Citation Nr: 21008814 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 17-04 733 DATE: February 18, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities is remanded. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities is remanded. REASONS FOR REMAND The Veteran had active service with the Army from December 1965 to December 1967. This matter is on appeal to the Board of Veterans’ Appeals (the Board) from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2020, the Veteran testified in a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is in the evidence of record. At the August 2020 hearing, the Veteran requested through his representative and was granted 60 days to submit a statement from his VA treating physician at Aurora Clinic, which was delayed due to the Covid-19 pandemic. No statement was received or associated with the claims file. However, the Veteran’s representative submitted a December 2012 nerve conduction study, which was duplicative of a document previously received and considered in the December 2016 statement of the case (SOC). This record was cumulative of the facts previously established. Personal statements from the Veteran and his wife were also submitted. See 38 C.F.R. § 19.31. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). The Board finds that more development is necessary prior to final adjudication of the claims on appeal. The threshold for finding a link between current disability and disease or injury in service is low. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in disability compensation claims, the VA must provide a medical examination when there is competent evidence of a current disability or persistent or recurrent symptoms of a disability; evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; and an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service-connected disability. However, there is insufficient competent medical evidence on file for the VA to make a decision on the claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The Veteran contends that his current peripheral neuropathy of the bilateral upper and lower extremities is due to his in-service herbicide agent exposure in Vietnam. In April 2020, the Veteran reported about a year after he returned from Vietnam, he noticed a tingling sensation in his hands and feet. At times, he had pain in two of the fingers in his right hand. During his August 2020 hearing, he testified that he noticed a tingling in his fingers about a year after he returned from Vietnam and as time went on a numbness from his knees into his calves. The bottom of his feet are now completely numb. Post service treatment records show the Veteran was diagnosed with peripheral neuropathy in November 2012. The December 2016 SOC found his military personnel records showed service in the Republic of Vietnam at a time when the Department of Defense acknowledges the use of Agency Orange as a defoliant. Therefore, exposure to an herbicide agent is conceded. To date, the Veteran has not been afforded a VA examination to determine the nature and etiology of his claimed peripheral neuropathy of the bilateral upper and lower extremities. Accordingly, the Board finds that a remand is necessary. Furthermore, the Veteran’s VA treatment records note in August 2013 and April 2014 that he received infrequent care from a Doctor Debry, a non-VA primary care physician. Treatment records from this provider have not been associated with the claims folder. Therefore, the Veteran should be provided the opportunity to complete a VA Form 21-4142 to authorize the release of information from the private medical provider(s) he identifies. The matters are REMANDED for the following action: 1. Provide the Veteran a VA Form 21-4142. Request that he identify all non-VA health care providers including the name and address who have treated him during the pendency of this appeal. If the Veteran identifies a private provider, make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. Obtain and associate all other outstanding VA and non-VA treatment records with the claims file. 2. Once the above development has been completed, schedule the Veteran for a VA examination of his peripheral neuropathy of the bilateral upper and lower extremities. The claims file should be forwarded to an appropriately qualified clinician. The complete record, to include a copy of this remand and the claims folder, must be made available to and reviewed by the examiner in conjunction with the examination. The examination report must include a notation that this record review took place. (a.) The reviewing clinician is asked to opine on the following: If it is at least as likely as not that his peripheral neuropathy of the bilateral lower extremities had its onset in service or was otherwise etiologically related to any event or circumstance of his service, to include exposure to an herbicide agent. If it is at least as likely as not that his peripheral neuropathy of the bilateral upper extremities had its onset in or was otherwise etiologically related to any event or circumstance of his service, to include exposure to an herbicide agent. 3. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran and his representative should be furnished with a supplement statement of the case and afforded the opportunity to respond. Thereafter, the case should be returned to the Board for further consideration. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K.L. Byers 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.