Citation Nr: 0814146 Decision Date: 04/29/08 Archive Date: 05/08/08 DOCKET NO. 05-32 950 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to service connection for disability of the right hand, to include arthritis. REPRESENTATION Appellant represented by: Tennessee Department of Veterans' Affairs WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Robert L. Grant, Associate Counsel INTRODUCTION The veteran had active service from March 1943 to September 1945. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2005 rating decision of the VA Regional Office (RO) in Nashville, Tennessee, which denied entitlement to the benefit sought. In October 2007 the Board remanded this matter to the RO for a VA examination of the veteran's right hand. That additional development having been completed, this claim has returned to the Board for appellate review. FINDINGS OF FACT The veteran's right hand disorder was not manifested during service and any current right hand disorder is not shown to be causally or etiologically related to active service. CONCLUSION OF LAW The veteran's right hand disorder was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION Before addressing the merits of the veteran's claim on appeal, the Board is required to ensure that the VA's "duty to notify" and "duty to assist" obligations have been satisfied. See 38 U.S.C.A. §§ 5103, 5103A (West 2002); 38 C.F.R. § 3.159 (2007). The notification obligation in this case was accomplished by way of letters from the RO to the veteran dated in November 2004 and November 2007. The RO provided the requisite notification regarding the disability evaluation or the effective date that could be assigned if service connection were granted in March 2006, November 2006, and November 2007 letters. See Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). The RO also provided assistance to the veteran as required under 38 U.S.C.A. § 5103A and 38 C.F.R. § 3.159(c), as indicated under the facts and circumstances in this case. The veteran and his representative have been kept informed of the RO's actions in this case by way of the Statement of the Case, and been informed of the evidence considered, the pertinent laws and regulations and a rationale for the decision reached in denying the claim. The veteran and his representative have not made the RO or the Board aware of any additional evidence that needs to be obtained in order to fairly decide this appeal, and have not argued that any error or deficiency in the accomplishment of the duty to notify and duty to assist has prejudiced him in the adjudication of his appeal. Mayfield v. Nicholson, 19 Vet. App. 103 (2005), rev'd on other grounds, 444 F.3d 1328 (Fed. Cir. 2006). Therefore, the Board finds that the duty to notify and duty to assist have been satisfied and will proceed to the merits of the veteran's appeal. A hearing in this matter was held before the RO in October 2005. At that time the veteran asserted that he sustained a laceration to the fingers of his right hand during an aircraft crash in France during 1944. A review of service medical records does not indicate any medical treatment to the right hand in 1944. However, the veteran's exit physical of September 1945 notes that the veteran injured his right hand and was treated at a field hospital in 1944. A scar on the veteran's right ring finger was also noted. In March 2006 the veteran provided a April 2006 letter from his cardiovascular surgeon. The physician indicated that the veteran's hand deformity at the 1st and 2nd fingers was attributable to a laceration of the extensor tendon. The physician reported that this injury apparently happened over 60 years ago during an aircraft crash in France. A VA examination was conducted in December 2007. The claims file was reviewed by the examiner. By history the veteran reported a laceration of the volar aspect of his right hand at the PIP joint of the fingers during an aircraft crash in France in 1944. The veteran reported intermittent pain in the index and long fingers of the right hand approximately three times a week, sometimes related to weather, but not necessarily related to activity. On physical examination the examiner noted a gross instability present at the distal interphalangeal joint of the index finger, with a loss of range of motion in terms of full extension. X-rays indicated significant degenerative changes at the distal interphalangeal joint of the index and the long finger. The examiner's assessment was moderate degenerative joint disease of the distal interphalangeal joint of the index and long finger. Also noted were residuals of laceration to the volar aspect of the index and middle finger. The examiner went on to state the opinion that the laceration and injury that the veteran sustained during active service is less likely than not related to his current hand condition. Rather, the condition was said to have appeared to be chronic in nature and had developed over a number of years. Applicable law provides that service connection will be granted if it is shown that a veteran suffers from a disability resulting from an injury suffered or a disease contracted in the line of duty, or for aggravation of a pre- existing injury suffered or disease contracted in the line of duty, in the active military, naval or air service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. If there is no showing of a resulting chronic condition during service, then a showing of continuity of symptomatology after service is required to support a finding of chronicity. 38 C.F.R. § 3.303(b). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Generally, to prove service connection, the record must contain: (1) Medical evidence of a current disability, (2) medical evidence, or in certain circumstances, lay testimony, of an in-service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus or a relationship between a current disability and the in-service disease or injury. Pond v. West, 12 Vet. App. 341 (1999); Caluza v. Brown, 7 Vet. App. 498 (1995). Based upon a review of the above, the Board concludes that the evidence in this matter does not support a finding of service connection for a disability of the right hand. Specifically, the record indicates that the veteran is suffering from a current disability of the right hand in the form of moderate degenerative joint disease of the distal interphalangeal joint of the index and long finger. The available medical evidence indicates that it is less likely than not that this condition is causally related to the veteran's 1944 hand laceration. Absent medical evidence of a nexus or a relationship between a current disability and the in-service disease or injury, a finding of service connection is not warranted. ORDER Service connection for a disability of the right hand, to include arthritis, is denied. ____________________________________________ V. L. JORDAN Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs