Citation Nr: 21022877 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 16-00 205A DATE: April 19, 2021 ORDER Entitlement to service connection for left lower extremity peripheral neuropathy is granted. Entitlement to service connection for right lower extremity peripheral neuropathy is granted. FINDINGS OF FACT 1. The Veteran’s left lower extremity peripheral neuropathy is caused by the Veteran’s service connected lumbar strain. 2. The Veteran’s right lower extremity peripheral neuropathy is caused by the Veteran’s service connected lumbar strain. CONCLUSIONS OF LAW 1. The criteria to establish service connection for left lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria to establish service connection for right lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1980 to October 1993. The Veteran appealed an August 2014 rating decision by the Agency of Original Jurisdiction (AOJ). In May 2019 and October 2020, the Board of Veterans’ Appeals (Board) remanded the Veteran’s claims to the AOJ for further action consistent with the Board’s remand directives. The claims are back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A Board hearing was held in August 2018. A transcript is of record. A veteran is entitled to the Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Veteran is diagnosed with bilateral lower extremity peripheral neuropathy. See December 2020 VA examination report. The Veteran is also service-connected for lumbar strain. The Veteran contends his lower extremity nerve condition is due to his service-connected low back condition. See June 2015 notice of disagreement (NOD); February 2021 Veteran statement. January 1997 treatment records noted right lower back pain and shooting sharp pain down the right leg. A June 1997 letter by chiropractor T.D., who was treating the Veteran’s back pain, noted the Veteran likely has lumbar disc involvement with sciatica and disc degeneration. November 2011 VA treatment records noted a possibility of lumbosacral radiculopathy. VA treatment records generally note the treatment of back and neuropathy pain together. See January 2014 and May 2015 VA treatment records. A November 2015 VA examination report regarding the back noted symptoms radiating into the legs. The December 2020 VA opinions noted 2011 MRI imaging indicated lumbar radiculopathy. The Board notes the December 2020 VA opinions regarding secondary service-connection suggest that the Veteran’s lower extremity nerve condition is related to his non-service-connected diabetes. However, the above medical evidence suggests that the Veteran had lower extremity radicular symptoms as early as 1997. Medical evidence of record does not suggest the existence of diabetes until approximately 2011. See December 2011 VA treatment records. Therefore, a medical condition other than diabetes must have been causing the Veterans lower extremity nerve condition since his symptomatology developed several years earlier than his diabetes. Overall, medical evidence suggests a link between the Veteran’s back condition and his lower extremity nerve condition. The Veteran had lower extremity radicular symptoms many years before developing diabetes. The Veteran did not have lower extremity radicular symptoms until after developing his back condition. The Board finds that the evidence is at least in equipoise as to whether the Veteran’s bilateral lower extremity peripheral neuropathy is related to his service-connected lumbar strain. Resolving reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s bilateral lower extremity peripheral neuropathy is caused by his service-connected lumbar strain. Accordingly, service connection for left and right lower extremity peripheral neuropathy is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Zheng, 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.