PERIPHERAL NERVE CONDITIONS

Summary

The Veteran, who served in the U.S. Air Force from November 1969 to November 1989, appeals the denial of service connection for bilateral lower extremity nerve conditions, specifically radiculopathy and diabetic neuropathy, claimed as secondary to his service-connected lumbar spine disability. The Board reviewed the evidence of record at the time of the AOJ decision, noting that any subsequent evidence could not be considered. The Veteran's claim was recharacterized to include bilateral lower extremity nerve conditions, as the record indicated diabetic neuropathy rather than the Veteran's self-diagnosis of radiculopathy. The primary issue was whether the bilateral lower extremity nerve condition was caused or aggravated by the service-connected lumbar spine disability. The Board considered multiple VA examinations from January 2019, April 2024, and October 2025, which consistently diagnosed diabetic neuropathy and linked it to the Veteran's non-service-connected diabetes. The Board noted the Veteran had only a brief period of leg pain in service with no continuity of symptoms, and the neuropathy symptoms first appeared 23 years post-service. A private chiropractor's letter in June 2025 opined that the condition was more likely than not a direct result of military service and lumbar spinal stenosis, but the Board found this opinion lacked sufficient rationale and afforded it low probative weight. The Board found the VA opinions persuasive, noting they were adequate and addressed the nexus issue. The Veteran's lay statements were given low probative value due to the medical nature of the diagnosis and the lack of continuity of symptoms. The Board found the weight of the evidence was against the claim, thus the benefit-of-the-doubt rule was not applied. Service connection for the bilateral lower extremity nerve conditions as secondary to the lumbar spine disability was denied.

Rationale

VA examinations diagnosed diabetic neuropathy, linked to non-service-connected diabetes.; No continuity of symptoms from brief in-service leg pain.; Symptoms first reported 23 years post-service.; Private chiropractor opinion lacked sufficient rationale for nexus to lumbar spine disability.

Full Decision Text

Citation Nr: A26024384
Decision Date: 03/18/26	Archive Date: 03/18/26

DOCKET NO. 251231-625285
DATE: March 18, 2026

ORDER

1. Entitlement to service connection for a left lower extremity nerve condition, to include radiculopathy and diabetic neuropathy, as secondary to the Veteran's lumbar spine disability, is denied.

2. Entitlement to service connection for a right lower extremity nerve condition, to include radiculopathy and diabetic neuropathy, as secondary to the Veteran's lumbar spine disability, is denied.

FINDINGS OF FACT

1. The Veteran's left lower extremity diabetic neuropathy is not related to the Veteran's lumbar spine disability.

2. The Veteran's right lower extremity diabetic neuropathy is not related to the Veteran's lumbar spine disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for left lower extremity diabetic neuropathy due to a lumbar spine disability have not been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for right lower extremity diabetic neuropathy due to a lumbar spine disability have not been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the U.S. Air Force from November 1969 to November 1989.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2025 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In a December 2025 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the October 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

Accordingly, the Board cannot consider evidence submitted subsequent to such rating decision. Id. If evidence was associated with the claims file during a period of time when additional evidence was not allowed, the Board has not considered it in this decision. 38 C.F.R. § 20.300. If the Veteran would like VA to consider any evidence that was added to the claims file that the Board could not consider, she 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service-the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 38 F.3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in the denial of service connection.

Additionally, service connection may be granted on a secondary basis when the evidence establishes (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); 38 C.F.R. § 3.310.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107;
 Cir. 2004)). The absence of any one element will result in the denial of service connection.

Additionally, service connection may be granted on a secondary basis when the evidence establishes (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); 38 C.F.R. § 3.310.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).  A claim will be denied if the evidence persuasively weighs against the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Entitlement to service connection for a left lower extremity nerve condition, to include radiculopathy and diabetic neuropathy, as secondary to the Veteran's lumbar spine disability, is denied.

2. Entitlement to service connection for a right lower extremity nerve condition, to include radiculopathy and diabetic neuropathy, as secondary to the Veteran's lumbar spine disability, is denied.

The Veteran contends that he has a bilateral lower extremity nerve condition related to his service-connected lumbar spine disability. See November 2020 Fully Developed Claim. The Board finds the elements of service connection have not been met.

