Citation Nr: 21021442 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 14-24 631 DATE: April 13, 2021 ORDER Entitlement to service connection for left lower extremity neuropathy is granted. Entitlement to service connection for right lower extremity neuropathy is granted. REMANDED Entitlement to service connection for a low back disability is remanded. FINDINGS OF FACT 1. Left lower extremity neuropathy was manifest during active service. 2. Right lower extremity neuropathy was manifest during active service.   CONCLUSIONS OF LAW 1. Left lower extremity neuropathy was incurred during peacetime service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. Right lower extremity neuropathy was incurred during peacetime service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1952 to March 1956. He died in December 2016. The appellant has been substituted onto the claim. Service Connection 1. Entitlement to service connection for left lower extremity neuropathy 2. Entitlement to service connection for right lower extremity neuropathy To establish service connection a Veteran must generally show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.” Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). The Veteran contended that his pain and numbness in his lower extremities was the result of an incident during his service when he was on a flight without heat. He repeatedly reported that during this flight he lost feeling in his lower extremities due to the cold. Service treatment records show that the Veteran was treated for leg pain in March 1955 and given wintergreen. At separation, the Veteran did not report any problems with the lower extremities and specifically denied cramps in his legs and neuritis. The Veteran received a VA examination in July 2012. The examiner opined that his pain and numbness in his legs were less likely than not due to his cold exposure during service because his peripheral artery disease and spinal stenosis most likely caused the majority of his symptoms. However, the examiner indicated that it was possible for cold exposure to cause neurological symptoms such as the Veteran reported. Further, the examiner stated only that the majority of the Veteran’s symptoms were most likely caused by his PAD and spinal stenosis, which indicates that some amount of his symptomatology was in fact caused by the cold exposure. A June 2014 VA treatment record notes that the Veteran reported being unable to feel water on his legs in the shower for two weeks after his cold exposure, that he was no longer able to play baseball and that by the 1970s he could not walk 18 holes of golf. In October 2016 the Veteran was examined by a VA neurologist. He reported having numbness and pain consistently after his cold exposure during service. He had been unable to dance or exercise since the incident. The neurologist opined that the Veteran’s current symptoms were due to his cold exposure. The stated rationale was that the Veteran did not walk much in the months following his exposure due to loss of proprioceptive and unsteady gait. This led to disuse atrophy in the calf muscles which in turn led to contracture pains throughout his lower extremities. The contracture pains, neuropathy and muscle spasms that the Veteran continued to report were the result. The Board finds that the preponderance of the evidence is in favor of a finding that the Veteran’s neuropathy in the bilateral lower extremities was due to his cold exposure during service. While the Veteran denied cramps and neuritis at separation, he has consistently reported ongoing pain and numbness in the legs since. Although July 2012 VA examiner rendered a negative nexus opinion, the stated rationale suggested that some of the Veteran’s symptoms stemmed from the cold exposure. The October 2016 medical opinion contained a complete rationale and directly related the Veteran’s lower extremity symptoms to his cold exposure during service. Therefore, service connection for peripheral neuropathy of the bilateral lower extremities is granted. REASONS FOR REMAND 1. Entitlement to service connection for a low back disability is remanded. Treatment records indicate a potential connection between the Veteran’s lower extremity neuropathy and his low back pain. Remand is necessary for a medical opinion addressing the possibility of secondary service connection. The matter is REMANDED for the following action: 1. Obtain an opinion from an appropriate clinician regarding whether the Veteran’s low back disability is at least as likely as not proximately due to or aggravated by a service-connected disease or injury.   2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. If the benefit sought is not granted, send the appellant and representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Creegan 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.