Citation Nr: 21009687 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 17-39 393 DATE: February 23, 2021 REMANDED Entitlement to service connection for respiratory condition, to include asthma is 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 served on active duty from July 1966 to June 1969 in the United States Army, to include active duty service in the Republic of Vietnam. 1. Entitlement to service connection for a respiratory condition, to include asthma is remanded. The claim is remanded to obtain a medical opinion that addresses whether the Veteran had a preexisting respiratory condition that was aggravated by service, or whether the Veteran’s current respiratory condition is etiologically related to active duty service. The basis of the denial in the rating action on appeal was that the Veteran had asthma before service that was not aggravated by service; however, there was related diagnosis of defect noted on the Veteran’s enlistment examination. 2. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities is remanded. 3. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities is remanded. The claims are remanded for a medical opinion to determine whether these conditions are etiologically related to active duty service, to include conceded herbicide exposure. 38 C.F.R. § 3.159 (c)(4). At the hearing before the undersigned, the Veteran recalled that he felt numbness in hands and arms within one year of separation from service and then in his feet, but never sought treatment. He also testified that a VA physician told him those complaints were relate to Agent Orange exposure. The Agency of Original Jurisdiction (AOJ) said those records not available; however, it appears the search for those records was limited to within one year of separation. On remand, the Veteran should be asked to clarify the dates of treatment at VA and then take all appropriate action to obtain the records. The matters are REMANDED for the following action: 1. Ask the Veteran to identify any providers who treated him for respiratory or peripheral neuropathy complaints since service, including the dates and periods of treatment at the East Orange VAMC. Take all appropriate action to obtain records from identified providers. 2. Obtain the Veteran’s VA treatment records for the period from February 2019 to the present. 3. After completion of the above, schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and likely etiology of any diagnosed respiratory condition, to include asthma. Copies of all pertinent records must be made available to the examiner for review. The examiner is asked to provide a response to the following: (a) Identify all diagnosed respiratory conditions. (b) Did any diagnosed respiratory disability clearly and unmistakably (i.e., it is undebatable) exist prior to his active service that began in 1966? The examiner should consider and discuss as necessary the 1966 enlistment examination and related Report of Medical History. (c) If the answer to (a) is yes, does the evidence clearly and unmistakably show (i.e., it is undebatable) that the respiratory disability was not aggravated by service or that any increase in disability was due to the natural progression of the condition? Please identify such evidence with specificity. (d) If the answer to either (b) or (c) is no, is it at least as likely as not that a diagnosed respiratory disability had its onset in or is otherwise related to service? A complete rationale must be provided for all opinions offered. 4. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the likely etiology of his bilateral upper and lower extremity peripheral neuropathy. Copies of all pertinent records must be made available to the examiner for review. The examiner is asked to provide a response to the following: (a) Is it at least as likely as not that the Veteran’s bilateral upper and lower extremity peripheral neuropathy is related to his service, to include conceded in-service exposure to herbicide agents? The examiner must consider the following: (i) the Veteran’s conceded herbicide exposure in service, and; (ii) a negative opinion cannot be based solely on the fact that the peripheral neuropathy did not manifest to a compensable disability within the requisite period following active duty service to be presumptively associated with exposure to herbicide agents. A complete rationale must be provided for all opinions offered. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P.S. McLeod 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.