Initially, the Board notes that the Veteran filed a claim for bilateral neuropathy secondary to spinal stenosis (radiculopathy, although the Veteran does not use that term); however, the record indicates the Veteran has a diagnosis for bilateral lower extremity diabetic neuropathy. As noted in Clemons, a Veteran may not be competent to diagnosis his or her particular disability. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Thus, VA will not limit the scope of a claim solely to the diagnosis as reported by the Veteran. Accordingly, the Board finds it appropriate to recharacterize the Veteran's claim as a claim for service connection for a bilateral lower extremity nerve condition, to include radiculopathy and diabetic neuropathy.

Regarding the Veteran's claimed primary disability, the Veteran is service connected for a lumbar spine disability; however, the Board notes, the Veteran is not presently service connected for diabetes.

The remaining question is whether the Veteran's bilateral lower extremity nerve condition was caused or aggravated by the Veteran's service-connected lumbar spine disability.

The Veteran has undergone VA examinations for the lumbar spine and/or neuropathy in January 2019, April 2024, and October 2025.

As noted above, the Veteran's nerve condition has been diagnosed as diabetic neuropathy throughout the VA examinations and VA treatment records. These records indicate the Veteran's diabetic neuropathy is directly related to the Veteran's non-service-connected diabetes. The Veteran had leg pain for two months while in service in 1980 but had no continuity of symptomatology or further treatment thereafter. The Veteran's symptoms of diabetic neuropathy were first reported in 2012, 23 years after military separation. There is no evidence given in these exams to support the Veteran's diabetic neuropathy is related to the Veteran's lumbar spine disability, rather, the medical evidence of record indicates the etiology of the Veteran's nerve condition is his diabetes. A July 2021 nerve conduction study did not show denervation, which should be present if he has radiculopathy due to lumbar spinal stenosis.

The Veteran provided a June 2025 letter from a chiropractor who has treated the patient, who gave a private medical opinion regarding radiculopathy in which the private examiner stated, "it is more likely than not that the Veteran's current condition he is suffering from is a direct result of his military service. Lumbar spondylosis with spinal canal stenosis, lateral recess or neural foraminal narrowing at multiple levels shown in his image report from the VA can and will cause the symptoms that he is experiencing." No other rationale was provided. While this medical opinion provides a general statement regarding causation between radiculopathy and lumbar spine disabilities, the Board finds it fails to show that the Veteran's diagnosed nerve condition is related to his lumbar spine disability. Accordingly, the Board affords this opinion low probative weight.

The Board finds the VA opinions persuasive.  The examiners noted the Veteran's self
 "it is more likely than not that the Veteran's current condition he is suffering from is a direct result of his military service. Lumbar spondylosis with spinal canal stenosis, lateral recess or neural foraminal narrowing at multiple levels shown in his image report from the VA can and will cause the symptoms that he is experiencing." No other rationale was provided. While this medical opinion provides a general statement regarding causation between radiculopathy and lumbar spine disabilities, the Board finds it fails to show that the Veteran's diagnosed nerve condition is related to his lumbar spine disability. Accordingly, the Board affords this opinion low probative weight.

The Board finds the VA opinions persuasive.  The examiners noted the Veteran's self-reported medical history, indicated a review of the claims file, and based their opinions on the Veteran's interview, the claims file review, and the VA examination results. See Bloom v. West, 12 Vet. App. 185, 187 (1999) (the value of a physician's statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion). Further, the VA opinions are the only adequate medical opinions of record that address the issue of medical nexus.

In adjudicating this claim, the competence and credibility of lay statements must be considered by the Board.  Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Washington v. Nicholson, 19 Vet. App. 362, 368-69 (2005).  The Veteran contends that his bilateral lower extremity symptoms are the result of his military service, specifically related to his service-connected lumbar back condition. While the Veteran may be credible to describe the particular symptoms which he experiences, determining the exact nature and diagnosis of lower extremity radiculopathy or neuropathy symptoms requires specialized testing and medical knowledge or training which the Veteran is not shown to have. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).  Therefore, he cannot provide an opinion as to etiology in such cases.  In addition, the pertinent evidence of record demonstrates that his lower extremity symptoms are due to diabetic neuropathy. Accordingly, his lay statements are entitled to low probative value. 

The Board has considered the benefit-of-the-doubt rule; however, since the weight of the evidence is persuasively against the claim, the benefit-of-the-doubt rule is not for application.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. Dec. 17, 2021). 

 

Thomas L. English

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Seibert, Andrew L. II

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.