Peripheral neuropathy decisions — 2023

The Board has remanded the case for additional development due to inadequate VA examinations and incomplete opinions regarding service connection for various disabilities, including a low back disability, right upper extremity neuropathy, left ankle disability, and right ankle disability.

The Board has remanded the claims for essential tremors, left and right lower extremity peripheral neuropathy due to lack of substantial compliance with prior remand directives. The Veteran's Parkinson's disease claim is denied as he does not have a diagnosis of Parkinson's disease.

The Veteran's cervical spine disability is being remanded due to inadequate examination opinions. The examiner must provide a detailed rationale for all opinions, including citations to the relevant medical literature and service treatment records.,The neurological disabilities of the upper extremities are also being remanded as they are inextricably intertwined with the cervical spine disability.

The Veteran's PTSD is rated at 70 percent prior to July 16, 2019, and at 70 percent thereafter. The Veteran's bilateral upper extremity peripheral neuropathy (median nerve) is rated at 30 percent for the right upper extremity and 20 percent for the left upper extremity. The Veteran's bilateral lower extremity sciatic nerve peripheral neuropathy is rated at 20 percent prior to July 15, 2019, and at 20 percent thereafter.,The Veteran's PTSD symptoms have more closely approximated a 70 percent rating throughout the appeal period due to occupational and social impairment with reduced reliability and productivity. The Veteran's bilateral upper extremity peripheral neuropathy (median nerve) is rated based on moderate incomplete paralysis of the median nerve bilaterally. The Veteran's bilateral lower extremity sciatic nerve peripheral neuropathy is rated based on moderate incomplete paralysis of the sciatic nerve bilaterally.

The Board has remanded the claims for service connection due to inadequate medical opinions regarding the onset and continuity of the Veteran's back disability, as well as the relationship between his service-connected back disability and his claimed neuropathies.

The Veteran's prostate cancer and diabetes are granted service connection due to herbicide exposure under the PACT Act.,Peripheral neuropathy of the upper and lower extremities, as well as chronic urticaria, are also granted service connection due to herbicide exposure.

The Veteran's claims for increased ratings and service connection are being remanded due to the need for additional medical examinations, as well as for obtaining outstanding VA and private treatment records.

The Veteran's diabetes mellitus is rated at 20 percent, and the rating for peripheral neuropathy of both upper extremities prior to June 10, 2016 is granted at 40 percent and 30 percent respectively. The ratings for peripheral neuropathy of the right and left lower extremities are denied.,The Veteran's peripheral neuropathy of the right upper extremity (major) was rated at 40 percent prior to June 10, 2016, and at 30 percent for the left upper extremity. The ratings for both upper extremities were denied higher than these levels.,The Veteran's peripheral neuropathy of the right lower extremity (sciatic nerve) was rated at 20 percent prior to December 4, 2019, and denied a higher rating. Similarly, the left lower extremity (sciatic nerve) was also denied a higher rating.

The Board has determined that the current examinations are inadequate and remands the cases for further examination to determine if the Veteran's conditions are related to service.

The Board has remanded the Veteran's claims for service connection due to outstanding VA medical records and a need for further development, including potential new examinations or opinions.

The Veteran's service-connected disabilities render him unable to secure and follow a substantially gainful occupation, and he is in need of regular aid and attendance. The Board has granted TDIU and SMC based on the need for aid and attendance. However, the claim for a higher rating for diabetes mellitus type II remains denied.

The Board has remanded the cases for further development due to insufficient evidence and need for updated examinations. Effective dates have not been assigned.

The Board denied the Veteran's claims for increased ratings for peripheral neuropathy of the right and left lower extremities, finding that the evidence did not support ratings in excess of 40 percent.

The Board has remanded the Veteran's claims for HIV, left leg and foot peripheral neuropathy, tinnitus, hypertension, acquired psychiatric disorder, kidney disorder, right arm, left arm, right hand, left hand, right leg, and right foot peripheral neuropathy due to new evidence of service connection being reopened. The VA is instructed to schedule examinations and obtain medical opinions regarding the etiology of these conditions.

The Board has granted service connection for bilateral lower extremity peripheral neuropathy, finding that the Veteran's exposure to herbicides in Vietnam and contaminated water at Camp Lejeune is at least as likely as not related to his condition.

The Veteran's service-connected right foot disabilities are rated at 10 percent, and he is denied a higher rating. Prior to May 11, 2017, the Veteran was not found unemployable due to his service-connected conditions. From May 11, 2017, the Veteran is granted TDIU.

The Veteran withdrew all remaining issues from his appeal, including those related to TDIU and DEA effective dates. The Board dismissed the appeal due to the appellant's withdrawal.

The Board denied higher initial disability ratings in excess of 40 percent for left and right lower extremity diabetic neuropathy from September 25, 2007.

The Veteran's service-connected frostbite residuals and peripheral neuropathy have resulted in the loss of use of both feet, warranting SMC at the 'l' rate. The Veteran also has lost effective function of his hands due to these conditions, which warrants SMC at the 'm' rate.

The Board has decided to remand the case due to insufficient opinions regarding the etiology of the Veteran's left arm disability, including whether it is related to military service or his service-connected conditions. The claim will be reviewed again with additional medical opinion.