Citation Nr: 21025945 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 15-11 899 DATE: April 29, 2021 REMANDED Entitlement to service connection for peripheral neuropathy right arm, to include as due to chemical exposure, is remanded. Entitlement to service connection for peripheral neuropathy left arm, to include as due to chemical exposure, is remanded. Entitlement to service connection for peripheral neuropathy right leg, to include as due to chemical exposure, is remanded. Entitlement to service connection for peripheral neuropathy left leg, to include as due to chemical exposure, is remanded. REASONS FOR REMAND The Veteran served honorably in the U.S. Army from March 1963 to February 1965. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2012 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). The Veteran testified before the undersigned at a hearing held in August 2018; a transcript of that hearing is of record. The Board previously considered this appeal in January 2019 and November 2020 and remanded these issues for further development including scheduling a VA examination. The case returned to the Board for further appellate review. The Board notes that medical records were requested from the Social Security Administration (SSA), but in a December 2020 correspondence, SSA indicated that there are no medical records for the Veteran and further efforts to obtain them will be futile. 1. Entitlement to service connection for peripheral neuropathy right arm, to include as due to chemical exposure, is remanded. 2. Entitlement to service connection for peripheral neuropathy left arm, to include as due to chemical exposure, is remanded. 3. Entitlement to service connection for peripheral neuropathy right leg, to include as due to chemical exposure, is remanded. 4. Entitlement to service connection for peripheral neuropathy left leg, to include as due to chemical exposure, is remanded. Unfortunately, the Veteran’s service connection claims for peripheral neuropathy of the bilateral upper extremity and bilateral lower extremity must once again be remanded for further development. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran’s claims so that he is afforded every possible consideration. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In February 2020, the Veteran was afforded a VA examination. The VA examiner stated that “none of the medical record show a confirmed diagnosis of peripheral neuropathy.” After the examination, the Veteran submitted a private electromyography report from September 2020 that reflected several abnormal ranges and concluded with an interpretation of “nerve conductions were completed of the left side. There is a moderately severe neuropathy (axonal). In light of the new evidence, the Board remanded the appeal in November 2020 for an addendum opinion and further discussion. In a January 2021 addendum medical opinion, the VA examiner indicated that the September 2020 EMG report shows left upper extremity and left lower extremity peripheral neuropathy only. The examiner again opined that the Veteran’s peripheral neuropathy of the left lower extremity and left upper extremity were less likely than not related to service, to include due to carbon tetrachloride. The rationale provided was that “[t]here are no STRs found to show complaints consistent with or treatment or diagnosis of neuropathy. Separation history and physical is silent for neuropathy. Review of the mainstream medical literature does not cite neuropathy as a result of carbon tetrachloride use.” In April 2012, the Veteran submitted an article which suggest a causal relationship between exposure to carbon tetrachloride and peripheral neuropathies. Furthermore, an April 2018 letter from Dr. K.M.T. indicates that potential chemicals may cause neuropathy. The article has not yet been reviewed by any of the examiners as part of an opinion on the etiology of the Veteran's peripheral neuropathy. As such, remand is necessary to obtain the appropriate opinions. Additionally, the claim must be remanded for proper testing as the record only shows a 2000 EMG with normal results and the September EMG report was performed only in the left side when the Veteran has complained of bilateral peripheral neuropathies of the upper and lower extremities throughout the appeal period. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to address his claim for service connection for bilateral upper and lower extremities peripheral neuropathy. The claims file must be reviewed in conjunction with the examination. Any tests deemed necessary, to include EMG, should be conducted if the Veteran consents, and all clinical findings should be reported in detail. If the Veteran does not consent, that fact should be documented in the examination report. Following review of the claims file and examination of the Veteran, the examiner should: (a.) Provide the diagnosis for any peripheral neuropathy identified during the pendency of the appeal. (b.) State whether it is at least as likely as not (50 percent probability or greater) that any such condition was incurred in or is otherwise related to active service, to include due to chemical exposure. The examiner must comment on the internet article provided by the Veteran on the relationship between carbon tetrachloride and peripheral neuropathy. The examiner must also comment on April 2018 letter from Dr. K.M.T. The examination report must include a complete rationale for all opinions provided. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Romero-Sanchez, 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.