Peripheral neuropathy decisions — 2023

The Veteran's service-connected disabilities, including lower back disability, radiculopathies, and hearing loss, have rendered him unable to maintain substantially gainful employment since July 28, 2022. The Board has granted TDIU based on the combined effect of these conditions.

The Veteran's service connection claims for high cholesterol, bilateral eye disability, bilateral lower extremity neuropathy, right upper extremity neuropathy, hypertension, diabetes mellitus, bilateral hearing loss, and tinnitus have all been denied. The evidence does not support a finding of current disabilities related to these conditions.,There is no persuasive medical evidence linking the Veteran's claimed conditions to his active-duty service.

The Veteran's initial ratings for left and right lower extremity peripheral neuropathy of the sciatic nerve, as well as his Charcot's arthropathy of the right foot, have been granted. He also received separate ratings for partial amputation of the right foot 4th digit and metatarsal head resections due to chronic ulcers in the right feet (2nd and 3rd digits).

The Board has granted service connection for right and left lower extremity idiopathic small fiber neuropathy, finding that the Veteran's exposure to herbicide agents in Vietnam during his active duty is causally linked to these conditions.

The Board has remanded the claims for service connection for a right knee disability and left lower extremity peripheral neuropathy due to insufficient medical opinions. The Veteran's current disabilities are not presumed, and there is no clear and unmistakable evidence of permanent aggravation.

The Veteran's appeal regarding his increased rating for bilateral peripheral neuropathy of the lower extremity and an automobile allowance is dismissed without prejudice due to the death of the Veteran.

The Board has remanded several issues related to the Veteran's hip disabilities and left lower extremity neuropathy due to incomplete development. The specific reasons for the remand include needing an addendum opinion explaining the damage to the right hip joint, as well as examining the current severity of the hip disabilities.

The Board has granted service connection for sleep apnea, bilateral upper and lower extremity peripheral neuropathy, all secondary to the Veteran's service-connected PTSD with alcohol abuse disorder. The decision is based on evidence showing that obesity caused by the service-connected condition led to the development of sleep apnea, which in turn caused the peripheral neuropathies.

The Board denied service connection for low back disability, obstructive sleep apnea, diabetes mellitus type II, right lower extremity diabetic peripheral neuropathy, and left lower extremity diabetic peripheral neuropathy. The reasons given were that the evidence did not establish a chronic disease during service or within one year of separation, and there was no causal relationship between these conditions and service.

The Veteran's appeal is remanded for additional examinations and opinions to determine the nature and etiology of his left elbow condition, cubital tunnel syndrome, shoulder condition, back condition, knee condition, acquired psychiatric disorder, eye condition, neuropathy of the hands, and neuropathy of the feet.,The Veteran's appeal is also remanded for an examination and opinion regarding his bilateral cubital tunnel syndrome (claimed as carpal tunnel syndrome).,The Veteran's appeal is also remanded for an examination and opinion regarding his shoulder condition.,The Veteran's appeal is also remanded to obtain a medical opinion regarding the nature and etiology of his back condition.,The Veteran's appeals are all remanded for additional examinations and opinions to determine the nature and etiology of his knee, eye, hand, and foot conditions.,The Veteran's acquired psychiatric disorder (cyclothymic disorder and PTSD) appeal is also remanded for an examination and opinion regarding its etiology.,The Veteran's appeals are all remanded for additional examinations and opinions to determine the nature and etiology of his eye condition.,The Veteran's appeals are all remanded for additional examinations and opinions to determine the nature and etiology of his hand and foot conditions.

The Veteran's claims for service connection were denied. The Board found that the Veteran did not meet the criteria for an initial disability rating in excess of 30 percent for agoraphobia, claimed as PTSD. Service connection was also denied for diabetes mellitus, type II and its secondary conditions (erectile dysfunction and peripheral neuropathy).

The Board has remanded the Veteran's claims for service connection for peripheral neuropathy of both lower extremities due to outstanding medical records and lack of cooperation from the Veteran.

The Board has remanded the claims for service connection for diabetes mellitus and peripheral neuropathy of the upper extremities due to exposure to chemicals/defoliants during active duty in Korea. The AOJ is instructed to verify the Veteran's claimed exposures, issue a formal finding if possible, and then refer the case to an appropriate clinician for medical opinion regarding the nature and etiology of the conditions with consideration of the reported exposures.

The Board has remanded the Veteran's claims for ratings in excess of 20 percent for his diabetic peripheral neuropathy due to issues with defining what constitutes 'moderately severe' incomplete paralysis and considering whether VA should obtain private treatment records from a non-VA provider.

The Board has reopened the appellant's claim for service connection for diabetes mellitus and remanded the remaining issues. The AOJ is instructed to obtain additional medical evidence, including treatment records from private providers, and to schedule examinations for the appellant's right knee disability, diabetes mellitus, diabetic neuropathies of the feet, left elbow disability, and TDIU.

The Board has determined that additional evidence is needed to determine the current severity of the Veteran's back disability, rhinitis, and other conditions. The VA will attempt to obtain relevant private treatment records from WHC and Dr. S., as well as any outstanding VA treatment records. A new VA examination will be scheduled for these claims.

The Veteran's claim for service connection for diabetes mellitus, type II and related diabetic peripheral neuropathy of the upper and lower extremities was reopened due to new and material evidence. Service connection is granted on a presumptive basis for diabetes mellitus, type II due to in-service Agent Orange exposure. Secondary service connection is also granted for diabetic peripheral neuropathy.

The Veteran's peripheral neuropathy of the left lower extremity (sciatic) and femoral nerves was granted increased ratings since February 17, 2023. The right lower extremity sciatic nerve condition remains at a 40% rating since February 17, 2023.

The Veteran withdrew his appeals for the claims of a rating in excess of 30 percent for residuals of fracture of second, third, and fourth toes of the left foot, entitlement to TDIU prior to September 1, 2014, service connection for peripheral neuropathy of the bilateral upper extremities, and service connection for peripheral neuropathy of the bilateral lower extremities.

The Veteran's diabetes and related neuropathy conditions are being remanded for further development, including clarification of hospitalization dates and additional medical evidence. The TDIU claim is also being remanded.