Citation Nr: 21069906
Decision Date: 11/22/21	Archive Date: 11/22/21

DOCKET NO. 15-41 442
DATE: November 22, 2021

REMANDED

Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as secondary to toxic herbicide exposure, is remanded.

Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to toxic herbicide exposure, is remanded.

Entitlement to service connection for peripheral neuropathy right (dominant) upper extremity, to include as secondary to herbicide exposure, is remanded.

Entitlement to service connection for peripheral neuropathy left (nondominant) upper extremity, to include as secondary to toxic herbicide exposure, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from February 1966 to February 1968, to include service in the Republic of Vietnam. 

In May 2019, the Veteran testified before the undersigned Veterans Law Judge. A transcript of that hearing is of record. 

These matters return to the Board of Veterans' Appeals (Board) following the issuance of a Joint Motion for Remand (JMR) by the Court of Appeals for Veterans' Claims (CAVC) in July 2021 in response to a September 2020 Board decision. 

1. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as secondary to toxic herbicide exposure, is remanded.

2. Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to toxic herbicide exposure, is remanded.

3. Entitlement to service connection for peripheral neuropathy right (dominant) upper extremity, to include as secondary to herbicide exposure, is remanded.

4. Entitlement to service connection for peripheral neuropathy left (nondominant) upper extremity, to include as secondary to toxic herbicide exposure, is remanded.

The Veteran contends that his bilateral upper and lower extremity peripheral neuropathy is related to active-duty service. Specifically, he asserts that these disabilities are related to his presumed herbicide exposure while serving in Vietnam. 

The Veteran underwent a VA examination in January 2020 for the issues on appeal, where the examiner opined that his bilateral peripheral neuropathy was not related to service and specifically to his toxic herbicide exposure, as it did not manifest soon after his exposure, and therefore could not be considered "early-onset" neuropathy for purposes of 38 C.F.R. §§ 3.307 and 3.309.  

However, was noted in the JMR, this opinion is not quite adequate.  While the examiner's finding that the Veteran's neuropathy was not "early-onset" and therefore not applicable to 38 C.F.R. §§ 3.307 and 3.309, it failed to address whether there is a direct relationship between herbicide exposure and the Veteran's bilateral peripheral neuropathy, which is a separate question and is based on the evidence of record, rather than the toxic herbicide regulations.  Therefore, an addendum opinion is necessary. Barr v. Nicholson, 21 Vet. App. 303 (2007). 

The matters are REMANDED for the following action:

1. The Regional Office (RO) should obtain all relevant VA treatment records not currently of record and incorporate them into the claims file. 

Invite the Veteran to submit additional evidence and argument in support of his claims. 

2. Obtain an addendum opinion to determine the nature and etiology of the Veteran's upper and lower bilateral peripheral neuropathy.  

The examiner is asked to provide a supplemental opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's neuropathy is etiologically related to his active duty service, to include exposure to toxic herbicides on direct basis.  In other words, whether the Veteran's neuropathy is related to his active duty service (to include his toxic herbicide exposure) based on the medical evidence of record, independent of the specific regulations addressing service connection on a presumptive basis.  

All opinions should be accompanied by adequate reasons and bases. If the examiner cannot provide the requested opinion without resorting to mere speculation, they should provide a complete explanation stating why this is so. 

A new VA examination is not necessary unless deemed so by the RO or the examiner.

3. The RO should then complete any additional development deemed necessary in order to readjudicate the Veteran's claims. 

 

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. McDonald