Citation Nr: 21009999 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-25 976 DATE: February 23, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the bilateral upper and lower extremities, to include as secondary to coronary artery disease (CAD) and hypertension, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to May 1972. In May 2017, the Veteran testified in a videoconference hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record and has been reviewed. In January 2018, the Board remanded the claim for further development, to include obtaining addendum opinions in connection with the Veteran’s claims. In October 2019, the Board granted entitlement to service connection for hypertension and remanded the issue of service connection for bilateral upper and lower extremity peripheral neuropathy to obtain an addendum medical opinion. Specifically, the Board requested an opinion for direct service connection, to include as due to exposure to herbicide agents, and secondary opinion as to whether the diagnosed bilateral upper and lower extremity peripheral neuropathy was caused or aggravated by the service-connected residuals of gunshot wound. A medical opinion was obtained in July 2020, in which the examiner explained why the diagnosed bilateral upper and lower extremity peripheral neuropathy is not related to service, to include conceded exposure to herbicide agents as well as to why it was not caused or aggravated by the service-connected residuals of gunshot wound. In a February 2021 appellate brief, the Veteran’s representative asserted that the July 2020 opinion is inadequate because it did not consider whether the diagnosed peripheral neuropathy of the upper and lower extremities was caused and/or aggravated by the service-connected CAD and hypertension. The Board disagrees that the examiner’s failure to consider this renders the VA examiner’s opinion inadequate because such was never raised by the Veteran or the record until the February 2021 argument; in other words, after the July 2020 examiner’s opinion. At any rate, given that the representative raised a new theory of entitlement, the Board will remand the claim an additional time to obtain an addendum medical opinion. The matters are REMANDED for the following action: 1. Obtain another medical opinion from an appropriate VA examiner with regard to the likely etiology of the Veteran’s peripheral neuropathy of the upper and lower extremities. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After a review of the record, the examiner is asked to respond to the following: Provide an opinion as to whether it is at least as likely as not (50 percent or higher probability) that the diagnosed peripheral neuropathy of the right and left upper and lower extremities was caused OR aggravated by the service-connected CAD and/or hypertension. A complete rationale should be provided for all opinions. 2. Thereafter, readjudicate the remanded claim, to include consideration of both direct and secondary service connection. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Yaffe, 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.