Citation Nr: 18153648 Decision Date: 11/28/18 Archive Date: 11/28/18 DOCKET NO. 18-03 105 DATE: November 28, 2018 REMANDED Entitlement to service connection for right elbow disability, to include as secondary to service-connected disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1990 to June 1991, and had Reserve service inactive duty training from April 7, 2001 to April 8, 2001 and from January 5, 2002 to January 6, 2002. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a March 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston Salem, North Carolina. The Veteran seeks service connection for a right elbow disability, which she asserts is related to her service. The medical evidence of record shows that the Veteran currently has right elbow lateral and medial epicondylitis and olecranon bursitis, that is considered disabling for VA purposes, and therefore a current disability has been shown. The Veteran’s Representative contends that the Veteran’s right elbow disability began during active duty, to include a period of inactive duty training (INACDUTRA). In aVA Form 9, Appeal to Board of Veterans Appeals, received in January 2018, the Veteran additionally asserted that her right elbow disability is secondary to her service-connected right shoulder disability. Additionally, the Veteran stated in an October 2015 VA examination, for her left elbow, that she had flare-ups of the right elbow, described as “stiffness pain,” and that they are “generally from the stroke that happened three days before my last deployment.” There are no records of a stroke associated with the record. VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with service, and the record does not contain sufficient information to make a decision on the claims. 38 U.S.C. 5103A (d) (2012); McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The requirement that the evidence "indicates" that the Veteran's disability "may" be associated with his service is a low threshold. Id. Thus, considering the Veteran's contentions and the record on appeal, a VA examination should be obtained to determine the probable etiology of the Veteran's right elbow disability, to include whether the Veteran's right elbow disability is related to service. (d); 38 C.F.R. 3.159 (c)(4)(i). The Board cannot make a fully-informed decision on the issue of entitlement to service connection for right elbow disability because no VA examiner has opined whether the Veteran’s right elbow disorder is due to her service, or proximately due to, or aggravated by, her service-connected right shoulder disability. The matter is REMANDED for the following action: (Please note, this appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). Expedited handling is requested.) 1. Contact the Veteran and request that she either provide the treatment records, including dates of treatment, for a stroke that she referenced at an October 2015 VA examination as having occurred three days before her last deployment and as having been the cause of right elbow “stiffness pain,” or identify the treatment provider and provide authorization for release of such records to VA. All attempts to obtain such records should be documented of record. Notice of any inability to obtain such records should be provided to the Veteran. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of each right elbow disability. The examiner must review the claims file in conjunction with the examination. Any and all studies, tests and evaluation deemed necessary by the examiner should be performed. The examiner must address the following: • Is it at least as likely as not (50 percent probability or more) that the Veteran has right elbow disability that is related to active service, and if not; • Whether it is at least as likely as not that the Veteran has right elbow disability that is proximately due to, or chronically aggravated beyond its natural progression by, her service-connected right shoulder disability. Rationale must be provided for the opinion(s) proffered. 4. After the above requested development, and any other development deemed necessary, has been completed, readjudicate the issue on appeal. If the benefit sought   remains denied, furnish the Veteran and her representative with a supplemental statement of the case and afford an appropriate amount of time for response. U. R. POWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S.E. Leary, Associate Counsel