Citation Nr: 1303686 Decision Date: 02/04/13 Archive Date: 02/08/13 DOCKET NO. 09-13 918 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUES 1. Entitlement to service connection for bilateral shin splints. 2. Entitlement to service connection for costochondritis. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Siobhan Brogdon, Counsel INTRODUCTION The Veteran served on active duty from September 1987 to October 2007. This appeal comes before the Department of Veterans Affairs (VA) Board of Veterans Appeals (Board) from a February 2008 rating decision of the VA Regional Office in Winston-Salem, North Carolina that, among other things, denied service connection for bilateral shin splints and costochondritis. The case was certified to the Board by the Detroit, Michigan RO. Following review of the record, the appeal is REMANDED to the RO via the Appeals Management Center (AMC) in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran asserts that he had shin splints and costochondritis during service, and that he continues to have painful residuals of such for which service connection is warranted. Service treatment records reflect that the appellant was treated for symptoms diagnosed as shin splints in 1999 and 2000, and for complaints of chest pain, right thoracic outlet syndrome, and rib fractures at times in 2003 and 2004. Review of the record discloses that following an application for service connection for the claimed disorders in June 2007, the Veteran was afforded examinations for VA compensation purposes in July and August 2007 while still in service. Following a July 2007 psychiatric evaluation in the former month, the diagnoses on Axis III included shin splints. However, following general medical examination in August 2007, the examiner stated that there was no diagnosis of bilateral shin splints or costochondritis because "there is no pathology to render a diagnosis." Conversely, the examiner commented that the effect of the disorder on the Veteran's daily activities was "limited amount of running because of bilateral shin pain." Clearly there is a conflict in the examiner's report of "no diagnosis" of shin splints and the ensuing remarks that Veteran's running was limited by shin splint pain. VA outpatient records dating from 2008 indicate that the Veteran requests VA care for complaints of right chest wall pain. He was diagnosed with right sided chest wall pain in May 2008. He underwent a VA examination in May 2009 for a condition unrelated to the current appeal where it was noted that he reported tightness in the chest 'where the rib bone and the cartilage comes[sic] together.' The Veteran indicated that it became "inflamed and out of whack." Following evaluation, sternal pain was included in the diagnoses. In view of the above, the Veteran should be afforded a current VA examination to clarify whether he currently has shin splints, and whether his continuing complaints of right sided chest pain may be characterized as or associated with the appellant's in-service complaints. The fulfillment of VA's statutory duty to assist the appellant includes requesting a contemporaneous and thorough VA medical examination when indicated, and providing a medical opinion that takes into account the records of prior medical treatment so that the disability evaluation will be a fully informed one. See Hyder v. Derwinski, 1 Vet.App. 221 (1991); Green v. Derwinski, 1 Vet.App. 121, 124 (1991). Additionally, as indicated previously, the Veteran has received treatment from VA. The most recent clinical records date through April 2009. VA has constructive possession of any subsequent records, they must be retrieved and associated with the other evidence on file. Bell v. Derwinski, 2 Vet.App. 611 (1992). Therefore, records dating from May 2009 to the present should be requested and associated with the claims folder. The Veteran should also be requested to provide authorization identifying any other health care provider who has treated him for shin splints and costochondritis, and the RO should thereafter secure these records. Accordingly, the case is REMANDED for the following actions: 1. Contact the Veteran and request that he furnish authorization that identifies all healthcare providers who have treated him for shin splints and costochrondritis since service. VA should request this clinical evidence if not already of record. 2. Request VA outpatient records dating from May 2009 to the present and associate those records with the claims folder. If the RO cannot locate such records, the RO must specifically document the attempts that were made to locate them, and explain in writing why further attempts to locate or obtain any government records would be futile. The RO must then: (a) notify the claimant of the specific records that it is unable to obtain; (b) explain the efforts VA has made to obtain that evidence; and (c) describe any further action it will take with respect to the claims. The claimant must then be given an opportunity to respond. 3. Thereafter, schedule the Veteran for an examination by an appropriate VA physician examiner. The claims folder, access to Virtual VA and a copy of this remand must be made available to the examining physician. The examining physician must indicate whether the claims folder and Virtual VA were reviewed. All indicated tests and studies should be performed and clinical findings must be reported in detail. The examination report should reflect consideration of the Veteran's documented medical history, current complaints, and other assertions, etc. Based on a thorough review of the evidence of record and the physical examination findings, the examiner must opine with a detailed and complete rationale whether it is at least as likely as not, i.e., is there a 50/50 chance that the Veteran currently has symptoms consistent with shin splints and/or costochrondritis that are related to his in-service pathology. The examination report must include well-reasoned rationale for all opinions and conclusions reached. 3. The RO must ensure that the medical report requested above complies with this remand and its instructions. If the report is insufficient, or if any requested action is not taken or is deficient, it should be returned for correction. 4. After taking any further development deemed appropriate, readjudicate the issues on appeal. If any benefit sought is not granted, provide a supplemental statement of the case to the Veteran and his representative before the case is returned to the Board. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). _________________________________________________ DEREK R. BROWN Veterans Law Judge, Board of Veterans Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).