Entitlement to service connection for bilateral upper extremity neuropathy is granted.

Citation Nr: A26069937 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 250815-575816 DATE: July 30, 2026 ORDER Entitlement to service connection for bilateral upper extremity neuropathy is granted. Entitlement to service connection for bilateral lower extremity neuropathy is granted. FINDINGS OF FACT 1. Resolving all doubts in favor of the Veteran, the Veteran's bilateral upper extremity neuropathy is related to his military service. 2. Resolving all doubts in favor of the Veteran, the Veteran's bilateral lower extremity neuropathy is related to his military service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral upper extremity neuropathy have been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for bilateral lower extremity neuropathy have been met. 38 U.S.C. §§ 1101, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty from November 1976 until 1979. By way of background, the Veteran filed for service connection for bilateral upper and lower neuropathy in September 2023 and February 2024. In April 2024, a rating decision was issued by the Department of Veterans Affairs (VA) Regional Office (RO) denying the Veteran's claim. In January 2025, the Veteran filed VA Form 20-0996, Decision Review Request: Higher-Level Review, and requested review of the April 2024 decision. In April 2025, the Higher-Level Reviewer determined that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development. In July 2025, the RO issued the rating decision on appeal denying the Veteran's claim. In August 2025 the Veteran filed VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the April 2024 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Entitlement to service connection for bilateral upper extremity neuropathy. Entitlement to service connection for bilateral lower extremity neuropathy. The Veteran contends his disabilities are due to his military service. See February 2024 VA 21-526EZ, Fully Developed Claim. A Veteran is entitled to disability compensation for a disability resulting from personal injury suffered or disease contracted in the line of duty or for aggravation of a preexisting injury suffered or disease contracted in the line of duty. 38 U.S.C. § 1110. To establish service connection for a present disability, the Veteran must show evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1167. For certain chronic diseases, a disability will be presumed related to service if it was shown as chronic in service or if it manifested to a compensable degree withing a presumptive period following separation from service. 38 C.F.R. §§ 3.307, 3.309. If the disease's chronicity was not noted in service, the disability can still be presumed related to service if the evidence shows there is a continuity of symptomatology since service. Walker v. Shinseki, 708 F.3d 1331, 1338. Under the Appeals Modernization Act (AMA), the Board is bound by favorable findings by the AOJ unless rebutted by evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). Here, the AOJ favorably found the Veteran has a disability of bilateral upper and lower extremity neuropathy. The AOJ also found the Veteran participated in a toxic exposure risk activity. See July 2025 Rating Decision - Narrative. As such, elements one and two of service connection have been met. The remaining question before the Board is whether the Veteran's bilateral upper and lower neuropathy is related to his military service. The Veteran was given a VA examination in October 2023. The examiner opined that the Veteran's bilateral upper and lower extremity neuropathies were at least as likely as not caused by the indicated toxic exposure risk activities, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. The examiner noted alcohol toxicity is an important cause of peripheral neuropathy. The examiner did not provide any further rationale nor was a direct service connection opinion provided. As such, the Board finds that this medical opinion is inadequate and only slightly probative. The Veteran was given another VA examination in June 2025. The examiner opined that the Veteran's bilateral upper and lower extremity neuropathies were less likely than not caused by the indicated toxic exposure risk activities, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. The examiner noted in 2018 the Veteran was diagnosed with mild bilateral peripheral neuropathy of the lower extremities and in 2023 diagnosed with mild bilateral peripheral neuropathy of the upper extremities. The examiner noted that an EMG was not performed to confirm neuropathy. Finally, the examiner states that potential neurotoxic should have manifested itself at the time of exposure and not delayed by 40 years. The Board finds this opinion is inadequate and less than probative as the examiner failed to fully explain why a delay of 40 years is significant and did not provide a direct service connection opinion. The Board finds that both VA opinions failed to fully provide an adequate rationale. However, although not perfect, the Board finds the evidence to at least be in equipoise. After resolving all doubt in favor, the Board finds the Veteran's bilateral lower and upper extremity neuropathy is related to his military service based on the positive nexus in October 2023. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. (Continued on the next page) ? As such, the Veteran's claim for entitlement to service connection for bilateral lower and upper extremity neuropathy is granted. JIMMY L. BARDIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bond, Tyana N. The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.