Citation Nr: 21076534 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 14-40 937 DATE: December 27, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the left upper extremity (LUE), claimed as bilateral carpal tunnel syndrome (CTS), to include as secondary to service-connected foot, knee, and back conditions, the use of assistive devices for such, and/or exposure to nerve agents is remanded. Entitlement to service connection for peripheral neuropathy of the right upper extremity (RUE), claimed as bilateral CTS, to include as secondary to service-connected foot, knee, and back conditions, the use of assistive devices for such, and/or exposure to nerve agents is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1971 to November 1973 and November 1990 to July 1991. This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) in May 2017. A transcript of the hearing is associated with the electronic claims file. The Board issued two prior remands on these claims in June 2018 and July 2020. The Board issued a decision on these claims in December 2020. However, following an appeal to the United States Court for Appeals for Veterans Claims, in August 2021 a Joint Motion for Partial Remand (Joint Motion) was entered, vacating portions of the Board's December 2020 decision. 1. Entitlement to service connection for peripheral neuropathy of the LUE, claimed as bilateral CTS, to include as secondary to service-connected foot, knee, and back conditions, the use of assistive devices for such, and/or exposure to nerve agents is remanded. 2. Entitlement to service connection for peripheral neuropathy of the RUE, claimed as bilateral CTS, to include as secondary to service-connected foot, knee, and back conditions, the use of assistive devices for such, and/or exposure to nerve agents is remanded. In the August 2021 Joint Motion, the parties agreed that the Board failed to address evidence in the record that reasonably raised the theory that the Veteran's bilateral peripheral neuropathy was due to exposure to nerve agents during his service in the Gulf War. Specifically, a July 1997 letter notifying the Veteran of potential exposure to nerve agents sarin and cyclosarin is noted, as well as a September 1997 treatment record indicating "peripheral neuropathy, rule out secondary to nerve gas exposure in Gulf War." Finally, in a June 2010 mental health nursing note the Veteran indicated that he had been exposed to nerve gas "and had physical problems they were not sure what was causing them." Accordingly, remand is warranted for further development. The matters are REMANDED for the following action: 1. Update the electronic file with any new VA treatment records and private treatment records. 2. Obtain an addendum opinion regarding the Veteran's bilateral peripheral neuropathy of the upper extremities and bilateral CTS. The examiner should be given a copy of the Veteran's entire claims file and a note that such was reviewed should be included in his or her report. The examiner should answer the following question: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's peripheral neuropathy of the bilateral upper extremities and/or his CTS was caused or aggravated by exposure to nerve agents during the Veteran's active service? A detailed rationale for the opinion must be provided. If the reviewing clinician is unable to offer the requested opinion, it is essential that the reviewing clinician offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Ruiz, 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.