Citation Nr: 21008855 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 19-06 561 DATE: February 18, 2021 REMANDED Entitlement to service connection for peripheral neuropathy in the lower left extremity, including as due to herbicide exposure, or as secondary to a service-connected lung disability, is remanded. Entitlement to service connection for peripheral neuropathy in the lower right extremity, including as due to herbicide exposure, or as secondary to a service-connected lung disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1966 to September 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2017 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). This appeal was previously remanded by the Board in October 2020 for additional development. That development has been accomplished and this appeal is again before the Board. 1. Entitlement to service connection for peripheral neuropathy in the lower left extremity, including as due to herbicide exposure, or as secondary to service-connected lung disability 2. Entitlement to service connection for peripheral neuropathy in the lower right extremity, including as due to herbicide exposure, or as secondary to service-connected lung disability The Veteran seeks service connection for peripheral neuropathy of the bilateral lower extremities. He asserts this disability results from herbicide exposure during active duty service. Unfortunately, there has not been substantial compliance with the Board’s previous October 2020 remand directives regarding these issues, and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Specifically, in the Board’s prior October 2020 remand order, the examiner was instructed to not rely on the fact that non-early onset peripheral neuropathy is not on the presumptive list of diseases associated with herbicide exposure. Upon review, however, the December 2020 VA examiner stated “in the absence of a diabetes diagnosis with secondary neuropathy, veterans of the Vietnam War are only eligible for claiming service connection for peripheral neuropathy within a year of herbicide exposure.” Thus, the examiner did not provide an opinion which specifically addressed the question of whether this Veteran’s exposure to herbicides could have resulted in peripheral neuropathy of the lower extremities in the present case. These matters are REMANDED for the following action: 1. Obtain a medical opinion to determine the nature and etiology of the Veteran’s peripheral neuropathy of the bilateral lower extremities. Examination of the Veteran is not required unless the examiner determines that an examination is necessary to provide a reliable opinion. Following a review of the claims file, the examiner should address the following: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s diagnosis of peripheral neuropathy of the bilateral lower extremities had its onset in service or is otherwise etiologically related to any in-service disease, injury, or event, including exposure to tactical herbicides? In providing the opinion, the examiner must take into account the Veteran’s personal circumstances and how the recognized risk factor(s) apply in his particular case. The examiner may not rely solely on the fact that the Veteran’s non-early onset peripheral neuropathy is not on the presumptive list of diseases associated with herbicide exposure. A fully articulated rationale for each opinion requested must be set forth in the medical report. The examiner must discuss the particulars of this Veteran’s medical history and the relevant medical science applicable to this case, which may reasonably make clear the medical guidance in the study of this case. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Thomas D. Jones, 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.