Citation Nr: 18154086
Decision Date: 11/29/18	Archive Date: 11/28/18

DOCKET NO. 16-46 008
DATE:	November 29, 2018
REMANDED
Service connection for a right wrist disability is remanded.
Service connection for a right hand disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the Army from September 1964 to March 1968.  This matter is on appeal from a May 2015 rating decision.  
On  April 12, 2018, the Veteran elected to participate in VA’s Rapid Appeals Modernization Program (RAMP), selecting the option for “Higher- Level Review.” However, appeals that have been activated by the Board are not eligible for RAMP processing.  This appeal was activated by the Board on December 12, 2017, prior to the receipt of the Veteran’s RAMP opt-in election.
Service connection for a right hand and right wrist disability is remanded.  
The Veteran was afforded a VA examination in June 2016.  The examiner discussed the Veteran’s contention that his current right hand and wrist disabilities are the result of a February 1968 injury, but did not discuss an additional injury to the Veteran’s right arm that was noted in a February 1965 service treatment record.  In addition, the examiner acknowledged the Veteran’s report of intermittent symptoms between the February 1968 injury and his 2004 diagnosis of arthritis but did not discuss that report in finding the current disability unrelated to the February 1968 injury.  The examiner also did not opine as to whether the Veteran’s current right hand and wrist disabilities manifested within one year of his separation from active duty service.  For these reasons, a remand is warranted to obtain an adequate nexus opinion.
The matter is REMANDED for the following action:
1. Arrange for an opinion by an appropriate clinician to determine the etiology of the Veteran’s right hand and wrist disabilities.  The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated.  A new examination is only required if deemed necessary by the examiner.  
The examiner must provide an opinion as to whether it is at least as likely as not (a probability of 50 percent or greater) that any current right hand or wrist disability, including arthritis, began in service, was caused by service, manifested within one year after separation from service, or is otherwise related to the Veteran’s active service.  
Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following:
a.  The February 1965 service treatment record noting the Veteran’s report of multiple falls on his right arm.
b.  The February 1968 service treatment records noting a bone bruise on the fifth metacarpal of the Veteran’s right hand.
c.  The October 2004 VA treatment record diagnosing severe degenerative disease of the radioscaphoid joint.
d.  The Veteran’s report during the June 2016 VA examination of cold weather irritation and intermittent stiffness between his active duty service and the 2004 diagnosis of arthritis.  
The rationale for any opinion expressed should be provided.  If an opinion cannot be made without resort to speculation, the examiner should so state and provide reasoning as to why a conclusion would be so outside the norm that such an opinion is not possible. 
2.  Readjudicate the claims.  If any decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board.
 
D. Martz Ames
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Ryan Frank, Counsel