Citation Nr: 21010502 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-41 083A DATE: February 25, 2021 ORDER Entitlement to service connection for nerve damage of the bilateral legs, to include as secondary to a service-connected disability, is granted. FINDINGS OF FACT 1. The Veteran is service connected for stress fractures of the right and left leg. 2. The Veteran has a current diagnosis of polyneuropathy of the bilateral lower extremities. 3. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s bilateral lower extremity polyneuropathy is due to her service-connected bilateral leg fractures. CONCLUSION OF LAW The criteria for service connection for nerve damage of the bilateral legs is met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from March 1985 to February 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office. In a May 2018 decision, the Board remanded the matter to obtain a VA examination regarding the nature and etiology of any diagnosed condition of the bilateral legs, to include nerve damage of the bilateral legs, including as secondary to a service-connected disability. See May 2018 Board Remand, pg. 10. In July 2019, a VA examination was completed in substantial compliance with remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for nerve damage of the bilateral legs, as secondary to a service-connected disability, is granted. The Veteran contends that nerve damage to her bilateral legs is related to service, or in the alternative, secondary to her service-connected bilateral stress fractures. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. Service connection is also warranted for a disability that is proximately due to or the result of or aggravated beyond its natural progression by a service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). In order to prevail under a theory of secondary service connection, there must be: (1) evidence of a current disorder; (2) evidence of a service-connected disability; and, (3) medical nexus evidence establishing a connection between the service-connected disability and the current disorder. See Wallin v. West, 11 Vet. App. 509, 512 (1998). For secondary service connection, the Veteran must show a current disability. In July 2019, the VA examiner noted that the Veteran has been diagnosed with polyneuropathy of the bilateral lower extremities. See July 2019, Peripheral Neuropathy Disability Benefits Questionnaire (DBQ), Section I Diagnosis, pg. 7. Thus, the Board finds that the Veteran’s claim meets the first element of secondary service connection. As to the second element of secondary service connection, the Veteran must show evidence of a service-connected disability. Per a March 1995 rating decision, the Veteran’s was service connected for a stress fractures of the left and right leg. Thus, as the Veteran is claiming that her condition of nerve damage of the bilateral legs is secondary to leg fractures, a service-connected disability, the Board finds that the claim meets the second element of secondary service connection. As to the last element of service connection, the Veteran must show a medical nexus evidence establishing a connection between the service-connected disability and the claimed condition. Weighing in the Veteran’s favor is a July 2019 positive nexus opinion which states that the Veteran’s peroneal branch of the sciatic nerve has been permanently affected as part of her polyneuropathy of her bilateral lower extremities. See July 2019 VA examiner opinion, pg. 7. The July 2019 examiner stated that a fracture of the tibia is a common cause of peroneal nerve damage and concluded that it is as likely as not that the Veteran’s bilateral leg fractures caused peripheral nerve damage. Id. The examiner noted a chronic stress reaction of the tibia based on physical examination and X-ray findings. See July 2019 Peripheral Nerve Conditions, DBQ, pg. 2; see also November 2016 Knee and Lower Leg Conditions, DBQ, pg. 2 (noting stress fractures of bilateral tibia). Due to this evidence it is at least as likely as not the Veteran's nerve damage diagnosed as polyneuropathy on the current exam of the bilateral legs is due to service-connected right and left leg stress fracture. The July 2019 examiner also provided a negative nexus opinion regarding bilateral lower extremity myositis. See August 24, 2019 Peripheral Nerve Conditions, Opinion, pg. 14. The examiner opined that myositis is not service related because there is no diagnosis of myositis. See id. at pg. 14. The Board recognizes that when a claimant makes a claim, he or she is seeking service connection for symptoms regardless of how symptoms are diagnosed or labeled. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). As the medical evidence of record notes the Veteran’s diagnosis is peripheral neuropathy, rather than myositis, the Board finds service connection for myositis is not warranted. The Board acknowledges the Veteran’s lay statements relating her bilateral lower extremity peripheral nerve damage to running while in service. The cause of any neuropathy disorder involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and effect relationship, she is not competent to render a complex medical opinion regarding the etiology of her peripheral nerve condition. As such, the question of etiology in this case may not be competently addressed by lay evidence. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, she is competent to describe her the nature of her leg symptoms and leg pain. Id. Upon review, the Board finds that the pertinent medical evidence of record reveals that the Veteran’s peripheral nerve condition is documented in her treatment records. See October 2000 VA Treatment record (noting possible early peripheral neuropathy); see also October 2012 (indicating polyneuropathy). Accordingly, the Board finds the preponderance of the competent and credible evidence is not against the claim; the benefit of the doubt doctrine applies. Entitlement to service connection for polyneuropathy of the bilateral lower extremities granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. McKenzie, Associate 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.