Citation Nr: 21014918 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 19-32 216 DATE: March 16, 2021 ORDER Service connection for right lower extremity peripheral neuropathy is granted. Service connection for left lower extremity peripheral neuropathy is granted. FINDINGS OF FACT 1. Resolving any reasonable doubt in the Veteran’s favor, his right lower extremity peripheral neuropathy is related to herbicide agent exposure in service. 2. Resolving any reasonable doubt in the Veteran’s favor, his left lower extremity peripheral neuropathy is related to herbicide agent exposure in service. CONCLUSIONS OF LAW 1. The criteria for service connection for right lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 2. The criteria for service connection for left lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1968 to May 1971. This case is before the Board of Veterans’ Appeals (Board) on appeal from a December 2018 rating decision issued by a Department of Veterans Affairs (VA) regional office. Service Connection for Peripheral Neuropathy The Veteran contends that he has peripheral neuropathy of the right and left lower extremities due to Agent Orange exposure in Vietnam. After careful review, the Board finds that service connection is warranted. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection generally requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (“nexus”) between the current disability and the disease or injury incurred or aggravated during service. Walker v. Shinseki, 708 F.3d 1331, 1333 (Fed. Cir. 2013). Service connection is also available on a presumptive basis for certain diseases, including early-onset peripheral neuropathy, which are associated with exposure to herbicide agents like Agent Orange. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). VA regulations provide that veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975 are presumed to have been exposed to herbicide agents. 38 C.F.R. §§ 3.307(a)(6). To establish presumptive service connection for early-onset peripheral neuropathy, the disease must have become manifest to a degree of 10 percent or more within a year after the last date of herbicide agent exposure in service. Id. In this case, military records reflect that the Veteran served in Vietnam from October 1968 to October 1969, receiving the Army Commendation Medal, the Vietnam Service Medal and the Vietnam Campaign Medal. He is therefore presumed to have been exposed to herbicide agents during service. Service treatment records do not document any complaints of numbness, sensory loss, or any other symptoms of peripheral neuropathy prior to separation. However, in a September 2018 statement, the Veteran reported that his symptoms go back to his Vietnam days. At the time, he attributed them to the “pounding [his] body took” from martial arts training in service, and he did not point them out to Army medical staff because he did not want to chance staying in Vietnam for treatment. As a layperson, the Veteran is competent to report the onset of subjective symptoms, like sensory disturbances in his legs and feet. See e.g. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board finds his statement credible. Post-service medical records show treatment for neuropathic symptoms, including burning in the toes, since 2011. In April 2019, EMG and nerve conduction testing revealed findings consistent with a severe motor and sensory polyneuropathy, but no evidence of radiculopathy, plexopathy or myopathy. A non-VA neurologist, “Dr. T.H.,” noted that clinical symptoms of polyneuropathy have been present since the Veteran’s service in Vietnam. Dr. T.H. concluded that his neuropathy is most likely related to Agent Orange exposure, reasoning that the Veteran has no family history of polyneuropathy, no history of alcohol use or abuse, no diabetes, no chronic illnesses that would predispose him to neuropathy, and that Agent Orange is a known cause of polyneuropathy. Dr. T.H.’s 2019 medical opinion provides a well-reasoned explanation for the Veteran’s peripheral neuropathy, based on the available medical evidence, as well as competent, credible lay statements. The Board finds it highly probative. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). It is also uncontradicted; the record does not contain any other medical opinions on the nature and etiology of the Veteran’s disability. (Continued on the next page)   Accordingly, resolving any reasonable doubt in the Veteran’s favor, the Board finds that his peripheral neuropathy of the right and left lower extremities is related to herbicide agent exposure in service. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Service connection is granted. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D.Z. Wall, 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.