicide agents. The examiner reasoned that the "Veteran has other conditions that are more likely than not the cause of his peripheral neuropathy, and the scientific literature does not support a causative linkage between delayed-onset chronic neuropathy and herbicide exposure." The Board, in its August 2021 decision, found that this opinion was also inadequate as the examiner failed to provide adequate rationale for the conclusion reached. The evidence in favor of the claim includes the September 2021 VA medical opinion which is the only probative opinion of record. Here, the examiner opined that it was at least as likely as not that the Veteran's peripheral neuropathy of the bilateral upper and lower extremities was caused by exposure to Agent Orange during service. The examiner reasoned that the Veteran had no alternate identified medical condition that would cause his peripheral neuropathy of the bilateral upper and lower extremities. Additionally, a December 2005 Agent Orange examination report reflects the Veteran's reports of having widespread pain and weakness since 1989. Also, VA treatment records notes the Veteran has neuropathy caused by a chemical substance. (Continued on the next page) Upon review of the record, and after resolving all doubt in favor of the Veteran, the Board finds that service connection for peripheral neuropathy of the bilateral upper and lower extremities is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. K.A. KENNERLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McDuffie, 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.