Citation Nr: 21008655 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 18-45 252 DATE: February 17, 2021 REMANDED Entitlement to an evaluation in excess of 20 percent for service-connected right lower extremity peripheral neuropathy (sciatic nerve) is remanded. Entitlement to an evaluation in excess of 20 percent for service-connected left lower extremity peripheral neuropathy (sciatic nerve) is remanded. Entitlement to an evaluation in excess of 20 percent for service-connected right lower extremity peripheral neuropathy (femoral nerve) is remanded. Entitlement to an evaluation in excess of 20 percent for service-connected left lower extremity peripheral neuropathy (femoral nerve) is remanded. Entitlement to an evaluation in excess of 20 percent for service-connected right upper extremity diabetic peripheral neuropathy is remanded. Entitlement to an evaluation in excess of 20 percent for service-connected left upper extremity diabetic peripheral neuropathy is remanded. Entitlement to an evaluation in excess of 40 percent for service-connected diabetes mellitus, type II is remanded. Entitlement to service connection for gastroesophageal reflux disease (claimed as Barrett’s esophagus and esophageal varices) is remanded. Entitlement to special monthly compensation (SMC) based on the need for aid and attendance is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1963 to October 1969. 1. Entitlement to increased ratings for peripheral neuropathy of the bilateral upper and lower extremities and entitlement to an evaluation in excess of 40 percent for service-connected diabetes mellitus, type II is remanded. The Board notes that additional medical records were associated with the claims file since the most recent December 2019 supplemental statement of the case (SSOC) was issued for these claims. Recently obtained VA treatment records address muscle strength in all 4 extremities and document a physical therapy evaluation for concerns regarding lower body strengthening and balance. See VA treatment records, January 2, 2020, and January 29, 2020. These newly obtained VA treatment records also concern diabetes management. See VA treatment record, September 2020. Therefore, these records are relevant. On December 3, 2020, the Board sent the Veteran and his representative a letter asking whether he would like to waive review by the Agency of Original Jurisdiction (AOJ) of newly received VA treatment records and VA examination reports. The Veteran was notified that he had 45 days from the date of this letter to respond, and that, if he did not respond within 45 days, his appeal would be remanded to the AOJ for review. Neither the Veteran nor his representative responded to this letter. As such, the claims for increased evaluations related to the Veteran’s bilateral upper and lower extremities and his service-connected diabetes mellitus must be remanded in order to allow for AOJ consideration of this new evidence. Moreover, given that the most recent VA examinations related to these disabilities were conducted in 2018 and 2019, the Board finds that new VA examinations should be conducted in order to ascertain the current severity of these service-connected disabilities. Further, on remand, all outstanding VA treatment records should be associated with the claims file. 2. Entitlement to service connection for gastroesophageal reflux disease (claimed as Barrett’s esophagus and esophageal varices) is remanded. With regard to the Veteran’s claim for entitlement to service connection for gastroesophageal reflux disease (claimed as Barrett’s esophagus and esophageal varices), the Veteran has claimed this condition as secondary to either his service-connected diabetes mellitus, type II or his service-connected nonalcoholic steatohepatitis (claimed as cirrhosis of the liver). In light of his assertions, the Board finds that a medical opinion should be obtained regarding the etiology of his claimed disability. 3. Entitlement to SMC based on the need for aid and attendance is remanded. In an April 2019 determination, the Board remanded this issue in order to provide the Veteran with a statement of case (SOC) addressing the issue of entitlement to SMC based on the need for aid and attendance. As no such SOC has been provided to the Veteran, this issue is remanded once again. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Send the Veteran a SOC on the issue of entitlement to SMC based on the need for aid and attendance. Advise him that he must submit a timely substantive appeal if he wishes the Board to consider this claim, as well as the time limits within which he must do so. 2. Associate with the claims file all outstanding treatment records from the following: (a.) The Fayetteville VA Medical Center (VAMC) and associated outpatient clinics from October 2020 to the present; (b.) The Durham VAMC and associated outpatient clinics from December 2019 to the present; (c.) And the Salisbury VAMC and associated outpatient clinics from July 2018 to the present. 3. Schedule the Veteran for appropriate VA examinations to ascertain the current severity and manifestations of his service-connected right and left lower extremity peripheral neuropathy (sciatic nerve), right and left lower extremity peripheral neuropathy (femoral nerve), and right and left upper extremity diabetic peripheral neuropathy. 4. Schedule the Veteran for an appropriate VA examination to ascertain the current severity and manifestations of his service-connected diabetes mellitus, type II. 5. Schedule the Veteran for a VA examination for his claimed gastroesophageal reflux disease (claimed as Barrett’s esophagus and esophageal varices). All appropriate tests and studies should be performed, and all clinical findings reported in detail. The claims file should be provided to the appropriate examiner for review, and the examiner should note that it has been reviewed. After reviewing the file, examining the Veteran, and noting his reported history of symptoms, the examiner should provide an opinion as to whether it is at least as likely as not that any previously diagnosed gastrointestinal disability (to include gastroesophageal reflux disease, Barrett’s esophagus, or esophageal varices) was caused or aggravated by his service-connected diabetes mellitus, type II or his service-connected nonalcoholic steatohepatitis. The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Durham, 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.