Peripheral neuropathy decisions — 2018

The Board has reopened the claim of service connection for a bilateral lower extremity disability and granted it. The Veteran's right foot disability is also granted. However, the increased rating for PTSD remains denied.

The Veteran's diabetes mellitus with peripheral neuropathy of the lower extremities is not shown to be causally or etiologically related to his active military service, and is not shown to be caused or aggravated by the service-connected hypertension. Therefore, the claim for service connection is denied.

The Board has determined that the Veteran's knee claim is not currently on appeal, but a remand is necessary to determine if his peripheral neuropathy is related to his military service and herbicide exposure.

The Veteran's service-connected disabilities, including PTSD, coronary artery disease, and neuropathies of the upper and lower extremities, have rendered him unable to maintain substantially gainful employment. The Board finds that his combined disability rating meets the threshold for TDIU.

The Veteran's diabetes mellitus, type II and peripheral neuropathy in the lower extremities are being remanded for further review.,Service connection is also being remanded for loss of smell, a sleep disorder, liver disability, memory loss, diabetic nephropathy, voiding dysfunction, stasis dermatitis, Dependents’ Educational Assistance award, SMC for loss of use of a creative organ, and total disability rating based on individual unemployability.

The Veteran's claims for service connection have been denied as there is no evidence of a link between his claimed conditions and service, or that they began in service.

The Veteran's peripheral neuropathy of the left lower extremity is rated at 80% on and after January 6, 2011. The right lower extremity condition remains at 40%. SMC based on need for aid and attendance is granted.

The Board has granted service connection for bilateral lower extremity peripheral neuropathy, finding that the evidence is in equipoise regarding whether herbicide exposure during service caused or aggravated this condition.

The Board has remanded the Veteran's claims for service connection for hypertension, COPD, acne, residuals of sebaceous cyst removal, and peripheral neuropathy of the bilateral lower extremities as related to Agent Orange exposure due to a lack of medical opinion regarding the etiology of these conditions.

The Veteran's service-connected disabilities, including diabetes mellitus and bilateral flatfoot, are being remanded for further evaluation.,Service connection is also being remanded for incomplete paralysis of the left and right sciatic nerves.

The Veteran's claim for increased ratings for bilateral peripheral neuropathy of the lower extremities has been denied as his symptoms do not warrant a rating in excess of 20 percent.

The Veteran's service-connected type II diabetes mellitus and peripheral neuropathy in the lower extremities cause a level of impairment such that no effective function remains other than what would be equally well served by an amputation stump at the site of election below the knees, with use of a suitable prosthetic appliance. The Veteran is also in need of regular aid and attendance due to his service-connected disabilities.

The Veteran's claims for clothing allowances were denied as his left leg/knee brace did not tend to wear or tear his clothes, the capsaicin cream was used for a service-connected musculoskeletal disability and not a skin condition, and he did not meet eligibility requirements for bilateral knee braces issued in 2015.

The Veteran's service-connected right eye arteritic ischemic optic neuropathy was rated at 20 percent prior to September 27, 2005. The Board denied a rating in excess of 20 percent for this condition. For the period from September 5, 2002 through July 14, 2010, the Veteran did not meet the schedular requirements for a TDIU rating under 38 C.F.R. § 4.16(a).

The Board denied service connection for multiple conditions, including fibromyalgia, prostate cancer, sleep apnea, gastrointestinal disorders, colon cancer, hiatal hernia, acid reflux, erectile dysfunction, skin disorder, and neuropathy of the upper and lower extremities. The Veteran's claims were based on direct service connection rather than presumptive exposure to herbicides or other conditions.

The Board has dismissed all service connection claims due to the Veteran's death.

The Veteran's claim for a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities has been denied. The Board found that the preponderance of evidence is against a finding that the Veteran was unable to secure and follow a substantially gainful employment due to his service-connected disabilities alone at any point during the appeal period.

The Board denied service connection for tinnitus, hypertension (to include as secondary to diabetes), and peripheral neuropathy of the upper and lower extremities due to lack of evidence linking these conditions to service or service-connected disabilities.,Service connection was not granted for tinnitus because there is no credible evidence that it began in service or is related to noise exposure. The Board found no current diagnosis of tinnitus, and the Veteran's statements about hearing ringing in his ears since service were deemed less than credible given the lack of documentation prior to 2011.,For hypertension, the Board noted the Veteran's long-term use of medication and good control over blood pressure, as well as the absence of any symptoms or diagnosis before 1982. The VA examiner opined that diabetes did not cause or aggravate hypertension, and there was no evidence of early-onset peripheral neuropathy due to herbicide exposure.,Regarding peripheral neuropathy, the Board found no current diagnosis in the Veteran's medical records, despite his testimony about symptoms since shortly after service. The VA examination conducted in 2012 did not reveal any signs or symptoms of peripheral neuropathy.

The Veteran's claims for increased ratings are remanded due to the need for additional examinations and evaluations of his service-connected conditions.

The Veteran's service-connected conditions, including CAD and DM with hypertension and ED, as well as associated peripheral neuropathy of the lower extremities and scar from CABG surgery, are restored effective March 1, 2015.