Citation Nr: 21023813 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 19-09 779 DATE: April 21, 2021 REMANDED Entitlement to service connection for a low back condition is remanded. Entitlement to service connection for peripheral neuropathy of the upper extremities, to include as due to herbicide agent exposure and a back disability, is remanded. Entitlement to service connection for peripheral neuropathy of the lower extremities, to include as due to herbicide agent exposure and a back disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1968 to September 1969. The Veteran died in June 2020. The Veteran’s spouse requested substitution, which was granted in September 2020. Therefore, the Veteran’s spouse is now the appellant. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2017 rating decision from a Department of Veterans Affairs (VA) Regional Office.   1. Entitlement to service connection for a low back condition is remanded. The Veteran contended that he injured his back when he fell from a fuel tank at Fort Bragg in the Spring/Summer of 1968. See VA 21-4138 Statement in Support of Claim received 3/27/2003. Alternatively, the Veteran has stated that his back condition was the result of jumps out of airplanes. See VA 21-4138 Statement in Support of Claim received 7/07/2017. Although the Veteran was involved in a post-service motor vehicle accident (MVA) in the 1980s, the Veteran argued that the back issues were already present and that the MVA only aggravated the pre-existing condition. See Form 9 received 3/29/2019. The Board regrets that another remand is warranted due to an inadequate medical opinion. In the Board’s October 2020 remand, the Board found that the December 2019 VA medical opinion was inadequate because the VA examiner relied on the absence of contemporaneous medical evidence to support a negative nexus opinion. See BVA Decision received 10/05/2020 at page 4; see also Buchanan v. Nicholson, 451 F.3d 1331, 1336–37 (Fed. Cir. 2006). On remand, the Board directed that the VA examiner discuss the Veteran’s contentions of whether his back condition was due to a fall off a truck or parachute jumps, and the VA examiner was asked to consider and discuss the Veteran’s lay statements. Id. at page 5. In the March 2021 VA medical opinion, the March 2021 VA examiner based the opinion, in part, on there being “no documented evidence to corroborate the Veteran’s statements regarding onset during service.” See C&P Exam received 3/10/2021 at page 2. Therefore, the March 2021 VA examiner also relied on the lack of contemporaneous medical records to conclude that service connection was not warranted. Additionally, the VA examiner did not discuss the Veteran’s contentions that about his parachute jumps. On remand, the Board will direct that an addendum opinion that discusses the Veteran’s contentions as to inservice injury and onset be provided. 2. Entitlement to service connection for peripheral neuropathy of the upper extremities to include as due to herbicide exposure and a back disability is remanded. 3. Entitlement to service connection for peripheral neuropathy of the lower extremities to include as due to herbicide exposure and a back disability is remanded. The Veteran contended that his upper and lower extremity peripheral neuropathy was due to in-service herbicide exposure, and alternatively secondary to his back condition. See Form 9 received 3/29/2019 at page 2. Since the appellant’s claim of service connection for a back disability is being remanded, the Board finds that the issues of service connection for upper and lower extermity peripheral neuropathy must also be remanded since a decision on the issue of service connection for a back condition could significantly impact a decision on the issue of secondary service connection due to his back condition. As such, the issues are inextricably intertwined. See Henderson v. West, 12 Vet. App. 11, 20 (1998) (holding that claims are inextricably intertwined when a decision on one issue would have a "significant impact" upon the other). A remand of the claims for right upper and left lower extermity neuropathy is required. These matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s back disability was at least as likely as not related to the fall off a truck during service or parachute jumps. **Inform the examiner that reliance on the lack of contemporaneous medical records alone will result in an inadequate opinion. The examiner is asked to review and address the Veteran’s competent lay statements. See VA 21-4138 Statement in Support of Claim received 3/27/2003; VA 21-4138 Statement in Support of Claim received 7/07/2017; and see also Form 9 received 3/29/2019.** A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Dixon, 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.