Citation Nr: 21023257 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 19-23 580 DATE: April 20, 2021 REMANDED Entitlement to service connection for left lower extremity neuropathy, to include as due to exposure to herbicide agents, is remanded. Entitlement to service connection for right lower extremity neuropathy, to include as due to exposure to herbicide agents, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from July 1963 to September 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for left lower extremity neuropathy is remanded. 2. Entitlement to service connection for right lower extremity neuropathy is remanded. The record shows that the Veteran is currently diagnosed with bilateral lower extremity neuropathy. Throughout the entire appeal process he has contended that his bilateral lower extremity neuropathy is the result of exposure to herbicide agents during his active service. Military personnel records indicate the Veteran had service in Vietnam from May 11, 1965 to July 15, 1965 and December 13, 1966 to May 3, 1967. See Military Personnel Record, received July 2014. The Board finds that additional development is needed prior to adjudication of the issues on appeal. There is insufficient evidence for the Board to render a determination on his claims, as the Veteran has not been afforded VA examinations for his bilateral lower extremity neuropathy. VA has a duty provide an examination or obtain a medical opinion on an issue of service connection when the record, 1) contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, 2) indicates that the disability or signs and symptoms of a disability may be associated with active service, to include exposure to herbicide agents while in service, and 3) the record does not contain sufficient information to make a decision on the issue. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The threshold for determining whether the evidence “indicates” that there “may” be a nexus between a current disability and an in-service event is a low one. McLendon, 20 Vet. App. at 83. As such, based on the record before the Board, a remand for VA examination is necessary to determine the nature and etiology of the Veteran’s bilateral lower extremity neuropathy. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his bilateral lower extremity neuropathy disability. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. All pertinent evidence of record must be made available to and reviewed by the examiner. After examining the Veteran and reviewing the pertinent evidence of record, the examiner should state: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s left lower extremity neuropathy had its onset during or is otherwise etiologically related to his period of active military service, to include, but not limited to exposure to herbicides? If it is less likely that the Veteran’s left lower extremity neuropathy is related to in-service exposure to herbicide agents, the examiner should explain why that is the case. (b.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right lower extremity neuropathy had its onset during or is otherwise etiologically related to his period of active military service, to include, but not limited to exposure to herbicides? If it is less likely that the Veteran’s right lower extremity neuropathy is related to in-service exposure to herbicide agents, the examiner should explain why that is the case. The examiner must note that applicable VA law establishes that the legal provision for presumptive service connection does not otherwise preclude a Veteran from establishing service connection with proof of actual direct causation on a non-presumptive, direct incurrence basis. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). A full rationale must be provided for any opinion offered and a thorough explanation would be helpful to the Board. The examiner is reminded that the term “at least as likely as not,” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as it is to find against. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity for an examination if an examination is deemed necessary. If a VA examination proves not feasible for any reason, the claims file should still be reviewed by an appropriate professional for the purpose of providing the requested opinions. 2. After completing the above development, and any other development deemed necessary, readjudicate the issues on appeal. If any benefit sought on appeal remains denied, provide a supplemental statement of the case to the Veteran and his representative, and return the appeal to the Board for appellate review, after the Veteran and his representative have had an adequate opportunity to respond. T.D. JONES Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Fairlie, 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.