Citation Nr: 21022086 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 14-42 791 DATE: April 14, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the left upper extremity is remanded. Entitlement to service connection for peripheral neuropathy of the right upper extremity is remanded. Entitlement to service connection for a left shoulder disorder is remanded. Entitlement to service connection for a right shoulder disorder is remanded. Entitlement to service connection for a left wrist disorder is remanded. Entitlement to service connection for a right wrist disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1968 to September 1971. The Veteran testified at a hearing before the undersigned Veterans Law Judge in December 2017. A transcript of that hearing is associated with the claims file. The Board regrets the delay of an additional remand, but finds that additional development is required to ensure a full and complete record upon which to adjudicate the Veteran’s claims. 1. Entitlement to service connection for peripheral neuropathy of the left upper extremity and entitlement to service connection for peripheral neuropathy of the right upper extremity are remanded. During the Veteran’s December 2017 hearing before the Board, the Veteran’s representative quoted a statement from L.M., M.D., one of the Veteran’s treating physicians. The representative reported that Dr. L.M. stated that the Veteran was “all eaten up with the neuropathy and definitely suffered . . . an early-onset diagnosis.” While the record contains private treatment records from Dr. L.M. from 2007 through 2011 and additional private treatment records from Dr. L.M.’s medical group dating from 2013 through 2018, none of the records in the claims file contain a note from Dr. L.M. with the above-noted quote or any evidence suggesting that the Veteran’s peripheral neuropathy was an early-onset peripheral neuropathy. Accordingly, upon remand, the Agency of Original Jurisdiction (AOJ) is asked to contact the Veteran’s representative and request that she submit a copy of the note from which she read during the December 2017 Board hearing that contains the above quotation, and any other pertinent medical records. 2. Entitlement to service connection for a left shoulder disorder; entitlement to service connection for a right shoulder disorder; entitlement to service connection for a left wrist disorder; and entitlement to service connection for a right wrist disorder are remanded. The Veteran contends that his osteoarthritis of the shoulders and wrists is etiologically related to bone disease which was first identified during his active duty service. In that regard, the Veteran’s service treatment records document findings of “bone disease” in the right foot, diagnosed as Freiberg’s disease. The Veteran alleges that his osteoarthritis of the shoulders and wrists is a continuation of the bone disease process that had its onset during service, or that it is otherwise related to the bone disease. Although the Veteran underwent a VA examination to assess the etiology of his arthritis of the wrists, the VA examiner’s negative opinion was based upon a finding that there was no evidence of wrist symptomatology during service. The examiner did not consider whether the Veteran’s current wrist disorders may be a continuation of or related to the “bone disease” or Freiberg’s disease, first shown in active duty service. Further, the Veteran has not undergone a VA examination to determine the etiology of his bilateral shoulder arthritis. Accordingly, a new VA examination is warranted. The matters are REMANDED for the following action: 1. Contact the Veteran’s representative and request that she submit a copy of Dr. L.M.’s notes from which she quoted during the December 2017 Board hearing which state that the Veteran was “all eaten up with the neuropathy and definitely suffered . . . an early-onset diagnosis,” and any other pertinent medical evidence that she may have. 2. Provide the Veteran with a new VA examination to determine the nature and etiology of his osteoarthritis of the bilateral shoulders and wrists. The Veteran’s claims file, all electronic records, and a copy of this remand must be reviewed by the examiner, and the examiner must state that this evidence was reviewed in the examination report. All pertinent symptomatology and findings must be reported in detail. All indicated tests and studies must be accomplished. Based upon a complete review of the evidence of record, the VA examiner must state whether it is at least as likely as not (i.e., a 50 percent probability or more) that any diagnosed bilateral shoulder or wrist disorder was caused or incurred as a result of the Veteran’s active duty service. Specifically, the examiner is asked to discuss whether the Veteran’s current bilateral shoulder and/or bilateral wrist disorders are a continuation of the disease process of, or otherwise related to, the “bone disease” or Freiberg’s disease first documented in the service treatment records. A complete rationale for all opinions must be provided. The examiner must consider and discuss all pertinent evidence in the claims file, to include the Veteran’s lay statements and testimony regarding in-service and post-service symptomatology. The examiner is advised that the Veteran is competent to report observable symptomatology. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Katz, 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.