Citation Nr: 21023335 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 15-13 576 DATE: April 20, 2021 REMANDED Entitlement to service connection for peripheral neuropathy of the left foot is remanded. Entitlement to service connection for peripheral neuropathy of the right foot is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1943 to February 1946, from April 1952 to April 1954, and from September 1969 to March 1973. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision issued by a Department of Veterans Affairs (VA) regional office (RO) rating decision. The Veteran testified before the undersigned in May 2018; a transcript is associated with the claims file. These matters were previously before the Board in June 2018 and May 2019, where the Board remanded the claims for further development. This claim was most recently before the Board in September 2019, where the Board denied the claims. The Veteran timely appealed to the Court of Appeals for Veterans Claims (Court). In a June 2020 order, the Court granted the parties’ joint motion for remand (JMR) as the Board failed to provide an adequate statement of reasons or bases for its decision. 1. Entitlement to service connection for peripheral neuropathy of the left foot is remanded. 2. Entitlement to service connection for peripheral neuropathy of the right foot is remanded. The Veteran asserts that he has bilateral foot neuropathy that is related to exposure to herbicide agents during military service. As previously noted, the Veteran is currently diagnosed with peripheral neuropathy of the bilateral feet and served in Vietnam during the Vietnam era. Thus, exposure to herbicide agents is presumed. 38 C.F.R. § 3.309(e). The Board notes that while the Veteran’s bilateral foot neuropathy did not onset in service or within one year of service (as the first diagnosis of this condition was 2013, almost 40 years after separation), the Veteran is not precluded from establishing entitlement to service connection by proof of direct causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). As the parties’ JMR stated, the Board denied the Veteran service connection on a direct basis by relying on the October 2017 and January 2019 VA examinations. However, the motion concluded that “it does not appear that either VA examination actually opined to direct service connection because both examiners based their negative nexus opinions on the fact that [the Veteran’s] neuropathy did not surface during service and/or the 1 year presumptive period after service under 38 C.F.R. § 3.309(e).” For this reason, the Board finds that the October 2017 and January 2019 VA examinations are inadequate and remand is warranted to obtain a VA medical opinion as to whether the Veteran’s bilateral foot neuropathy is etiologically related to service, to include presumed exposure to herbicides on a direct basis. The matters are REMANDED for the following action: Obtain an addendum VA medical opinion regarding the nature and etiology of the Veteran’s left and right foot peripheral neuropathy. An in-person examination or telehealth interview need not be scheduled unless it is deemed necessary by the examiner or otherwise required by the evidence. The entire claims file, to include this remand, must be reviewed by the examiner. The examiner must provide a thorough, well-reasoned opinion as to whether the Veteran’s left and right foot peripheral neuropathy is at least as likely as not (50 percent or greater probability) related to his military service, to include his presumed exposure to herbicides. The examiner is advised that the sole basis of a negative opinion cannot be the fact that the Veteran’s service treatment records or medical treatment records within 1 year of service separation are silent as to any peripheral neuropathy disability. Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Finelli, 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.