Citation Nr: 21014713 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 14-27 563 DATE: March 15, 2021 ORDER Entitlement to service connection for peripheral neuropathy of the left upper extremity is denied. Entitlement to a total rating for compensation purposes based on individual un-employability due to service-connected disabilities (TDIU) is dismissed. FINDINGS OF FACT 1. On August 14, 2019, prior to the promulgation of a decision in the appeal, the Board received notification from the appellant that a withdrawal of the appeal for entitlement to TDIU is requested. 2. The preponderance of the evidence is against finding that peripheral neuropathy of the left upper extremity began during active service or is otherwise related to an event, injury, or disease during service or a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for dismissal of entitlement to TDIU have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. The criteria for service connection for peripheral neuropathy of the left upper extremity are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from January 1966 to May 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2014rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. 1. Entitlement to TDIU The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the appellant or the authorized representative. 38 C.F.R. § 20.204. The appellant has withdrawn the appeal for TDIU and there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal and it is dismissed. In addition, the Board notes the withdrawal was effective when received by the RO in August 2019, notwithstanding the subsequent filing of the February 2021 brief. 38 C.F.R. § 20.204. If the Veteran wants to re-file his claims in the future, he may do so. 2. Entitlement to service connection for peripheral neuropathy of the left upper extremity The Veteran contends that he is entitled to service connection for peripheral neuropathy of the left upper extremity because the claimed disability is the result of active service. In the alternative, the Veteran asserts that the claimed disability was caused or aggravated by service-connected diabetes mellitus. Service connection may be established for 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. To establish service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be established for a disability that is proximately due to, or aggravated by, service-connected disability. 38 C.F.R. § 3.310. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an event, injury, or disease during service, or to a service-connected disability. The Board concludes that, while the Veteran has a current diagnosis of peripheral neuropathy of the left upper extremity, the preponderance of the evidence weighs against finding that disability began during service or is otherwise related to an in-service injury, event, or disease, or to have been caused or aggravated by a service-connected disability. The Board also concludes that the preponderance of the evidence is against finding that peripheral neuropathy of the left upper extremity is proximately due to or the result of or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995); 38 C.F.R. § 3.310(a). Medical treatment records prior to February 2018 noted that the Veteran did not have diabetic peripheral neuropathy of the upper extremities. However, a February 2018 neurology note indicated “left CTS and Ulnar neuropathy.” In May 2019, the Board remanded the claim for a medical opinion on causation and aggravation. In a January 2020 VA examination, the VA examiner noted a diagnosis of peripheral neuropathy/left ulnar neuropathy. The examiner opined that the claimed disability was not secondary to the service-connected diabetes mellitus. The rationale provided was that left ulnar neuropathy and diabetes mellitus were not medically related. “Ulnar neuropathy is a common problem.” It happens when the ulnar nerve (in the arm) becomes compressed and can cause numbness, tingling, and pain down the arm into part of the hand. “Therefore, no aggravation is noted.” The examiner also opined that the claimed disability was not incurred in or caused by service. In support of that opinion, the examiner reasoned that the service medical records did not show complaints, treatment, or diagnosis of peripheral neuropathy or left ulnar neuropathy during service. The examiner also highlighted that there was no evidence of chronicity of care. The Board finds that opinion was provided by a qualified examiner based on review of the record and examination of the Veteran and is persuasive evidence. The Veteran believes that peripheral neuropathy of the left upper extremity is related to an in-service injury, event, disease or is secondary to a service-connected disability. The Veteran is not competent to provide a diagnosis or etiology opinion regarding the issues presented in this claim. The issues are medically complex, as they requires knowledge of the interaction between multiple organ systems in the body and anatomical relationships. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to provide medical opinions. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Kahana v. Shinseki, 24. Vet. App. 428 (2011). The Board finds that the most persuasive evidence in this case is the opinion of the January 2020 VA examiner because of the training of the examiner and the examination conducted. The Board finds that there is no competent evidence of record which relates any left upper extremity neurologic disability to service or show that any left upper extremity neurologic disability was caused or aggravated by any service-connected disability. (Continued on the next page)   Accordingly, the Board finds that the preponderance of the evidence is against the claim for service connection for a left upper extremity neurologic disability. Therefore, the claim must be denied. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Cross, 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.