Citation Nr: 21069553 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 19-31 663 DATE: November 18, 2021 ORDER The claim of entitlement to service connection for peripheral neuropathy of the bilateral upper extremities, to include as secondary to diabetes mellitus, is granted. FINDING OF FACT The Veteran has bilateral peripheral neuropathy of the upper extremities as a result of his service-connected diabetes mellitus. CONCLUSION OF LAW The criteria for entitlement to service connection for neuropathy of the bilateral upper extremities as secondary to diabetes mellitus, type II, have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Air Force from January 1964 to July 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). 1. The claim of entitlement to service connection for peripheral neuropathy of the bilateral upper extremities, to include as secondary to diabetes mellitus, is granted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, service connection for certain chronic diseases, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted on a secondary basis for disability which is proximately due to or the result of service-connected disease or injury, or for additional disability resulting from the aggravation of a nonservice-connected disability by a service-connected disability. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). In a September 2015 statement, the Veteran alleged that his peripheral neuropathy of the bilateral upper extremities was related to herbicide exposure while deployed to Thailand. In a July 2016 Notice of Disagreement, the Veteran also asserted that his peripheral neuropathy was likely secondary to his service-connected diabetes mellitus. First, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). In an August 2021 VA examination, the Veteran was diagnosed with diabetic neuropathy of the bilateral upper extremities. Second, the Board finds that the Veteran is properly service connected for diabetes mellitus. Third, the Board finds that the evidence of record does support a finding that the diabetic neuropathy of the bilateral upper extremities is secondary to the Veteran's service-connected diabetes mellitus. In an August 2021 VA diabetic sensory motor peripheral neuropathy examination, the examiner indicated that the Veteran began experiencing diabetic peripheral neuropathy symptoms such as numbness and tingling in his hands due to his long history of diabetes mellitus. (Continued on the next page) Accordingly, service connection is granted. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board AK 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.