Citation Nr: 21077054 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-50 807 DATE: December 28, 2021 REMANDED Entitlement to service connection for upper right extremity peripheral neuropathy, to include as due to Agent Orange exposure, is remanded. Entitlement to service connection for upper left extremity peripheral neuropathy, to include as due to Agent Orange exposure, is remanded. Entitlement to service connection for lower right extremity peripheral neuropathy, to include as due to Agent Orange exposure, is remanded. Entitlement to service connection for lower left extremity peripheral neuropathy, to include as due to Agent Orange exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1969 to March 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2017 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). Bilateral Upper and Lower Extremity Peripheral Neuropathy While the Veteran was provided with a May 2017 VA Peripheral Nerves Conditions examination the Board finds it to be inadequate for adjudication purposes. While the examiner diagnosed the Veteran with idiopathic sensory peripheral neuropathy of his bilateral upper and lower extremities, the examiner did not proffer an opinion regarding the etiology of the Veteran's disabilities. The Veteran's service treatment records (STRs) do not indicate that he experienced peripheral neuropathy on active-duty service; however, the Veteran has claimed that his peripheral neuropathy was potentially caused by his exposure to Agent Orange while on active-duty service. The Veteran was boots on the ground in Vietnam, therefore, Agent Orange exposure is conceded. Additionally, the Board notes the Veteran's VA treatment records contain a May 2017 Neurology note which states that the Veteran's neuropathy could be due to Agent Orange. While late onset peripheral neuropathy is not a presumptive condition due to herbicide exposure, that does not bar the Veteran from direct service connection for the claimed conditions based on his herbicide exposure. Based on the foregoing, the Board finds a medical opinion is necessary to determine whether the Veteran's bilateral upper and lower extremity peripheral neuropathy conditions are etiologically related to his active military service, to include as due to the Veteran's conceded Agent Orange exposure The matters are REMANDED for the following action: Afford the Veteran a VA examination by a VA examiner with sufficient expertise to address the etiology of the Veteran's upper and lower extremity peripheral neuropathy disabilities. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether the Veteran's bilateral upper and lower extremity peripheral neuropathy disabilities at least as likely as not (a 50 percent probability or greater) originated during the Veterans period of active service or are otherwise etiologically related to his active service. The examiner must specifically opine whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's bilateral upper and lower extremity peripheral neuropathy disabilities were due to, or otherwise etiologically related to, the Veteran's conceded Agent Orange exposure while serving in Vietnam. The examiner must provide a complete rationale for all proffered opinions. In this regard, the examiner must discuss and consider the Veteran's competent lay statements. In rendering an opinion, the examiner must address the articles cited in the Veteran's August 2021 Appellant's Brief. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Gresham 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.