Citation Nr: 18141664 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 16-29 457 DATE: October 11, 2018 ORDER service connection for the residuals of a nondisplaced fracture of the left second metacarpal is granted. FINDING OF FACT The Veteran experiences painful limitation of motion of the left hand as a result of an in-service nondisplaced fracture of the left second metacarpal. CONCLUSION OF LAW The criteria for establishing service connection for the residuals of a nondisplaced fracture of the left second metacarpal are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1989 to April 1992. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. Initially, although the Veteran initiated appeals on other issues, his substantive appeal (VA Form 9) dated June 2016 was expressly limited to service connection for the residuals of a nondisplaced fracture of the left second metacarpal. Accordingly, the claims for service connection for tinnitus and an increased rating for post-traumatic stress syndrome are not in appellate status. 38 U.S.C. § 7105. The Veteran’s Contentions The Veteran seeks service connection for the residuals of a nondisplaced fracture of the left second metacarpal, contending that “arthritis has definitely set in” and that he has continued pain and discomfort in his left hand and usage issues due to the fracture. Service Connection for residuals of a nondisplaced fracture second metacarpal left hand Generally, to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). The service treatment records reflect that the Veteran sustained a nondisplaced fracture at the base of the second metacarpal on his left hand in August 1990. A VA examination was conducted in March 2013. The Veteran complained of occasional numbness and tingling starting at the hand and going to the elbow. The examiner found no limitation of motion or evidence of painful motion, no functional loss, no pain on palpation and full grip strength. The x-ray conducted in connection with the VA examination found minimal osteoarthritic change at the first metacarpophalangeal and incidental bone islands at the second middle phalanx and head of the second metacarpal. The VA examiner concluded that the incidental bone islands were less likely than not caused by the nondisplaced fracture because a bone island is a benign tumor of cartilage, the formation of which is not associated with trauma. The examiner also concluded that the minimal degenerative arthritis of the first metacarpal was due to aging and not related to the fracture. VA treatment records reflect that the Veteran sought treatment for his complaints of hand pain in May 2014 and June 2015. The Board finds that the first element for service connection, a current disability, is met, as the Veteran’s reports of pain are sufficient to establish the existence of a current disability. See Saunders v. Wilkie 866 F.3d 1356, 1368 (Fed. Cir. 2018). The Veteran’s hand pain and numbness are observable symptoms indicative of a disability and the Veteran is competent to report them. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The second element for service connection is also met, as the STRs clearly document an in-service injury to his left hand. Although the VA examination concludes that there is no nexus between the in-service fracture and the bone islands in the second metacarpal, the Board finds the opinion inadequate and entitled to little probative weight because the examiner did not address the Veteran’s competent and credible complaints of pain, numbness and usage issues that have persisted since the in-service injury. The Board credits the Veteran’s report of his symptoms and, according the Veteran the benefit of the doubt, determines that service connection for residuals of a nondisplaced fracture of the second metacarpal left hand is warranted. S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Snyder, Associate Counsel