Citation Nr: 21040933 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 16-56 914 DATE: July 7, 2021 REMANDED Entitlement to a compensable disability rating for right upper extremity peripheral neuropathy associated with diabetes mellitus, type II, is remanded. Entitlement to a compensable disability rating for left upper extremity peripheral neuropathy associated with diabetes mellitus, type II, is remanded. Entitlement to a compensable disability rating for right lower extremity peripheral neuropathy associated with diabetes mellitus, type II, is remanded. Entitlement to a compensable disability rating for left lower extremity peripheral neuropathy associated with diabetes mellitus, type II, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1966 to September 1969. During his period of service, he earned the Purple Heart, Bronze Star Medal with V Device, Vietnam Service Medal with one (1) Silver Service Star, National Defense Service Medal, Republic of Vietnam Campaign Medal, three (3) Overseas Bars, Marksman Badge (Rifle), Meritorious Unit Commendation, Presidential Unit Citation, Republic of Vietnam Gallantry Cross with Palm Unit Citation, and Republic of Vietnam Civil Actions Honor Medal First Class Unit Citation. 1. Entitlement to a higher rating for right upper extremity peripheral neuropathy 2. Entitlement to a higher rating for left upper extremity peripheral neuropathy The Veteran seeks compensable ratings for his service-connected peripheral neuropathy of the bilateral upper extremities. The Veteran appeared for a VA diabetic sensory-motor peripheral neuropathy examination in April 2014. She noted that the Veteran had been diagnosed with entrapment of the left ulnar sensory nerve in 2012 on electrodiagnostic study and his right arm issues instead stemmed from his right shoulder. Accordingly, the VA examiner determined that the Veteran did not have symptoms of the bilateral upper extremities attributable to diabetic peripheral neuropathy. Since the time of his April 2014 VA examination, the Veteran has contended that his peripheral neuropathy symptoms have persisted; however, it is unclear whether the symptoms are caused by a nonservice-connected right shoulder condition or his service-connected peripheral neuropathy of the bilateral upper extremities. Thus, a remand for an updated examination is therefore necessary. 3. Entitlement to a higher rating for right lower extremity peripheral neuropathy 4. Entitlement to a higher rating for left lower extremity peripheral neuropathy The Veteran seeks compensable ratings for his service-connected peripheral neuropathy of the bilateral lower extremities. The Veteran appeared for a VA diabetic sensory-motor peripheral neuropathy examination in April 2014. The VA examiner noted that the Veteran had neuromas, osteoarthrosis, and heel spurs bilaterally and indicated that his foot pain may be primarily due to his bilateral neuromas, which were treated in December 2013. Accordingly, the VA examiner determined that the Veteran did not have symptoms of the bilateral upper extremities attributable to diabetic peripheral neuropathy. Since the time of his April 2014 VA examination, the Veteran has contended that his peripheral neuropathy symptoms have persisted; however, it is unclear whether the symptoms are caused by a nonservice-connected neuromas, osteoarthrosis, and heel spurs or his service-connected peripheral neuropathy of the bilateral lower extremities. Thus, a remand for an updated examination is therefore necessary. The matters are REMANDED for the following action: Schedule the Veteran for VA examination with the appropriate examiner to determine the current severity and manifestations of his service-connected peripheral neuropathy of the bilateral upper and lower extremities. The claims folder must be made available to the examiner for review in connection with the examinations. The examination report must reflect that such a review was conducted. All necessary testing must be performed. The examiner should assess the severity of peripheral neuropathy in each extremity and address the functional effects of the Veteran's peripheral neuropathy in the upper and lower extremities. (a.) With regard to peripheral neuropathy of the bilateral upper extremities, the examiner should also indicate whether the Veteran's symptoms associated with service-connected peripheral neuropathy are distinguishable from any symptoms associated with nonservice-connected entrapment of the left ulnar sensory nerve and right shoulder disorder. (b.) With regard to peripheral neuropathy of the bilateral lower extremities, the examiner should also indicate whether the Veteran's symptoms associated with service-connected peripheral neuropathy are distinguishable from any symptoms associated with nonservice-connected neuromas, osteoarthrosis, and heel spurs. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tracy O. Joseph, 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.