Citation Nr: 21013589 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 12-05 659 DATE: March 9, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for service-connected right upper extremity neuropathy is remanded. Entitlement to an initial disability rating in excess of 10 percent for service-connected left upper extremity neuropathy is remanded. Entitlement to an initial disability rating in excess of 20 percent for service-connected right lower extremity neuropathy is remanded. Entitlement to an initial disability rating in excess of 20 percent for service-connected left lower extremity neuropathy is remanded. REASONS FOR REMAND The Veteran had active service from October 1966 to June 1969. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in May 2011 by a Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Board denied entitlement to an initial disability rating in excess of 10 percent each for service-connected bilateral upper extremity neuropathy and entitlement to an initial disability rating in excess of 20 percent each for service-connected bilateral lower extremity neuropathy. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In October 2020, the Court issued an Order that granted a Joint Motion for Partial Remand (JMPR) filed by counsel for the Veteran and VA, vacating that portion of the Board’s decision that denied initial disability ratings in excess of 10 percent each for left and right upper extremity neuropathy and initial disability ratings in excess of 20 percent each for left and right lower extremity neuropathy, and remanded the matters to the Board for readjudication in compliance with the JMPR. The Court’s Order did not disturb that portion of the Board’s decision that granted initial disability ratings of 10 percent each for bilateral upper extremity neuropathy and initial disability ratings of 20 percent each for bilateral lower extremity neuropathy. 1. Entitlement to increased ratings for bilateral upper and lower extremity neuropathy. In the October 2020 JMPR, the parties agreed that the Board erred, in part, by relying on inadequate VA examinations and opinions when denying the Veteran’s claims for entitlement to higher initial disability ratings for his service-connected neuropathy of the upper and lower extremities. In an October 2014 decision, the Board observed, after reviewing September 2010 and November 2012 VA examinations, that it was unclear which nerves were affected by the Veteran’s service-connected neuropathy as the examination reports identified conflicting nerve involvement. On remand, the Board directed the agency of original jurisdiction (AOJ) to schedule the Veteran for a VA neurological examination in order to assess the nature and severity of his service-connected neuropathy of the upper and lower extremities. The examiner was directed to perform all indicated tests and studies and to detail the findings in the examination report. Further, the examiner was directed to specifically identify which nerves were affected. While numerous VA examinations were conducted following the October 2014 Board decision, no additional testing was conducted. Rather, it appears that each of the subsequent VA examinations relied upon the testing that was conducted during the November 2012 VA examination. Also, none of the subsequent examinations adequately identified which nerves were affected by the Veteran’s neuropathy of the upper and lower extremities, as directed in the October 2014 Board remand instructions. The parties to the JMPR agreed that, following remand by the Court, the Board was to ensure that a new VA examination be obtained that specifically identifies all of the affected nerves in the Veteran’s upper and lower extremities pursuant to the October 2014 Board remand instructions. Therefore, remand is warranted to so that the Veteran may be afforded a new VA examination. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from March 2018 to the present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected upper and lower extremity neuropathy. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. All appropriate testing should be conducted, including but not limited to EMG and/or NCV testing. The examiner is asked to respond to the following: (a.) Identify each nerve involved in the Veteran’s upper and lower extremity neuropathy. The examiner should attempt to reconcile his/her current findings with any conflicting finding in the September 2010, November 2012, April 2017, January 2018, and March 2018 VA examination reports and opinions. (b.) Clarify whether the Veteran’s upper extremity neuropathy involves the median or musculocutaneous nerve, or both. Again, the examiner should attempt to reconcile his/her current findings with any conflicting finding in the November 2012 and January 2018 VA examination reports. All opinions should be supported by a medical explanation or rationale. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. CHRISTOPHER A. WENDELL Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Bristow Williams, 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.