Peripheral neuropathy Board decisions

The Board has determined that the Veteran is entitled to an effective date of January 5, 2009 for the award of a total disability rating based on individual unemployability due to service-connected disabilities (TDIU). The decision was granted.

The Veteran's claim for an increased rating for residuals of a right hand second metacarpal fracture is granted, with a maximum rating of 10 percent. A separate compensable rating is also granted for digital neuropathy as a residual of the same condition. The issue of reopening the claim for service connection for a right knee disability has been found to have new and material evidence supporting it.

The Veteran's service-connected bilateral lower extremity peripheral neuropathy has been granted a separate 20 percent rating for each leg, with symptoms of moderate constant pain; severe intermittent pain; moderate paresthesias and/or dysesthesias; and moderate numbness. The disability picture most nearly approximates moderate incomplete paralysis of the sciatic nerve.

The Veteran's claim for service connection for diabetes mellitus is denied as there is no current diagnosis of the condition. The claims for peripheral neuropathy, right foot disorder, hypertension, osteoporosis, and kidney cancer are remanded for further development.

The Veteran's posttraumatic sensory neuropathy left upper extremity has not been manifested by symptoms warranting a higher evaluation prior to December 17, 2014 and on or after that date.

The Veteran's service-connected peripheral neuropathy of the right and left upper extremities has been rated at 30 percent since October 19, 2012. Since October 31, 2015, it is rated at 60 percent for each upper extremity. The lower extremities have also been rated at 40 percent since October 19, 2012 and remain at 40 percent.

The Board has granted service connection for the Veteran's claimed disabilities, including coronary artery disease, hypertension, and other conditions, based on presumed exposure to herbicides while serving in the Republic of Vietnam. The effective date is set as August 31, 2010, which is when VA added ischemic heart disease (IHD) as a presumptive disability.

The Veteran's left lower extremity neurological disorder is rated at 20 percent from September 12, 2011 to April 4, 2014 and at 40 percent thereafter. The combined effect of his service-connected disabilities does not preclude him from securing or following a substantially gainful occupation.

The Board denied claims for earlier effective dates for service connection and increased ratings due to lack of evidence supporting earlier effective dates or entitlement to the benefits sought.

The Veteran's appeal is being remanded for additional development, including obtaining medical records and scheduling VA examinations to assess the severity of her service-connected disabilities.

The Veteran's service-connected disabilities did not render him so helpless as to require the regular aid and attendance of another person, nor did they cause him to be housebound. Therefore, SMC based on the need for aid and attendance or at the housebound rate is denied.

The Veteran meets the schedular criteria for TDIU due to his service-connected disabilities, including atherosclerotic cardiovascular disease, diabetes mellitus, type II, and peripheral neuropathy of the right and left upper and lower extremities. The Board finds he is unable to obtain or maintain substantially gainful employment as a result of these conditions.

The Board has determined that the Veteran is presumed to have been exposed to herbicide agents, including Agent Orange, during his service in Vietnam and thus meets the criteria for presumptive service connection for ischemic heart disease.

The Veteran's claims for service connection have been reopened due to the submission of new and material evidence. However, his claims for residuals of myocardial infarction, diabetes mellitus, bilateral upper extremity peripheral neuropathy, and bilateral lower extremity peripheral neuropathy remain denied as there is no credible evidence linking these conditions to active service.,The Veteran's exposure to herbicides during service at Korat RTAFB has not been conceded. The Board finds insufficient evidence of record to support the claim for service connection based on herbicide exposure.

The Board denied a rating in excess of 20 percent for the Veteran's diabetes mellitus type II, finding that his condition does not require regulation of activities as part of its management.

The Veteran's service-connected disabilities have rendered him unable to secure and follow a substantially gainful occupation since July 2010.

The Board has granted service connection for neuropathy of the right and left lower extremities, as well as sleep apnea, all secondary to herbicide agent exposure. Service connection for soft tissue sarcoma is denied.

The Veteran's major depressive disorder and peripheral neuropathy of the bilateral upper extremities are found to be aggravated by his service-connected hepatitis C.

The Board has determined that the Veteran's claims of service connection for a lumbar spine disability, peripheral neuropathy of the bilateral upper and lower extremities, psychiatric disorder (including PTSD and depression), and dementia are not supported by the evidence. The preponderance of the evidence is against these claims.

The Veteran's G6PD deficiency was aggravated during service, while his bilateral upper and lower extremity peripheral neuropathy is not secondary to his service-connected diabetes mellitus.