Citation Nr: 21071162 Decision Date: 11/30/21 Archive Date: 11/29/21 DOCKET NO. 16-58 558 DATE: November 30, 2021 REMANDED Entitlement to service connection for right upper extremity peripheral neuropathy is remanded. Entitlement to service connection for left upper extremity peripheral neuropathy is remanded. Entitlement to service connection for right lower extremity peripheral neuropathy is remanded. Entitlement to service connection for left lower extremity peripheral neuropathy is remanded. REASONS FOR REMAND 1. Entitlement to service connection for bilateral upper extremity peripheral neuropathy; and entitlement to service connection for bilateral lower extremity peripheral neuropathy are remanded. The Veteran served on active duty from November 1965 to January 1969.This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2014 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). These matters return to the Board following an August 2021 remand. The Board now finds that additional remand is necessary. The Veteran has advanced two theories of entitlement to service connection. First, he asserts that peripheral neuropathy is related to exposure to herbicide agents while serving in Vietnam. Second, he asserts that peripheral neuropathy is related to exposure to contaminants at Camp Lejeune. The Veteran's military personal records confirm that he deployed to Vietnam in 1967 and was stationed at Camp Lejeune for three weeks in November 1966 and again for three weeks in January 1968. In August 2021 the Board remanded the Veteran's claims to obtain a VA medical opinion that addressed the nature and etiology of the Veteran's claimed peripheral neuropathy. The September 2021 VA examiner noted a 1995 VA examination during which the Veteran reported episodes of pain in his back, arms and, legs since 1970. The examiner cited to an April 2004 statement by the Veteran that his symptoms began after return from Vietnam and worsened until the 1980s, at which point the symptoms stabilized. The examiner stated that the history of the Veteran's peripheral neuropathy symptoms was inconsistent with exposure to herbicide agents, as neuropathy due to toxin exposure may continue to worsen after exposure has ceased, and/or it may stabilize, but it will not stabilize only to later destabilize. 09/20/2021, C&P Exam, p. 5. The Board here notes that peripheral neuropathy is presumptively related to herbicide agent exposure where it manifests to a degree of 10 percent or more within a year of the last date the Veteran was exposed to herbicide agents. 38 C.F.R. §§ 3.307, 3.309. Laypeople are competent to report symptoms and experiences observable by their senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA must consider all medical and lay evidence of record and make appropriate determinations of competence, credibility, and weight. 38 U.S.C. § 5107; Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Accordingly, it is critical that the record be complete and accurate as to the Veteran's reports of peripheral neuropathy symptoms. However, the record currently before the Board does not include a February 1995 VA examination, nor any lay statements or medical records from April 2004. The earliest VA treatment records associated with the claims file date to 2013. With the exception of a private medical note from 1979 not pertinent to the Veteran's peripheral neuropathy claim, the earliest non-VA treatment records associated with the claims file date to 2011. Without access to the purported February 1995 and April 2004 records, the Board is unable to evaluate the probative value of either the existing record of statements by the Veteran as to the history of his claimed symptoms, or the September 2021 VA medical opinion that cites to them. In light of the foregoing, the Board finds that this claim should be remanded for the RO to make all reasonable efforts to ensure that all pertinent material has been associated with the claims file. The matters are REMANDED for the following action: 1. Ask the Veteran to execute a VA form 21-4142 identifying all VA and non-VA providers he has seen for his bilateral upper and lower extremity peripheral neuropathy, to include dates of treatment. (Continued on the next page) 2. Obtain medical records from all VA and non-VA providers identified by the Veteran in his executed VA Form 21-4142. 3. Ensure that all records obtained pursuant to this remand, and any VA treatment records from the period prior to 2013 are associated with the claims file. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sametshaw, Eric C. 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.