Citation Nr: 21074208 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 16-48 164 DATE: December 14, 2021 REMANDED Entitlement to service connection for left upper extremity peripheral neuropathy, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for right upper extremity peripheral neuropathy, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for left lower extremity peripheral neuropathy, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for right lower extremity peripheral neuropathy to include as secondary to a service-connected disability, is remanded. Entitlement to a total rating based on individual employability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active military service from November 1984 to January 2008. This matter is on appeal from an April 2016 rating decision, and was previously remanded by the Board of Veterans' Appeals (Board) in April 2018, October 2020, January 2021, and June 2021. Unfortunately, there has not been substantial compliance with the Board's most recent remand directives regarding the service connection issues. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Bilateral upper and lower extremity peripheral neuropathy The Board's June 2021 remand instructed that medical opinions be obtained as to whether any diagnosed bilateral upper and bilateral lower extremity peripheral neuropathy is related to the Veteran's military service, or is caused or aggravated by a service-connected disability. In this regard, the Veteran is service-connected for both cervical and lumbar spine disabilities. The Veteran was provided an examination in September 2021. The examiner opined that the Veteran's peripheral neuropathy is not related to service, but did not opine was to whether it is secondary to a service-connected disability as requested. Remand for an addendum medical opinion is necessary. 2. TDIU Finally, because a decision on the remanded service connection issues could significantly impact a decision on the issue of entitlement to TDIU, the issues are inextricably intertwined. A remand of the claim for TDIU is required. The matters are REMANDED for the following action: 1. In accordance with 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 2. Obtain an addendum medical opinion from the September 2021 VA peripheral nerve conditions examiner (or, if unavailable, from a medical professional with appropriate expertise) to determine the etiology of the diagnosed bilateral upper and bilateral lower extremity peripheral neuropathy. The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (an approximate balance of positive and negative evidence) that bilateral upper and bilateral lower extremity peripheral neuropathy is caused or is aggravated by a service-connected disability (listed in a March 2021 rating decision). If bilateral upper and bilateral lower extremity peripheral neuropathy is found to have been aggravated by a service-connected disability, the examiner should quantify the approximate degree of aggravation. The examiner is reminded that the Veteran is service-connected for cervical myositis and degenerative changes at the C3-4, and C3-C6 disc bulging with bilateral foraminal narrowing; and for lumbosacral strain, lumbar myositis with degenerative changes, facet arthropathy, spondylosis L1-L4 disc desiccation with bilateral foraminal narrowing and L5-S1 nerve root compression. A complete rationale should be given for all opinions and conclusions expressed. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Barstow, Counsel 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.