Peripheral neuropathy decisions — 2017

The Veteran's service-connected disabilities, including PTSD, diabetes mellitus with retinopathy, peripheral neuropathy of both lower extremities, tinnitus, coronary heart disease, bilateral hearing loss, and erectile dysfunction, are rated at a combined 80 percent. The Board finds that these conditions render the Veteran unemployable due to their severity and his limited education and work experience.

The Board has denied the Veteran's claims for service connection for various conditions, including coronary artery disease, hypertension, type II diabetes mellitus, bilateral lower extremity peripheral neuropathy, and a bilateral hand disability. The evidence does not support a finding that these conditions are related to service or herbicide exposure.

The Veteran's diabetes was evaluated as 20 percent disabling. The Board denied a higher rating for diabetes, but found that the Veteran is entitled to separate ratings for his peripheral neuropathy of the lower extremities and right upper extremity.

The Veteran's peripheral neuropathy of the upper extremities was not incurred in or aggravated by service and is not attributable to a service-connected disease or injury.

The Board has denied the Veteran's claims for service connection for peripheral neuropathy and a left elbow disorder, finding that there is no nexus between these conditions and his active duty service. The Board also found that the Veteran did not develop symptoms of peripheral neuropathy until after separation from service.

The Board finds that the evidence is in relative equipoise as to whether the Veteran requires the aid and attendance of another person to protect him in his daily environment due to service-connected disabilities. As such, entitlement to special monthly compensation based on the need for aid and attendance is granted.

The Board found that the Veteran's varicose veins resolved without residual manifestations and did not have a recurrence during the appeal period. The service treatment records were silent in regard to neuropathy while in service, and there is no evidence of current disability for peripheral neuropathy. Therefore, service connection was denied.

The Veteran's peripheral neuropathy of bilateral lower extremities is rated at 40 percent from September 27, 2007 to November 19, 2015 and at 60 percent thereafter.

The Board has determined that the Veteran was in need of regular aid and attendance due to his service-connected disabilities, which resolved in favor of granting SMC based on aid and attendance prior to his death.

The Veteran's service-connected disabilities do not meet the criteria for special monthly compensation based on the need for aid and attendance or at the housebound rate.

The Veteran's appeal is being remanded for additional development, including VA examinations to assess the current severity of his PTSD and hypertension, as well as determine the nature and etiology of his neuropathy. The RO must also obtain updated VA treatment records and any relevant private medical records.

The Veteran's appeal is remanded due to the need for additional evidence and a new VA examination. The issues include service connection for various conditions, with no specific theory of service connection provided.

The Veteran's appeal involves multiple service connection claims for various conditions, including EBV, NPC, dysphagia, dry mouth, immune homeostasis, and neuropathy of the bilateral feet. The VA has not yet provided a final decision on these matters due to ongoing issues with the January 2016 VHA expert opinion regarding NPC.

The Veteran's peripheral neuropathy of the lower extremities was found to be secondary to his service-connected diabetes mellitus type 2, and thus granted service connection for this condition.

The Board has decided to remand the case for further development, including obtaining an addendum opinion from a VA examiner and reviewing the Veteran's Vocational Rehabilitation and Employment file.

The Board has determined that the Veteran's diabetes mellitus, type II, does not warrant a rating in excess of 20 percent as it is currently manifested by insulin and restricted diet without regulation of activities.

The Veteran's combined rating for service-connected disabilities is 60 percent from February 24, 2014. The Board finds that referral for extraschedular consideration for the period since June 2009 is not warranted as the Veteran is capable of performing the physical and mental acts required by sedentary jobs.

The Veteran's appeals for higher ratings were denied. The bilateral eye disability, atherosclerotic coronary heart disease, diabetes mellitus, and peripheral neuropathy of the lower extremities are all rated at their maximum levels.

The Board found that the Veteran's current medical problems, including pneumonia, right-sided empyema, left vocal cord paralysis, polyneuropathy, septic shock, blood clots, memory loss, and bilateral tremors (attributed to GBS with associated sequelae of focal demyelination, CPM, and/or CIDP), were not caused by the influenza vaccination he received at a VA medical facility on November 10, 2009.

The Board has determined that the Veteran's current disabilities, including residuals of mild decompression syndrome, carpal tunnel syndrome, and peripheral neuropathy, are not related to his service. The Veteran's right shoulder rotator cuff tendonitis is considered a separate issue.