Peripheral neuropathy decisions — 2020

The Veteran's service-connected disabilities do not meet the criteria for a TDIU at any time during the appeal period as his adverse symptomatology is both contemplated and considered by the rating criteria.

The Veteran's left foot wound or ulcer is granted service connection as it is aggravated by his service-connected diabetes. The Veteran's bilateral lower extremity peripheral neuropathy and CAD are not rated higher than the current assigned ratings.

The Board has remanded the case for further development, including obtaining an addendum opinion from a clinician regarding the etiology of the Veteran's cervical spine disability and left arm peripheral neuropathy. The examiner must opine whether these conditions are related to service or secondary to service-connected left shoulder disability.

The Veteran's claims for increased rating, service connection for left shoulder disability, neuropathy of the left upper extremity (ulnar), back disability, and neck disability are all remanded due to new evidence received since the last denial. The Veteran is also granted to reopen his claims for service connection for left shoulder disability, left ulnar nerve disability, and back disability.

The Veteran's claim for a higher disability rating for his left foot shrapnel injury, including residuals of pain, osteoarthritis, and neuropathy, is being remanded due to the need for additional evidence.

The Veteran's claim for higher ratings for Type II Diabetes Mellitus and Peripheral Neuropathy of the lower extremities was denied. The rating for Type II Diabetes Mellitus remains at 20% since December 2006, but a separate 10% rating is granted for Peripheral Neuropathy of the lower extremities as of October 2007.

The Veteran's initial rating for obstructive sleep apnea is denied as his condition does not meet the criteria for a higher rating.,The Veteran's diabetes mellitus rating is also denied since he has not experienced episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or visits to a diabetic care provider, and no complications are present that would be compensable if separately evaluated.,Service connection for GERD and Barrett's esophagus is remanded as the evidence does not clearly establish whether these conditions are proximately due to or aggravated by service-connected diabetes mellitus.,The Veteran's lower extremity diabetic peripheral neuropathy ratings remain unchanged, with his claims for increased ratings being remanded.,TDIU prior to March 14, 2016 is also remanded as the evidence does not clearly establish whether this condition has rendered the Veteran unemployable due to service-connected disabilities.

The Veteran's claim for an initial compensable rating for bilateral hearing loss is remanded.,The Veteran's claim of service connection for peripheral neuropathy of the bilateral upper and lower extremities (polyneuropathy) is remanded due to a lack of updated private treatment records from his lifetime providers.,The Veteran's claim of service connection for radiculopathy of the bilateral upper and lower extremities is remanded.,The Veteran's claim of service connection for erectile dysfunction, to include as secondary to service-connected disabilities, is remanded.,The Veteran's claim of service connection for a gastrointestinal disability, to include GERD, to include as secondary to service-connected disabilities, is remanded.,The Veteran's claim of service connection for depression and anxiety, to include as secondary to service-connected disabilities, is remanded.

The Veteran's bilateral hearing loss disability is rated at 10 percent from April 7, 2015 forward. The Board has denied a higher rating as the evidence does not support such.,For the entire period on appeal from August 20, 2014 forward, the Veteran's peripheral neuropathy of the left and right femoral nerves are rated at 20 percent each.

The Board denied service connection for residuals of right and left leg injuries as the Veteran does not have a current diagnosis of these conditions separate from diabetic peripheral neuropathy.

The Board has granted special monthly compensation (SMC) based on the need for aid and attendance due to the Veteran's service-connected disabilities, including low back disability, peripheral neuropathy in the lower extremities, and erectile dysfunction. The issue of SMC at the housebound rate is dismissed as moot because SMC based on aid and attendance is a greater benefit.

The Veteran's tinnitus was not present in service or for many years thereafter and is not otherwise related to service.,The Veteran’s acne pre-existed service; it was not aggravated beyond its natural progression by or during service.

The Board has remanded three issues related to service connection for various conditions, including a lumbar spine disorder and bilateral knee disorders. The decision does not specify the rating assigned or effective date.

The Board has remanded the cases due to incomplete development, specifically the lack of EMG and MRI studies performed during the Veteran's service in Vietnam. The VA is instructed to obtain all relevant records and schedule a VA examination for further evaluation.

The Board has granted service connection for bilateral upper and lower extremity peripheral neuropathy associated with diabetes mellitus type II, as well as coronary artery disease. The initial evaluation for diabetes mellitus type II remains at 20 percent. The increased rating claim for erectile dysfunction is dismissed.

The Board has remanded the Veteran's claims for service connection for peripheral neuropathy of his upper and lower extremities, including as due to in-service exposure to an herbicide agent. The AOJ is instructed to schedule a VA examination to determine if these conditions are related to active service.

The Board has remanded the case due to incomplete development of other claims, and TDIU is deferred until these issues are resolved.

The Veteran's claims for peripheral neuropathy of the upper left and right extremities, hypertension, cerebrovascular accident (CVA), tinnitus, bilateral hearing loss, and fibromyalgia are all denied as there is no current disability at any time pertinent to the claim on appeal. The Veteran’s service connection claim for hypertension is remanded due to in-service exposure to herbicides.

The Board has decided that the Veteran's claims for service connection for peripheral neuropathy of the upper and lower extremities, as well as erectile dysfunction, should be remanded due to a lack of available VA treatment records.

The Board has remanded several issues related to the Veteran's service-connected disabilities, including diabetes mellitus and peripheral neuropathy of the upper extremities. The main reasons for the remand include providing adequate statements of reasons or bases for increased ratings, obtaining medical opinions regarding employment impact due to service-connected conditions, and resolving conflicts in evidence concerning the severity of diabetes mellitus.