Citation Nr: 19128167 Decision Date: 04/12/19 Archive Date: 04/11/19 DOCKET NO. 14-26 326 DATE: April 12, 2019 ORDER The claim of entitlement to service connection for a left knee disorder is dismissed. REMANDED The claim of entitlement to service connection for a left wrist disorder is remanded. The claim of entitlement to service connection for a right wrist disorder is remanded. The claim of entitlement to service connection for a left hand disorder is remanded. The claim of entitlement to service connection for a right hand disorder is remanded. The claim of entitlement to service connection for a right knee disorder is remanded. FINDING OF FACT At the November 2018 Board of Veterans’ Appeals (Board) videoconference hearing, prior to issuance of a decision in the appeal, the Veteran withdrew his claim for entitlement to service connection for a left knee disorder. CONCLUSION OF LAW The criteria for withdrawal of a claim for entitlement to service connection for a left knee disorder have been met. 38 U.S.C. § 7105 (2012); 38 C.F.R. § 20.204 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Navy from September 2007 to September 2012. This case is before the Board on appeal of a January 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office in San Diego, California. In November 2018, a videoconference hearing was held before the undersigned; a transcript of the hearing is included in the claims file. Withdrawn Claim – Service Connection for a Left Knee Disorder An appeal may be withdrawn by an appellant or his or her authorized representative as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204 (2018). At the November 2018 videoconference hearing before the Board, the Veteran withdrew his appeal in connection with claim of entitlement to service connection for a left knee disorder. See Hrg. tr. at pg. 3. Accordingly, the Board does not have jurisdiction to review this appellate claim, and it is dismissed. REASONS FOR REMAND Service Connection for Right and Left Wrist Disorders, Right and Left Hand Disorders, and Right Knee disorder. The Veteran alleges that he has current disorders of the wrists and hands, as well as the right knee, which are of service origin. The service treatment records (STRs) include an undated report that the Veteran suffered trauma (car door slammed on finger) to the 4th digit of the left hand. The contusion was dressed, and he was to return if the condition worsened. The STRs are negative for additional report and/or complaints associated with this injury. The STRs also show that when the Veteran was seen in June 2008 for right knee complaints, it was noted that he had been in a car accident two months prior. He continued to have knee pain, but X-ray showed a normal right knee. In 2011, the right knee resulted in additional medical review. The examiner found that there was right knee patellar femoral syndrome. He noted that the Veteran would benefit from strengthening exercises and education on how to use the right knee correctly. Separation examination report in May 2012 included reports of bilateral wrist and hand pain, as well as right knee pain. A history of Quervain tenosynovitis of the right wrist was noted. The Veteran continued to experience pain as a result. In subsequently dated STRs in July and August 2012, bilateral Quervain’s tenosynovitis was reported. The Veteran filed a claim for service connection benefits prior to service discharge. VA conducted various examinations in October 2012 to address the medical questions at hand. There were complaints associated with the hands/fingers noted, and no diagnosis of right or left hand conditions. As to the wrists, the Veteran’s history of Quervain’s tenosynovitis was noted, but this was reportedly resolved without residuals. As to the right knee, no permanent residual disability was shown to be present as a result of inservice knee problems. Subsequently dated VA records through 2014 reflect that he continues to report wrist, hand, and knee pain. At the 2018 hearing, the Veteran testified that he continued to have bilateral wrist and hand problems. He associated these conditions with inservice activities, to include the constant repetitive motion of tightening chains while on ship and flight deck. He recalled bilateral hand and wrist pain at the time which had continued. He wore a brace at the hearing on both extremities. Medical records show that the Veteran was noted to have bilateral wrist complaints in July and August 2012. At the hearing, the Veteran submitted the report of a private magnetic resonance imaging (MRI) of the right knee that was performed in February 2016. It showed mild to moderate chondromalacia patella and small popliteal cyst. He had on a knee brace for his knee complaints which included continued pain and giving away. Assistance by VA includes providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d) (2012); 38 C.F.R. § 3.159(c)(4) (2018). When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. The matters are REMANDED for the following action: 1. Obtain any missing VA treatment notes and associate them with the claims file. Moreover, invite the Veteran to identify any additional medical providers who treated him for the conditions on appeal. After receiving this information and any necessary releases, contact the named medical providers and obtain copies of the related medical records which are not already in the claims folder. 2. Then provide the Veteran with an appropriate examination to determine the etiology of his claimed bilateral hand, wrist, or finger disorders. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. (a) The examiner is requested to clarify any currently present bilateral hand, wrist, or finger disorders. The examiner’s attention is directed to the Veteran’s reported symptoms of associated pain. (b) The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that a diagnosed hand, wrist, or finger condition had onset in, or is otherwise related to, active military service. (c) The examiner must specifically address the Veteran’s reports of in-service hand and wrist symptoms, and the report of trauma to the left fourth digit of the left hand, as well the diagnosis of Quervain’s tenosynovitis, bilaterally. 3. The Veteran should also be provided an appropriate examination to determine the etiology of a claimed right knee disorder. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. (a) The examiner is requested to clarify any currently present right knee disorders. The examiner’s attention is directed to the Veteran’s reported symptoms of associated pain, giving away, and the February 2016 MRI report which showed mild to moderate chondromalacia patella and a small popliteal cyst. (b) The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that any diagnosed right knee disorder had onset in, or is otherwise related to, active military service. (c) The examiner must specifically address the Veteran’s reports of in-service right knee problems in 2008, 2011, and 2012. BARBARA B. COPELAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Hal Smith