Citation Nr: 21068688 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 19-35 218 DATE: November 12, 2021 REMANDED Entitlement to service connection for peripheral neuropathy, claimed as due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1966 to August 1969, to include service in the Republic of Vietnam. Entitlement to service connection for peripheral neuropathy, claimed as due to exposure to herbicide agents, is remanded. The Veteran contends that his peripheral neuropathy is due to in-service exposure to herbicide agents while serving in the Republic of Vietnam. The Veteran's personnel records show that he served in Vietnam from April 1967 to April 1968 and, thus, herbicide exposure is presumed. Moreover, the medical evidence of record shows that the Veteran has been diagnosed with peripheral neuropathy. A Veteran may be entitled to service connection for early onset peripheral neuropathy on a presumptive basis due to exposure to herbicide agents. See 38 C.F.R. §§ 3.307, 3.309. "Early-onset peripheral neuropathy" must become manifest to a degree of 10 percent or more within one year after the date of last exposure to herbicides in order to qualify for the presumption of service connection. 38 C.F.R. § 3.307 (a)(6)(ii). However, even if the presumption does not apply, the Veteran is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). The Veteran was afforded a VA fee-based examination in July 2018. The Veteran reported that his symptoms began 15 years prior. However, the examiner did not provide an etiological opinion. Once VA undertakes the effort to provide an examination when developing a claim, even if not statutorily obligated to do so, it must provide an adequate exam. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As such, this case must be remanded to afford the Veteran a VA examination to determine the etiology of his peripheral neuropathy. Further, VA clinical records indicate that the Veteran primarily receives private treatment for his disabilities. Thus, on remand, VA should attempt to obtain authorization and request any outstanding private treatment records. Moreover, any additional VA clinical records should also be obtained. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for any outstanding private treatment records pertaining to his peripheral neuropathy. Make two requests for the authorized records from any identified private facilities, unless it is clear after the first request that a second request would be futile. 2. Obtain VA clinical records dated from October 2019 to the present. 3. After completing the above development, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his peripheral neuropathy. The claims file must be reviewed. The examiner must opine whether it is at least as likely as not (50 percent probability or greater) that any current peripheral neuropathy disability had its onset during service; within one year after the date of last exposure to herbicide agents; or is otherwise related to an in-service injury, event, or disease, to include exposure to herbicide agents (Agent Orange exposure). The examiner must provide a detailed rationale for all opinions given. The examiner should be advised to consider and specifically discuss whether the Veteran's peripheral neuropathy is due to in-service herbicide-Agent Orange exposure and that simply stating that peripheral neuropathy occurring more than one year after exposure is not a presumptive disorder under the regulations is not a medical rationale. The examiner must give a clear rationale on whether the Veteran's peripheral neuropathy is related to in-service herbicide-Agent Orange exposure. The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.N. Moats 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.