Citation Nr: 18161306 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 17-02 633 DATE: December 31, 2018 REMANDED The issue of entitlement to service connection for left shoulder disorder is remanded. The issue of entitlement to service connection for left wrist disorder is remanded. The issue of entitlement to service connection for left wrist carpal tunnel is remanded. The issue of entitlement to service connection for right leg varicose veins is remanded. REASONS FOR REMAND The appellant served on active duty for training (ACDUTRA) from January 1975 to June 1975 and on active duty from January 1991 to May 1991; she was a member of the Air Force Reserve from January 1975 to January 2013. The appellant’s service personnel records in the evidence include a list of payments made for each service period for the appellant from 1975 to 2000. However, this is a financial statement and it runs only through 2000. Upon remand, the RO must obtain her service personnel records relevant to determine the nature of the appellant service with the Reserve from 1975 to 2013. 1. The issue of entitlement to service connection for left shoulder disorder is remanded. The appellant asserts that her left shoulder arthritis is caused by various injuries that she incurred while in service, and this condition is separate from her condition from the neck disability. See December 2016 appellant’s statement; May 2018 appellant’s statement. To support her claim, she has submitted medical evidence, including imaging studies, some of which indicates some evidence of cyst from a traumatic old injury. See, e.g., May 2016 X-ray imaging. The Board notes that a November 2013 VA medical opinion concluded that the appellant’s left shoulder condition does not match the mechanism of injury from the 2007 fall in Belize, and thus, her left shoulder arthritis is not related to service. The Board finds that this opinion is insufficient because it only considered one particular accident in 2007 and did not evaluate cumulative impact from other documented injuries in service. Moreover, the May 2016 X-ray imaging was not available at the 2013 VA examination. Therefore, upon remand, a new medical examination must be scheduled to ascertain the nature and etiology of her left shoulder condition. 2. The issue of entitlement to service connection for left wrist disorder is remanded. The appellant submitted additional medical evidence, which includes an August 2015 X-ray imaging of her left wrist. This X-ray found “mild widening of the scapholunate articulation possibly due to ligamentous injury or old fracture.” The evidence documents a 2007 fall in Belize, where the appellant fell on her wrist and shoulder. As for the left shoulder, a November 2013 VA medical opinion concluded that the appellant’s left wrist arthritis is not related to service. But this opinion is insufficient since new medical examination suggests that the appellant’s arthritis in the left wrist might be related to an old injury or fracture. Therefore, upon remand, a new medical examination must be scheduled to ascertain the nature and etiology of her left wrist condition.   3. The issue of entitlement to service connection for left wrist carpal tunnel is remanded. The appellant has a current diagnosis of carpal tunnel syndrome in bilateral wrist. She underwent a VA examination in October 2013 for her carpal tunnel syndrome. However, there is no medical opinion evaluating whether the carpal tunnel condition is related to service. Provided that the appellant was a medical administrator and she states that her work as a reserve officer requires a lot of typing, a medical opinion must be obtained. Upon remand, a new medical examination must be scheduled to ascertain the nature and etiology of her left wrist carpal tunnel, separate from her left wrist osteoarthritis. 4. The issue of entitlement to service connection for right leg varicose veins is remanded. The appellant has a current diagnosis of right leg varicose veins, and the medical evidence indicates that she was diagnosed with it in September 1997. However, etiology of this disease is not clear from the evidence of record. Therefore, upon remand, a new medical examination must be scheduled to ascertain the nature and etiology of her right leg varicose veins. The matters are REMANDED for the following action: 1. Obtain the appellant’s complete service personnel records, to include all documents pertaining to her service in the Air Force Reserve. Verify all active duty for training and inactive duty training dates for alleged service in the Air Force Reserve from 1975 to 2013. If necessary, a request should be made to the Defense Finance and Accounting Service (DFAS). Document all requests for information as well as all responses in the claims file. All Reserve service treatment records should be obtained. 2. After determining characterization of her service, schedule the appellant for examination(s) by an appropriate clinician to determine the nature and etiology of her left shoulder disorder, left wrist disorder, including carpel tunnel, and right left varicose veins. All records obtained should be forwarded to the examiner(s) for review in conjunction with any examination(s). The examiner(s) must opine whether any disorder is found, is at least as likely as not related to an in-service injury, event, or disease, including a 2007 fall in Belize and other falls documented in her STRs. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Y. Taylor, Associate Counsel