Citation Nr: 19164751 Decision Date: 08/21/19 Archive Date: 08/20/19 DOCKET NO. 16-61 951 DATE: August 21, 2019 REMANDED Entitlement to service connection for a right wrist injury, to include arthritis is remanded. Entitlement to service connection for nerve damage as secondary to a right wrist injury is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 1970 to May 1974. This matter is before the Board of Veterans’ Appeal on appeal from a June 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Providence, Rhode Island. The rating decision, inter alia, denied service connection for right wrist injury, arthritis, and nerve damage. The Veteran timely appealed. The Statement of the Case was issued in October 2016. The Veteran originally filed three separate claims with respect his right wrist. These claims have been re-characterized into two claims, one for service connection for right wrist injury, to include arthritis and the other for service connection for nerve damage as secondary to the claimed right wrist injury. The claim for service connection for a wrist injury is broadly construed to include any disability that may reasonably be encompassed by the description of the claim, reported symptoms, and other information of record. Clemons v. Shinseki, 23 Vet. App. 1 (2009). A grant of service connection for right wrist injury to include arthritis incorporates all such symptomatology reported by the Veteran. See Clemons, supra; Mittleider v. West, 11 Vet. App. 181, 182 (1998). 1. Entitlement to service connection for a right wrist injury, to include arthritis. The Veteran seeks a service connection for a right wrist disability and requests a new VA examination, to include the issue of whether his post-service right wrist fracture is an aggravation of his in-service soft tissue right wrist injury. The Veteran’s service treatment records (STRs) reveal that he complained of right wrist pain for approximately nine months in service in 1973. In December 1973 he was diagnosed with right wrist subluxation, recurrent, extensor capri ulnaris. It was noted that he had a history of pain and snapping sensation at his right wrist for nine months. The onset occurred while the Veteran was bowling but did not involve unusual stress on the wrist. The X-rays were noted to be normal. The Veteran’s private treatment records dated August 2014 indicate that the Veteran reported fracturing his wrist “later in life.” The same treatment note indicated that the Veteran had to have a procedure to break the adhesions in the forearm and wrist following that fracture. The records do not indicate how or when the Veteran fractured his wrist. The Veteran submitted a private Disability Benefits Questionnaire (DBQ) for his right wrist dated March 2015, along with an October 2015 addendum. Neither record mentions a post-service right wrist fracture. They do mention a post-service procedure in the 1980’s (distal ulna resection arthroplasty by Dr. B in Vermont) and private treatment records for the Veteran’s wrist, but no such records were obtained and associated with the file. In June 2015, the Veteran underwent a VA examination for his right wrist. He was diagnosed with residuals of a post-service fracture of the right wrist which has eclipsed the in-service right wrist soft tissue injury, status post scheker radial-ulnar joint prosthesis, and carpal tunnel syndrome. The VA examiner was not able to discern how or when the Veteran fractured his wrist after service. The VA examiner concluded that there is no nexus between the Veteran’s in-service right wrist injury and his current condition. The VA examiner noted that the conclusion is based on the available documentation, which is limited. In his July 2019 Appellate Brief, the Veteran’s representative asserts that the Veteran injured his wrist twice in-service, in 1971 and 1973. He also asserts that the Veteran is entitled to a new VA examination to address, among other things, the current severity of his right wrist injury, explanation as to why his current right wrist disability is not related to his in-service soft tissue injury, and whether his in-service right wrist injury was aggravated by his post-service right wrist fracture. However, he likewise did not provide any information regarding the timing or nature of his post-service right wrist fracture. The Board notes that with respect to aggravation, the proper inquiry in this matter would be whether the Veteran’s in-service soft tissue injury caused or aggravated his post-service fracture. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). As the claim of service connection for residuals of the in-service soft tissue injury is being remanded, there is no basis for a claim of aggravation of a nonservice-connected disability by a service-connected disability at this time. Nevertheless, the question remains as to whether the post-service injury would have occurred if the in-service injury had not occurred. In other words, did the in-service injury weaken the wrist making it more likely that the post-service injury is related to the in-service injury? The Board finds that the record in this matter is incomplete and does not allow for a proper adjudication of the claim. When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213, 216 (1992). The matter is remanded to obtain the Veteran’s post-discharge records, to include his wrist fracture, as well as a new VA examination based on those records. 2. Entitlement to service connection for nerve damage as secondary to right wrist injury. The Veteran contends that he suffered nerve damage as a result of his right wrist disability. The issue of service connection for right wrist disability is being remanded, and these claims are inextricably intertwined. Accordingly, adjudication of that matter will be deferred until further development of the inextricably intertwined issue is completed. Gurley v. Peake, 528 F.3d 1322 (Fed. Cir. 2008) (noting that remand of inextricably intertwined claims was warranted for reasons of judicial economy even in absence of administrative error); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (providing that two or more issues are inextricably intertwined if one claim could have significant impact on the other). The matters are REMANDED for the following action: 1. The RO should request that the Veteran provide the names and addresses of all health care providers who have treated the Veteran’s right wrist. These records should include, but not be limited to private treatment records from Dr. Jeffrey Haasbeck, private treatment records regarding the Veteran’s post-discharge right wrist fracture, and all records associated with any right wrist procedures. After acquiring this information and obtaining any necessary authorization, the RO should obtain and associate these records with the claims file. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of his right wrist disability. The VA examiner is requested to obtain the nature and etiology of the Veteran’s post-discharge right wrist fracture and any related procedures. The examiner is requested to determine whether it is at least as likely as not that the Veteran’s right wrist disability had its onset during service, within one year of service, or is otherwise causally related to service. Additionally, the VA examiner is requested to determine whether the Veteran’s soft-tissue right wrist in-service injury caused, or is otherwise related to the post-service right wrist fracture. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.