Citation Nr: 25005366 Decision Date: 04/21/25 Archive Date: 04/21/25 DOCKET NO. 18-11 962 DATE: April 21, 2025 ORDER Entitlement to service connection for peripheral neuropathy of the right lower extremity is denied. Entitlement to service connection for peripheral neuropathy of the left lower extremity is denied. FINDINGS OF FACT 1. The evidence is persuasively against a finding that the Veteran has had peripheral neuropathy of the right lower extremity at any time during or approximate to the pendency of the claim. 2. The evidence is persuasively against a finding that the Veteran has had peripheral neuropathy of the left lower extremity at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for peripheral neuropathy of the right lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for entitlement to service connection for peripheral neuropathy of the left lower extremity have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from November 1967 to September 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at a hearing before the undersigned in July 2021. A transcript of the hearing is of record. In April 2022, the Board initially remanded the Veteran's appeal for further development to include associating updated VA treatment records with the claims file and scheduling a new examination. The Agency of Original Jurisdiction (AOJ) completed this development, and it returned the Veteran's appeal to the Board after issuing a June 2024 supplemental statement of the case (SSOC). This matter was most recently before the Board in September 2024 when the Veteran's appeal was again remanded for further development. Specifically, due to evidence that suggests the Veteran's reported symptoms of pain, numbness, and tingling in the lower extremities are likely the result of bilateral radiculopathy associated with a lumbar spine condition rather than the explicitly claimed peripheral neuropathy, the Board directed the AOJ to develop and adjudicate a pending lumbar spine claim that, at that time, was subject to an identified duty-to-assist error. The AOJ readjudicated the lumbar spine claim in a November 2024 rating decision but continued the denial of service connection for a lumbar spine disability; therefore, the AOJ completed the actions required by the Board's September 2024 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran has appealed the November 2024 rating decision in the modernized review system under the Appeals Modernization Act (AMA) with the appeal now pending on the Board's hearing docket under # 241212-493241. As a result, the Board will now adjudicate the peripheral neuropathy claim with consideration of neurological impairment associated with a lumbar spine condition being a component of the appeal docketed under # 241212-493241. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303. The evidence must show (1) the existence of a current disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3; see also Lynch v. McDonough, 999 F.3d 1391 (Fed. Cir. 2021). 1. Entitlement to service connection for peripheral neuropathy of the right lower extremity 2. Entitlement to service connection for peripheral neuropathy of the left lower extremity In June 2013, the Veteran submitted a service connection claim for "neuropathy bilateral feet." While the Veteran is not required nor expected to arrive at the precise diagnosis to support his compensation claim, the procedural posture of his case and a related claim requires a focused analysis of the specifically claimed peripheral neuropathy in the context of the present appeal. See Clemons v. Shinseki, 23Vet. App.1(2009). Initially, the Board finds the evidence is persuasively against a finding that the Veteran has had a diagnosis of peripheral neuropathy affecting either lower extremity at any time during or approximate to the pendency of his claims. See Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The competent evidence rather establishes the Veteran's reported symptoms of pain, numbness, and tingling in the lower extremities are likely the result of radiculopathy associated with a lumbar spine condition. This distinction is well documented in treatment records and confirmed on examinations in June 2023 and February 2024, as well as noted in a private October 2021 opinion the Veteran submitted to support several compensation claims. The Board acknowledges the VA examination reports indicate the Veteran has a "peripheral nerve condition or peripheral neuropathy" affecting the bilateral lower extremities, as asked on the applicable disability benefits questionnaire (DBQ), but the diagnosis section of these DBQs clearly indicate such peripheral nerve condition is bilateral lower extremity radiculopathy associated with a lumbar spine condition as opposed to peripheral neuropathy attributable to some other cause. While the Veteran may believe he has peripheral neuropathy, he does not possess the requisite skill or training to attribute his symptoms to a specific diagnosis with experts consistently arriving at the conclusion that he does not have peripheral neuropathy as claimed. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As the evidence weighs heavily against a finding of a diagnosis of peripheral neuropathy, the benefit-of-the doubt does not apply. The Board acknowledges there are certain presumptive service connection provisions for peripheral neuropathy, which may have prompted the Veteran's specific neuropathy claim; however, consideration of these provisions is not warranted because, as noted above, the evidence is persuasively against a finding of a diagnosis of peripheral neuropathy in his case. See 38 C.F.R. § 3.309. The Board also recognizes a diagnosis is not necessarily required to establish service connection for symptoms that result in functional impairment in earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (2018). However, the Veteran's case is not circumstance where the meaningful effect of the Saunders decision applies because the record does not establish a lack of diagnosis but rather a circumstance where the expert evidence establishes the reported symptoms are attributable to a secondary condition that is outside the scope of this appeal due to a pending AMA appeal for a service connection claim for the primary disability. In sum, the evidence is persuasively against a finding that the Veteran has had a diagnosis of peripheral neuropathy affecting either lower extremity at any time during or approximate to the pendency of his claims; there is no doubt to resolve regarding this issue. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Lynch, supra. The competent evidence rather establishes his reported symptoms are attributable to bilateral lower extremity radiculopathy associated with a lumbar spine condition, but the Board, again, does not have jurisdiction of the appeal of the claim for the primary disability in the context of the present appeal because it is pending in the modernized review system under the AMA. Accordingly, service connection for peripheral neuropathy is denied, in the context of this appeal, with consideration of neurological impairment associated with the primary lumbar spine condition being an element of the docketed AMA appeal, which will be adjudicated at a later date. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Makarenko, Darya A. 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.