Citation Nr: 21028958 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 15-14 300A DATE: May 12, 2021 ORDER Entitlement to service connection for peripheral neuropathy, left lower extremity, is granted. Entitlement to service connection for peripheral neuropathy, right lower extremity, is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran's favor, his peripheral neuropathy, left lower extremity, is at least as likely as not related to in-service exposure to an herbicide agent. 2. Resolving reasonable doubt in the Veteran's favor, his peripheral neuropathy, right lower extremity, is at least as likely as not related to in-service exposure to an herbicide agent. CONCLUSIONS OF LAW 1. The criteria for service connection for peripheral neuropathy, left lower extremity, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for peripheral neuropathy, right lower extremity, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Navy from February 1970 to June 1971, including service in the Republic of Vietnam. Service Connection 1. Entitlement to service connection for peripheral neuropathy, bilateral lower extremities The Veteran contends that his peripheral neuropathy of the bilateral lower extremities (BLE peripheral neuropathy) was caused by exposure to an herbicide agent during service. The Board concludes that the Veteran has a current BLE peripheral neuropathy disability that is related to in-service exposure to an herbicide agent. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Because the Veteran served in the Republic of Vietnam between January 9, 1962 and May 7, 1975, he is presumed to have been exposed to an herbicide agent during active service. 38 C.F.R. § 3.307(a)(6)(iii). If early onset peripheral neuropathy manifests to a degree of at least 10 percent disabling within one year of a veteran's last in-service exposure to an herbicide agent, then the condition will be considered to have been incurred in or aggravated by service even though there is no evidence of such disease during the period of service. 38 C.F.R. § 3.307(a)(6). However, there is no evidence that the Veteran experienced symptoms of BLE peripheral neuropathy at any time during active service or within one year of his last possible in-service exposure to an herbicide agent. Presumptive service connection for the Veteran's BLE peripheral neuropathy under 38 C.F.R. § 3.307(a)(6) is therefore not warranted. VA treatment records from April 2011 show the Veteran has a current diagnosis of BLE peripheral neuropathy, confirmed by an August 2012 nerve conduction study. The Veteran's service treatment records and post service treatment records before April 2011 are silent for complaint, diagnosis, or treatment of BLE peripheral neuropathy or related symptoms. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes the December 2019 and September 2020 opinions of VA examiners and the lack of any complaint of peripheral neuropathy symptoms approximately four decades after from service. The December 2019 VA examiner opined that the Veteran's BLE peripheral neuropathy was less likely than not related to service because symptoms developed so long after the Veteran's last in-service exposure to an herbicide agent. The examiner cited a 2010 study that found no association between herbicide exposure and delayed onset peripheral neuropathy. Delayed onset was defined as more than one year after exposure. The December 2020 VA examiner offered a similar opinion with similar reasoning. The evidence in favor of the claim includes a January 2020 opinion from Dr. P.C. and the Veteran's lay statements. The Veteran did not explicitly claim that he remembered symptoms during the year after his last day in Vietnam, but he stated that when he was younger he ignored symptoms that did not affect his daily functioning and would not have sought treatment for mild numbness in his lower extremities. Dr. P.C. examined the Veteran and ruled out possible causes for BLE peripheral neuropathy including diabetes and spinal degenerative arthritis. Based on the Veteran's age, presentation, and symptomatology, Dr. P.C. opined that occupational exposure was more likely than not the cause of the Veteran's condition. Finally, the Veteran submitted a list of his post-service occupations. They included bank teller, college student, accountant, insurance agent, software trainer/manager, golf course employee, and LA Dept. of Veterans Affairs VSONW regional manager. He stated that none of these jobs exposed him to herbicide agents or other chemicals known to cause peripheral neuropathy. While Dr. P.C. did not directly address the study cited by the VA examiners, the VA examiners also failed to suggest any other possible cause for the Veteran's BLE peripheral neuropathy. The Board also notes that the cited study is over ten years old and may no longer be up to date. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current BLE peripheral neuropathy is related to his in-service exposure to an herbicide agent. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for BLE peripheral neuropathy is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Zimmerman, Micah 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.