Citation Nr: 21071323 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-03 947 DATE: November 30, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as due to herbicide agent exposure is remanded. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include due to herbicide agent exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from June 1965 to April 1969. This issue comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision issued by a Department of Veteran's Affairs Regional Office (RO). In May 2019, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. The transcript is of record. Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include due to herbicide agent exposure. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include due to herbicide agent exposure. The Veteran contends that his current lower bilateral radiculopathy is the result of his active-duty service, to include exposure to herbicide agents including Agent Orange. In November 2011, a VA Examination for peripheral nerves was completed. See November 2015 VA Examination. The examiner did not render an opinion as to whether the Veteran's bilateral lower extremity peripheral neuropathy was due to his military service. The examiner noted that the Veteran reported experiencing numbness in his feet since service, worsening over the years. At his examination, the Veteran presented with mild paresthesias and/or dysesthesias and severe numbness of his bilateral lower extremities. He also walked with an abnormal gate, had marked diminution of light touch sensation up to the mid-foreleg level bilateral, and diminution of pinprick and temperature sensations up to the knee bilaterally. The examiner found that the veteran's mobility and balance are adversely affected by the sensory neuropathy in his lower extremities. The VA has a duty to assist veterans in developing their claims for benefits. 38 C.F.R. § 3.159. The duty to assist includes providing a medical examination when necessary to decide a claim. 38 C.F.R. § 3.159(c)(4). Once VA undertakes the effort to provide an examination, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board finds the November 2015 opinion insufficient for adjudication as it does not provide a service connection opinion. Notably, the Veteran's service treatment records include complaints of and treatment for knee and ankle pain. See Service Treatment Records; see also Medical Treatment Records. A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As the examiner failed to provide an opinion that appropriately addressed and consider the evidence of record, a remand is necessary to obtain an addendum medical opinion. The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. Neither the Veteran's credibility nor any lack thereof should be presumed in this remand. 2. Obtain updated VA and/or private treatment records. If such records are unavailable, the Veteran's claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 3. Return the claims file to the examiner who prepared the 2015 examination reports and request that they prepare and addendum to the report which addresses the following question. Only schedule another examination of the Veteran if the examiner determines that this is necessary to provide the requested opinions. If the examiner who prepared the 2015 report is unavailable, arrange to obtain the requested opinion from a suitably qualified health care professional. The examiner must review the Veteran's claims file and make a notation that the claims file has been reviewed. Based on a review of the record including the private medical evidence, and the examination results, the examiner must address the following: (a.) Clarify whether the Veteran has a current diagnosis of peripheral neuropathy of the lower extremities. (b.) If so, determine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's peripheral neuropathy is related to the Veteran's military service, to include due to exposure to herbicide agents, to include Agent Orange. The examiner must consider and address the service treatment records (STRs) that note complaints of and treatment of knee and ankle pain. The fact that a condition may not a disability presumed to be related to herbicide agent exposure is not sufficient to serve as a rationale in this case. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V. Schmidt 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.