Citation Nr: 18148136 Decision Date: 11/07/18 Archive Date: 11/06/18 DOCKET NO. 16-34 717 DATE: November 7, 2018 REMANDED Entitlement to service connection for residuals of right hand surgery is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for a skin disorder (claimed as cyst) is remanded. REASONS FOR REMAND 1. Entitlement to service connection for residuals of right hand surgery is remanded. 2. Entitlement to service connection for a skin disorder (claimed as cyst) is remanded. 3. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran served on active duty from August 1997 to June 2001. A Department of Veterans Affairs (VA) regional office (RO) denied the Veteran’s service connection claims in an August 2011 rating decision. The RO noted that the Veteran had had hand surgery in service but that there was no residual effect; that the Veteran’s service treatment records (STRs) contained no evidence of a skin or cyst disorder; and that the Veteran did not have a current diagnosis of hearing loss. The Veteran was not afforded a VA examination for any of these claimed disabilities. The Board notes that the Veteran’s claims file appears to be incomplete. The STRs associated with the file contain only the Veteran’s June 2001 separation examination and report of medical history, on which his hand surgery is mentioned, and his subsequent examination for entry into the Naval Reserve. There is no medical record of the hand surgery itself, nor any other medical records to cover the Veteran’s four-year enlistment. The Board notes that the Veteran’s post-service VA medical records contain a notation of a painful right hand, skin problems, and the excision of a cyst. The latest VA medical records date from 2016. In the case of a claim for disability compensation, VA is required to obtain the claimant’s service medical records and other relevant service records, as well as medical records from VA facilities and VA-contracted medical providers. 38 U.S.C. § 5103A(b) (2012); 38 C.F.R. § 3.159(c) (2018). On remand, these records should be obtained and associated with the claims file. The matters are REMANDED for the following action: 1. Undertake appropriate efforts to obtain the Veteran’s complete service treatment records and any relevant outstanding VA or private medical records, and associate them with the claims file. 2. Thereafter, afford the Veteran VA examinations to determine the nature and etiology of any diagnosed right hand or forearm disorder; any diagnosed skin disorder, to include cysts; and an audiological examination to determine the current extent of any hearing loss. The Veteran’s claims file must be provided to each examiner, who must note his or her review of the file. The examiner must obtain a detailed clinical history from the Veteran. All pertinent pathology found on examination must be noted in the report of the evaluation. Any testing deemed necessary must be performed. The examiner(s) must offer comments and a well-reasoned opinion addressing the following: • Whether it is at least as likely as not (i.e., probability of 50 percent or greater) that any diagnosed right hand or forearm disorder began during the Veteran’s service, or is causally or etiologically related to service, to include his in-service right hand surgery. • Whether it is at least as likely as not (i.e., probability of 50 percent or greater) that any diagnosed skin or cyst disorder, to include eczema, began during the Veteran’s service, or is causally or etiologically related to service. • Whether it is at least as likely as not (i.e., probability of 50 percent or greater) that any diagnosed hearing loss began during the Veteran’s service, or is causally or etiologically related to service. The examiner is advised that the Veteran is competent to report history and symptoms and that those reports must be considered in formulating any requested opinion. If the examiner rejects the Veteran’s reports, the examiner must provide a rationale for doing so. A complete rationale must be given for all opinions and conclusions expressed. If it is not possible to provide a requested opinion without resorting to speculation, the examiner should state why speculation would be required (e.g., if the requested determination is beyond the scope of current medical knowledge, actual causation cannot be selected from multiple potential causes, etc.). If there are insufficient facts or data within the claims file, the examiner should identify the relevant testing, specialist’s opinion or other information needed to provide the requested opinion. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD David S. Katz, Associate Counsel