Citation Nr: 18149830 Decision Date: 11/13/18 Archive Date: 11/13/18 DOCKET NO. 16-17 255 DATE: November 13, 2018 REMANDED Entitlement to service connection for residuals of a right hand fracture is remanded. REASONS FOR REMAND The Veteran had active duty from March 1995 to March 1998. 1. Entitlement to service connection for residuals of a right hand fracture is remanded. The Veteran claims entitlement to service connection for residuals of a right hand fracture. The Agency of Original Jurisdiction (AOJ) denied the claim based on a finding that the Veteran has a preexisting right 5th finger condition, and the evidence was insufficient to show that it was aggravated in service. Notably, a February 1995 pre-induction examination indicates the Veteran was assessed for past trauma of the little finger. The medical service provider indicated the Veteran had suffered trauma to the right little finger as a child. The Veteran had full flexion but less than normal extension. He had good grip strength. He could play basketball and football despite his condition. The medical service provider concluded that there was no reason the Veteran would be unable to perform all functions with his finger. In addition, a February 1995 x-ray report showed no fracture or dislocation. A November 1995 service treatment note indicates that the Veteran was treated for a right hand injury. The Veteran report that he hit his hand when a wrench slipped. He showed pain and swelling. X-ray results showed a transverse fracture of the right 5th metacarpal. The Veteran underwent a VA examination in July 2014. The examiner was erroneously asked to issue an opinion regarding whether the Veteran’s right wrist condition was at least as likely as not worsened due to or the result of his right hand fracture. In response, the examiner noted that the Veteran stated that he did not have a previous wrist condition. The examiner indicated that the Veteran did have a flexion deformity of the fifth finger prior to service and that the metacarpal fracture did not affect his preexisting finger condition. The examiner’s opinion did not address whether the Veteran’s current right hand symptoms are directly related to his in-service 5th metacarpal fracture. In addition, he did not provide a reasoning regarding his conclusion that the metacarpal fracture did not affect the Veteran’s preexisting finger condition. Thus, a new examination and medical opinion is needed. The claims file includes VA treatment records from December 2008 to December 2014. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records from prior to December 2008 and from December 2014 to present. 2. After completion of the above development, arrange for the Veteran to undergo a VA examination to determine the current nature and severity of any right hand condition. For each diagnosis, the examiner should issue medical opinions as to the following (a) Whether it is at least as likely as not (50 percent probability or higher) the right hand condition had its onset in service or is related to service to include his metacarpal fracture of the 5th finger. (b) Whether is it clear and unmistakable that the Veteran’s pre-existing right 5th finger disability WAS NOT aggravated by his right 5th metacarpal fracture in service? In other words, please determine whether it is clear and unmistakable that there was no increase in disability during service, or that it is clear and unmistakable that any increase in disability was due to the natural progress of the pre-existing condition. The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached 3. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.A. Williams, Associate Counsel