Citation Nr: 21075341 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 17-45 597 DATE: December 20, 2021 REMANDED Entitlement to service connection for right foot and right leg peripheral neuropathy to include as due to herbicide exposure is remanded. Entitlement to service connection for left foot and left leg peripheral neuropathy to include as due to herbicide exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1965 to October 1969. He passed away in July 2020. The appellant is the Veteran's surviving spouse. The RO has accepted her as claimant in substitution of the Veteran. These matters come before the Board of Veterans' Appeals (Board) on appeal from a February 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The case was previously remanded by the Board in May 2019 and September 2021 for additional development. The matters were also before the Board in September 2020, when it was dismissed prior to the appellant being substituted. 1. Entitlement to service connection for right foot and right leg peripheral neuropathy to include as due to herbicide exposure. 2. Entitlement to service connection for left foot and left leg peripheral neuropathy to include as due to herbicide exposure. Although the Board sincerely regrets additional delay, there has not been substantial compliance with the Board's previous remand directives regarding the issues and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board's September 2021 remand directives sought an addendum medical opinion as to whether it was as likely as not that the Veteran's bilateral peripheral neuropathy was related to his active service, including his presumed in-service herbicide exposure. An addendum VA medical opinion was provided in October 2021. The examiner found it less likely than not the Veteran's bilateral peripheral neuropathy was related to service. Regarding the Veteran's right foot and right leg peripheral neuropathy, the clinician's rationale only stated the right foot peripheral neuropathy is consistent with sciatic nerve impingement as shown in medical treatment records in September 2017. Regarding the Veteran's left foot and left leg peripheral neuropathy, the clinician again found it less likely than not related to service but offered an identical rationale, focusing solely on the Veteran's right foot peripheral neuropathy. The Board finds there has not been substantial compliance with its directives. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As to the Veteran's right foot and right leg peripheral neuropathy, the clinician failed to address the Veteran's lay statements in his hearing with the RO in October 2017 where he stated he first notice pain in his legs and feet soon after service in 1970. The clinician's opinion solely relies on the sciatic nerve impingement shown in September 2017 medical records. The Veteran's statements as to pain before evidence of the nerve impingement were not considered or evaluated. It is well settled that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006); Barr v. Nicholson, 21 Vet. App. 303 (2007). As to the Veteran's left foot and left leg peripheral neuropathy, the clinician's rationale is inapplicable. It refers only to the Veteran's right lower peripheral neuropathy. As such, the clinician's opinion is left unsupported by any relevant rationale. For the above reasons, the Board finds a remand is warranted. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral peripheral neuropathy of the lower extremities is at least as likely as not related to active service, to include his presumed in-service herbicide exposure. The examiner is reminded that the absence of a disease from the presumptive list does not preclude a Veteran from otherwise proving that his disability resulted from exposure to herbicide exposure. The examiner's attention is drawn to the Veteran's October 2017 hearing with the RO where he states his leg and foot pain began soon after service in 1970. The mere absence of evidence of contemporaneous treatment in the service treatment records cannot, standing alone, serve as the sole basis for an unfavorable opinion. However, it is permissible to consider this as one factor in the determination regarding the origins of the claimed disability, providing there is also sufficient explanation as to why it is reasonable to have expectation of treatment in the circumstance presented. All opinions provided must be supported by a clear rationale. The examiner is asked to explain in detail the underlying reasoning for his or her opinion, to include citing to relevant evidence, supporting factual data, prior medical opinions, and medical literature, as appropriate. If any requested opinion cannot be provided without resorting to mere speculation, the examiner must explain why a more definitive response is not possible or feasible. In other words, merely saying he or she cannot respond will not suffice. K.A. KENNERLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lee Feldman, Associate 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.