Citation Nr: 21027321 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 18-51 636 DATE: May 5, 2021 REMANDED Service connection for bilateral arthritis of the hands, lower wrists, and the thumbs is remanded. Service connection for bilateral upper extremity neuropathy is remanded. Service connection for an eye condition remanded. Service connection for alopecia areata is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1967 to January 1969. The Veteran provided testimony before the undersigned Veterans Law Judge (VLJ) at a January 2021 Board hearing. A complete transcript is of record. 1. Service connection for bilateral arthritis of the hands, lower wrists, and the thumbs is remanded. 2. Service connection for bilateral upper extremity neuropathy is remanded. The Veteran asserts that his upper extremity neuropathy and bilateral hand arthritis is due to his service-connected diabetes. The Veteran is not seeking service connection on a direct basis. The Veteran testified that he experiences a neuropathy type pain in his hands, fingers, and wrist but is unsure as to whether the symptoms are from arthritis or neuropathy. He also testified that his treating VA physician had suggested to him that the neuropathy and pain was related to his diabetes, although such an opinion does not appear to have been put into writing. The Board notes that the Veteran was afforded a VA examination for diabetes in May 2018, but there were no complications noted. Here, the Veteran's credible testimony indicates that he may have diabetic neuropathy and the Board finds that a new VA examination is warranted to address the etiology of his hand and upper extremity conditions. The Board also finds that a remand is necessary to obtain an examination to clarify the diagnosis of the Veteran's upper extremity conditions because it is unclear whether arthritis or neuropathy is the cause of his symptoms in his hands. Accordingly, service connection for upper extremity neuropathy and for bilateral arthritis of the hands, lower wrists, and the thumbs is remanded. 3. Service connection for an eye condition remanded. The Veteran asserts that he did not have any issues with his eyes, prior to his diagnosis for diabetes. The Veteran is not seeking service connection on a direct basis. The Veteran testified that he has had issues with his eyes, specifically "floaters," and started experiencing such symptoms after his diagnosis for diabetes. The Board finds that remand is necessary to obtain an etiology opinion regarding the Veteran's eye condition. Accordingly, service connection for an eye condition is remanded. 4. Service connection for alopecia areata is remanded. The Veteran asserts that his alopecia is due to his exposure to herbicide agents. The Veteran is presumed to have been exposed to herbicide agents, which was the basis for the grant of service connection for diabetes. However, alopecia is not a disability that is subject to presumptive service connection. The Veteran has not submitted any medical evidence regarding his service connection claim for alopecia. However, the Veteran reported in his Form 9 that he has spoken with other Vietnam Veterans who have alopecia from their exposure to Agent Orange. Here, based on the Veteran's presumed exposure to herbicide agents and his assertion that his alopecia is due to such exposure, the Board finds that a remand is necessary to obtain a medical opinion to determine whether any such diagnosis is caused by or related to his active duty service. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Accordingly, service connection for alopecia areata is remanded. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his clamed bilateral arthritis of the hands, lower wrists, and thumbs. The examiner should clarify the diagnosis of the Veteran's claimed hand conditions, specifically determining whether the symptoms he experiences in his hands, lower wrists, and thumbs are due to arthritis or neuropathy. If a diagnosis is provided, the examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that his hand, lower wrist, and thumb condition, has been caused or aggravated (made worse) by his service-connected diabetes. Why or why not? 2. Schedule the Veteran for a VA examination to determine the nature and etiology of his claimed upper extremity neuropathy. The examiner should answer the following question: Is it at least as likely as not (50 percent probability or greater) that the Veteran's upper extremity neuropathy has been caused or aggravated (made worse) by his service-connected diabetes. Why or why not? 3. Schedule the Veteran for a VA examination to determine the nature and etiology of his claimed eye condition. The examiner should answer the following question: Is it at least as likely as not (50 percent probability or greater) that his eye condition, has been caused or aggravated (made worse) by his service-connected diabetes. Why or why not? The examiner's attention is directed to the Veteran's hearing testimony that he did not begin experiencing "floaters" prior to his diagnosis for diabetes. 4. Schedule the Veteran for a VA examination to determine the nature and etiology of his alopecia. The examiner should answer the following questions: a) Is it at least as likely as not (50 percent or greater) that the Veteran's alopecia is the result of his presumed exposure to herbicide agents? Why or why not? (Continued on the next page) b) Is it at least as likely as not (50 percent or greater probability) that the Veteran's alopecia was caused or aggravated (made worse) by his service connected diabetes mellitus? Why or why not? MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fu, 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.