Citation Nr: 1100953 Decision Date: 01/10/11 Archive Date: 01/20/11 DOCKET NO. 08-28 810 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Roanoke, Virginia THE ISSUE Entitlement to service connection for residuals of right wrist surgery. REPRESENTATION Appellant represented by: Virginia Department of Veterans Services ATTORNEY FOR THE BOARD G. Slovick, Associate Counsel INTRODUCTION The appellant is a Veteran who served on active duty from April 1982 to December 2006. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2007 rating decision by the Winston- Salem, North Carolina, Regional Office (RO) of the Department of Veterans Affairs (VA). FINDING OF FACT Residuals of right wrist surgery are due to service. CONCLUSION OF LAW Residuals of right wrist surgery were incurred in active service. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2010); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2010). REASONS AND BASES FOR FINDING AND CONCLUSION As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), the United States Department of Veterans Affairs (VA) has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a). In this decision, the Board grants service connection, and as such, no further action is required to comply with the VCAA. Laws and Regulations Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. Such a determination requires a finding of current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993). Service connection may be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, to prove service connection, a claimant must submit (1) medical evidence of a current disability, (2) medical evidence, or in certain circumstances lay testimony, of in- service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus between the current disability and the in-service disease or injury. Pond v. West, 12 Vet. App. 341, 346 (1999). Factual Background and Analysis In this case, the Veteran's service treatment records contain multiple reports of right wrist pain due to electrodiagnostically confirmed carpel tunnel syndrome. In May 2006 the Veteran was granted convalescent leave following right hand carpal tunnel surgery. A June 2006 hand surgery note recorded that the Veteran had scar sensitivity. In her October 2006 report of medical assessment, the Veteran reported bilateral wrist pain due to carpel tunnel syndrome. The Veteran was afforded a QTC examination in November 2006. In the QTC report, it is noted that the Veteran had right wrist surgery. Her presurgical symptoms were better after the surgery. The Veteran reported that she was unable to vacuum and push a lawn mower because of pain. Neurological examination showed normal right upper extremity sensory function. The examiner diagnosed left, but not right, carpal tunnel syndrome. The examiner did not observe a scar. In her December 2008 notice of disagreement, the Veteran stated that she had a 1.5 inch visible scar from her right hand surgery. The Veteran also stated, contrary to the QTC report, that she described feeling bilateral wrist numbness and pain while performing daily tasks during her QTC examination. After resolving reasonable doubt in the Veteran's favor, the Board concludes that service connection is warranted for residuals of right wrist surgery. See 38 U.S.C.A. § 5107(b). The Veteran clearly underwent surgery for right wrist carpel tunnel syndrome in-service. She had post operative residual pain. See October 24, 2006 Report of Medical Assessment; October 30, 2006 Application for Compensation and Pension. The Veteran has continuously reported symptoms such as pain since her surgery. She is competent to report such symptoms. 38 C.F.R. § 3.303(b); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (a lay person can speak as to etiology in some limited circumstances in which nexus is obvious merely through lay observation.) While the QTC examiner failed to diagnose right hand carpel tunnel syndrome, the Board finds probative the Veteran's continuous complaints of pain and tingling since her in-service surgery. The evidence demonstrates an in-service incurrence of right wrist symptoms, present symptoms which the Veteran is competent to report, and continuous reports of such symptoms since her right hand surgery. This is a nexus between the surgery and the presently observed symptoms. Accordingly, without addressing what rating is warranted, service connection for residuals of a right wrist surgery is granted. ORDER Entitlement to service connection for residuals of right wrist surgery is granted. ____________________________________________ DEREK R. BROWN Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs