Citation Nr: 21041696 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 19-00 298 DATE: July 9, 2021 ORDER Service connection for peripheral neuropathy of the right lower extremity is granted. Service connection for peripheral neuropathy of the left lower extremity is granted. FINDINGS OF FACT The Veteran's peripheral neuropathy of the lower extremities is related to his Vietnam service. CONCLUSIONS OF LAW 1. The criteria for service connection for peripheral neuropathy of the right lower extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1116, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. 2. The criteria for service connection for peripheral neuropathy of the left lower extremity have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1116, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from July 1967 to February 1971. A virtual hearing before the undersigned Veterans Law Judge was held in July 2021. SERVICE CONNECTION Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active duty or active duty for training or for disability resulting from injury incurred in or aggravated by inactive duty for training. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Where a veteran served for at least 90 days during a period of war and manifests organic disease of the nervous system to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as opposed to merely isolated findings or a diagnosis including the word "chronic." When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303 (b). The term "chronic disease" refers to those diseases listed under section 1101(3) of the statute and section 3.309(a) of VA regulations. 38 U.S.C. § 1101 (3); 38 C.F.R. § 3.309 (a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Veteran was presumptively exposed to herbicides during service. Service incurrence for certain diseases will be presumed based on an association with certain herbicide agents (e.g., Agent Orange). 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e). Early onset peripheral neuropathy (with an onset within one year of exposure) is among the disease specified. When a claimed disorder is not included as a presumptive disorder, direct service connection may nevertheless be established by evidence demonstrating that the disease is related to service, to include the in-service herbicide exposure. See Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). Postservice medical records reveal histories of numbness and tingling in the toes and pads of the feet. The Veteran has reported that he served in Vietnam and that he experienced numbness in the toes during service and told the separation examiner about the numbness and the examiner told him it was most likely monsoon related and would resolve. A May 2016 VA examination record reveals diagnosis of peripheral neuropathy of the lower extremities with an onset in 2014. The examiner stated that the peripheral neuropathy was at least as likely as not incurred in or caused by in-service herbicide exposure. The examiner explained that a 1996 update associated early onset peripheral neuropathy with herbicide exposure. (Continued on the next page) A November 2018 medical report reveals the Veteran's history of bilateral foot numbness and tingling for over 40 years, since returning from Vietnam. The record reports that there was no electrodiagnostic evidence for radiculopathy, entrapment neuropathy, or classic peripheral neuropathy but the Veteran had clinical symptoms consistent with peripheral neuropathy or small fiber neuropathy. After consideration of the record, the Board finds service connection is warranted for peripheral neuropathy. The record includes a current diagnosis of peripheral neuropathy. The record also indicates that the Veteran was exposed to herbicides in service, and the Veteran has competently and credibly reported symptoms attributed to peripheral neuropathy during and since serving in Vietnam, where he was presumptively exposed to herbicides. Resolving all doubt in favor of the Veteran, the Board finds service connection is warranted. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Snyder, 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.