Peripheral neuropathy decisions — 2020

The Veteran's diabetes mellitus, type II, and related peripheral neuropathy of the bilateral lower extremities have been granted service connection. The Board found that his exposure to herbicides in Thailand during service was presumed, and he has a current disability (diabetes) associated with this exposure.

The Board has determined that the Veteran's peripheral neuropathy of the bilateral upper and lower extremities is not related to his military service, including exposure to herbicides. The claim for service connection is denied.

The Veteran's initial claim for a higher evaluation for coronary artery disease (CAD) with cardiomyopathy was granted, but the appeal for an increased rating from February 15, 2018 was denied. The claims for evaluations in excess of 20 percent for peripheral neuropathy of both lower extremities were also denied.

The Veteran's type II diabetes mellitus is denied as it did not manifest during service or until more than a year after discharge, and there is no evidence of exposure to herbicide agents.,Erectile dysfunction is denied as it did not originate in service or until more than a year after discharge, and is not related to the Veteran's type II diabetes mellitus or any other service-connected condition.,Peripheral neuropathy, bilateral lower extremities, is denied for similar reasons: no evidence of onset during service or within one year post-service, and not linked to the Veteran's type II diabetes mellitus or any other service-connected condition.,Retinopathy is denied as it did not originate in service or until more than a year after discharge, and is not related to the Veteran's type II diabetes mellitus or any other service-connected condition.

Service connection is granted for bilateral hearing loss and tinnitus.,The Veteran's peripheral neuropathy of the lower extremities may be related to exposure to herbicide agents during service, but further verification from JSRRC is needed. Service connection will be remanded for this issue.

The Veteran's lumps on head are not related to service.,There is no evidence of a separate clinical diagnosis of anxiety disorder during the appeal period.,Evidence received since June 2010 rating decision that denied service connection for neuropathy of the left upper extremity is new and material, raising a reasonable possibility of substantiating the claim.,The Veteran's right upper extremity peripheral neuropathy may be related to his service-connected diabetes mellitus. However, there is conflicting evidence on this issue.,Right hand tremors are not related to service-connected diabetes mellitus.,Left hand tremors are not related to service-connected diabetes mellitus.

The Veteran's claims for service connection for peripheral neuropathy of the right and left lower extremities have been granted with effective dates set at March 29, 1991 and November 12, 1998 respectively. The claim for an initial rating greater than 20 percent for diabetes mellitus type II remains pending.,The Veteran's claims for service connection for kidney insufficiency, high blood pressure, and gout have been remanded.

The Veteran's claim for service connection for tinnitus has been reopened, and the appeal is granted to this extent. The Board has also remanded cases related to pinched C6 nerve, bilateral neuropathy of upper and lower extremities, and tinnitus.

The Board has remanded four issues related to peripheral neuropathy of the Veteran's upper and lower extremities due to a lack of VA examination, incomplete medical records, and the need for further analysis.

The Veteran's lumbar strain is currently rated at 20 percent, but the Board finds that a higher rating is not warranted due to his limited range of motion and pain. The Veteran also meets criteria for TDIU based on his service-connected disabilities.,The Veteran has open angle glaucoma associated with diabetes mellitus type II, which requires further examination as visual field testing results are missing from the file.

The Board has reopened the claims for service connection for peripheral neuropathy of the right and left upper extremities as secondary to diabetes mellitus with erectile dysfunction due to new evidence submitted. However, the claim remains denied because there is no medical opinion linking the peripheral neuropathy to the service-connected diabetes.

The Veteran's service-connected type II diabetes mellitus and peripheral neuropathy of the bilateral lower extremities do not render him unable to secure or follow a substantially gainful occupation.

The Board has remanded the Veteran's claims for service connection for bilateral lower extremity peripheral neuropathy due to a duty to assist error. The VA examiner is requested to provide an opinion on whether there is a relationship between the Veteran's diagnosed neurological disorders and his military service, including exposure to herbicide agents.

The Board has denied the Veteran's claims for service connection for neuropathy of the left and right lower extremities, degenerative joint disease of the left hip, left knee medial meniscus tear, and gastroesophageal reflux disease. The issues have been remanded for further examination and opinion regarding the relationship between the Veteran's current conditions and his service-connected disabilities.

The Veteran's tinnitus and left ear hearing loss have been granted service connection. The Board has found an approximate balance of positive and negative evidence regarding the Veteran's right ear hearing loss, stroke, facial numbness, right leg numbness, hypertension, skin cancer, diabetes mellitus, peripheral neuropathy, and erectile dysfunction. These issues are remanded for further development.

The Veteran's appeal is being remanded due to insufficient evidence and the need for a new VA examination covering his bilateral upper extremity peripheral neuropathy from July 22, 2005 onwards. The Veteran contends that his disabilities have worsened.

The Board denied service connection for diabetes mellitus and peripheral neuropathy of the right and left lower extremities, finding no evidence of herbicide exposure during service.

The Veteran's OSA with asthma is rated at 50 percent, effective June 1, 2011. The Board denied a higher rating as the evidence did not show chronic respiratory failure or tracheostomy.,Gout was granted an initial 20 percent rating, effective June 1, 2011. The Veteran had at least four gout flares per year and his medication controlled his symptoms.,Migraines were denied a compensable rating as the evidence did not show prostrating attacks averaging one in two months over the last several months.,Right shoulder disability was granted a 30 percent rating effective March 26, 2019. The Veteran had limitation of motion at shoulder level and midway between side and shoulder level.,Bilateral upper extremity neurological disability was granted a 10 percent rating prior to March 26, 2019, but denied any higher rating thereafter.,Left upper extremity neurological disability was denied any higher rating.

The Veteran's death was caused by myelogenous leukemia or myelodysplastic syndrome, which the VA examiner found less likely than not related to exposure to herbicide agents. The claim for service connection of the cause of death must be remanded.,Service connection for leukemia is also being remanded as the VA examiner's opinion did not address whether it was secondary to herbicide agent exposure.

The Veteran's claims for increased ratings and separate compensable disability ratings for peripheral neuropathy of the lower extremities, right femoral nerve peripheral neuropathy, left femoral nerve peripheral neuropathy, and diabetic retinopathy are being remanded due to missing VA treatment records and a need for new examinations.