Citation Nr: 21014719 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 17-64 528 DATE: March 15, 2021 REMANDED Service connection for right lower extremity peripheral neuropathy (PN). Service connection for left lower extremity PN. REASONS FOR REMAND The Veteran served on active duty from September 1967 to September 1969, including in the Republic of Vietnam. He testified before the undersigned Veterans Law Judge (VLJ) in September 2020. A copy of the transcript has been associated with the record. He asserts that bilateral lower extremity peripheral neuropathy is a direct result of exposure to herbicides during his service in the Vietnam. As to the contention of service connection based on direct causation due to herbicide exposure, VA and private treatment records reveal that he was diagnosed with bilateral lower extremity PN in December 2013. Further, service in Vietnam is confirmed and herbicide exposure is conceded. Next, he submitted two separate opinions in March 2020 which suggest that, by a process of exclusion, PN was likely related to herbicide exposure. As to the contention that service connection is warranted on a secondary basis, VA treatment records suggest that the Veteran underwent lower extremity saphenous vein grafts in accordance with his service-connected coronary artery disease (CAD), which could be related to lower extremity PN. Nonetheless, no examiner or treatment provider has provided any reasoning or rationale in support of their opinion. Thus, an addendum opinion must be obtained. The matters are REMANDED for the following actions: 1. Identify and obtain any outstanding, pertinent, VA and private treatment records and associate them with the claims file. 2. Direct the claims file to a clinician to assess the nature and etiology of the Veteran’s bilateral lower extremity PN. After reviewing the file, the clinician is asked to provide an opinion as to the following: • whether it is at least as likely as not (50 percent probability or greater) that bilateral lower extremity PN is directly related to herbicide exposure. o The clinician is cautioned that the opinion cannot be based on the absence of “early onset” PN but rather the clinician is asked to consider whether PN is due to herbicide exposure on a direct causation basis. • whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral lower PN is proximately due to, or permanently worsened by, service connection CAD. A thorough rationale is required for any opinion rendered. 3. If the clinician determines that an examination is necessary in order to provide the requested opinions, then one should be scheduled. L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Yacoub, 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.