Citation Nr: 18147915 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 17-62 345 DATE: November 6, 2018 REMANDED Entitlement to service connection for chronic left wrist sprain is remanded. REASONS FOR REMAND The Veteran served active duty in the U.S. Army from August 1974 to September 1980. This case comes before the Board on appeal from an October 2016 rating decision. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). Entitlement to service connection for chronic left wrist sprain is remanded. The Veteran contends that his left wrist disability was the result of an in-service injury. Based on the evidence of record, a remand is necessary to obtain an addendum opinion. Here, the Veteran was diagnosed with a chronic left wrist sprain. See May 2017 VA Examination. Likewise, the Veteran’s service treatment records (STRs) show that he suffered a left wrist sprain during a parachute jump exercise in June 1978. He was admitted to the emergency room at Fort Bragg medical clinic, with a complaint of a tender left wrist. X-rays were taken to rule out a navicular fracture. A week later, the Veteran was assessed with a status post left wrist sprain. See June 1978 STR entries. In the May 2017 VA examination, the Veteran was diagnosed with a chronic left wrist sprain. The Veteran reported that his disability began in June 1978 during a practice combat parachute jump on Ft. Bragg drop zone that resulted in a bad left wrist sprain. The VA physician indicated that the Veteran may have had a hairline fracture. The Veteran reported he was treated with a brace, but did not see an orthopedist. The Veteran explained that rainy weather caused his wrist to flare-up with pain and discomfort. After conducting the examination, the VA physician opined that the Veteran’s chronic left wrist sprain was less likely than not caused by the claimed in-service injury. The physician reasoned that medical records showed the Veteran was evaluated/treated for his condition while in service and there were no subsequent medical records showing continuity of care for the Veteran’s condition since 1978. The physician concluded that he would have to resort to speculation to elucidate a correlation. The Board finds the VA physician’s opinion to be inadequate for rating purposes. Specifically, the physician’s opinion rested on the rationale that the Veteran did not seek medical treatment for his left wrist following service. The Board notes that continuity of symptoms, not treatment, is important. See Dalton v. Nicholson, 21 Vet. App. 23 (2007); Savage v. Gober, 10 Vet. App. 488 (1997). Moreover, during the VA examination, the Veteran discussed the onset of his left wrist disability and the continuing pain and discomfort he suffers. In rendering his opinion, the physician failed to adequately consider the Veteran’s lay statements. Furthermore, the Veteran submitted lay statements describing his left wrist symptomatology since onset in service. See September 2017 Correspondence. Therefore, on remand, an addendum medical opinion should be obtained to assess the etiology of the Veteran’s chronic left wrist sprain. The matter is REMANDED for the following action: 1. Obtain all relevant outstanding VA treatment records, and any private treatment records identified by the Veteran. All records and/or responses received should be associated with the claims file. 2. Obtain a VA addendum medical opinion to determine the nature and etiology of the Veteran’s chronic left wrist sprain. If an opinion cannot be obtained without an examination, then the Veteran should be afforded a VA examination. The record, including a copy of this remand, must be made available to and reviewed by the examiner. The VA examiner should address the following: (a) Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s chronic left wrist sprain was caused by the in-service injury or is otherwise causally related to any event or circumstance of the Veteran’s service. The examiner should cite to the pertinent medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resort to speculation, it should be so stated and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resort to speculation. 3. After undertaking any additional development deemed necessary, the AOJ must readjudicate the claim on appeal. If the claim remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and afforded the requisite opportunity to respond before the case is returned to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD I. Umo, Associate Counsel