Citation Nr: 21007892 Decision Date: 02/11/21 Archive Date: 02/11/21 DOCKET NO. 17-10 907 DATE: February 11, 2021 REMANDED The issues of entitlement to service connection for peripheral neuropathy of the left and right feet are remanded for additional development. REASONS FOR REMAND The Veteran served on active duty from February 1976 to May 1976 and from January 1977 to December 1979. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an April 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the April 2016 rating decision, the RO, in relevant part, denied the Veteran’s claim for service connection for peripheral neuropathy of the left foot and right foot, right foot bunion, and left foot hammertoes. In June 2018, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is of record. In March 2019 and October 2020, the Board remanded the issues of entitlement to service connection for peripheral neuropathy of the left foot and right foot for further evidentiary development. Pursuant to the October 2020 Board remand, addendum opinions were obtained in November 2020. The November 2020 VA examiner opined that the Veteran’s bilateral peripheral neuropathy was more likely than not related to the Veteran’s chronic alcohol consumption but did not address whether the Veteran’s chronic alcohol consumption was related to or aggravated by his service-connected post-traumatic stress disorder (PTSD). Based on the foregoing deficiencies, the Board finds that another addendum opinion is required prior to adjudicating the claim. The matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from the November 2020 VA clinician, or a psychiatrist/psychologist, to determine the nature and the etiology of the Veteran’s chronic alcohol consumption. The contents of the entire electronic claims file, to include a complete copy of this REMAND, must be made available to the designated clinician. The clinician should opine on the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s chronic alcohol consumption is proximately due to service-connected PTSD? (b.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral foot neuropathy is aggravated beyond its natural progression by (chronic alcohol consumptions associated with) service-connected PTSD? The term “aggravation” means an increase in the claimed disability; that is, a worsening of the condition beyond the natural clinical course and character of the condition due to the service-connected disability as contrasted to a temporary worsening of symptoms. If aggravation is found, the examiner must note the baseline level of severity of the chronic alcohol consumption to aggravation by the service-connected PTSD. The examination report must include a complete rationale for all opinions expressed. A rationale for any opinions expressed should be set forth. If the examiner cannot provide an above opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). 2. After completing the requested actions, and any additional action deemed warranted, the AOJ should readjudicate the claim. If the benefit sought on appeal remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and given the opportunity to respond thereto. The case should then be returned to the Board for further appellate consideration, if in order. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Bilstein, 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.