Citation Nr: 21071584 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 18-49 473 DATE: November 30, 2021 REMANDED Entitlement to service connection for peripheral neuropathy or the left lower extremity is remanded. Entitlement to service connection for peripheral neuropathy of the right lower extremity is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 2006 to June 2007. This matter is before the Board of Veterans' Appeals (Board) on appeal from a September 2016 rating decision. The Veteran's October 2018 Form 9 explicitly limited his appeal to service connection for left and right lower extremity peripheral neuropathy. As the Veteran has explicitly limited the scope of his appeal, the Board finds that those are the only issues before the Board at this time. In November 2021, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge. A transcript of that testimony has not yet been added to the file, as this decision is being processed under the Board's "One Touch" hearing program. A copy of the transcript will be added to the Veteran's claims file in the ordinary course of business. Entitlement to service connection for left and right lower extremity peripheral neuropathy The Veteran has reported bilateral symptoms of burning, numbness, and tingling from the knee down, which is worsened with prolonged activity or standing. At his November 2021 hearing, the Veteran reported that he first experienced symptoms in April or May 2007, shortly before discharge from service. A July 2012 VA treatment record diagnosed the Veteran with sensory polyneuropathy below the knees but did not give an etiology opinion. In a December 2014 VA examination of the knees, the Veteran complained of burning complain that the Veteran "calls a neuropathy," but the examiner did not assess the Veteran's peripheral nerves or provide a diagnosis. Additionally, the Veteran is service connected for bilateral knee disabilities and a nerve condition of the left great toe. The Veteran claims his lower extremity peripheral neuropathy is due to service-connected disability/ies. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for peripheral neuropathy of the right and left lower extremities because no VA examiner has opined whether the Veteran's claimed bilateral lower extremity peripheral neuropathy is at least as likely as not related to service, secondary to service-connected disability, or aggravated by service-connected disability. The matters are REMANDED for the following action: 1. Attempt to associate with the record all outstanding adequately identified non-VA treatment records prior to 2012 after obtaining any necessary authorizations. 2. Please associate with the record updated VA treatment records from February 2018 to present. 3. Schedule the Veteran for a VA examination for his claimed peripheral neuropathy of the bilateral extremities. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a.) Identify all neuropathy disorders of the lower extremities. VA treatment records (September 1, 2017) assess neuropathy of the lower extremities and note the Veteran was taking Gabapentin, so a finding of bilateral lower extremity neuropathy during the course of this appeal should be taken as fact. (b.) Is the Veteran's neuropathy of the left and right lower extremities at least as likely as not related to service, including the reported in-service onset of symptoms and continuity of symptoms since service? Please consider and address as necessary the July 26, 2012 VA neurology consultation indicating "[t]he joint laxity in his feet [identified as consistent with joint hypermobility disease such as benign joint hypermobility disease or Ehlers Danlos syndrome] is likely the cause of his sensory polyneuropathy." (c.) Is the Veteran's peripheral neuropathy of the left lower extremity at least as likely as not proximately due to (i) his service-connected left knee disability (ii) his service-connected right knee disability or (iii) service-connected nerve damage of the left great toe? Please consider and discuss as necessary the July 26, 2012 VA neurology consultation indicating the numbness of both feet is a progression of the service-connected left great toe numbness. (d.) Is the Veteran's peripheral neuropathy of the left lower extremity at least as likely as not aggravated (any increase in disability) by (i) his service-connected left knee disability or (ii) or his service-connected right knee disability (iii) his service-connected nerve damage of the left great toe? Provide a rationale to support the opinions. M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Beeler, 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.