Citation Nr: 19167347 Decision Date: 08/29/19 Archive Date: 08/29/19 DOCKET NO. 14-31 647 DATE: August 29, 2019 REMANDED Entitlement to service connection for a right hand disability is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1965 to January 1969, followed by service in the Army National Guard. This matter comes to the Board of Veterans’ Appeals (Board) from a November 2011 rating decision which, in pertinent part, denied entitlement to service connection for a right hand disability due to shrapnel. In September 2018, the Board remanded the claim for additional development, including obtaining a VA examination and medical opinion. Entitlement to service connection for a right hand disability is remanded. The Board cannot make a fully-informed decision on the issue of service connection for a right hand disability. In September 2018, the Board found that Veteran’s allegations that he suffered an in-service shrapnel wound to his hand as not credible. However, the Board noted that a December 1968 service treatment record showed that the Veteran received treatment for a laceration of his right thumb and that a November 2010 imaging study revealed osteoarthritis of the right hand with a small metallic foreign object in the soft tissues anterior to the index finger metacarpal head. As no VA examiner had opined as to the nature and etiology of the Veteran’s claimed right hand disability, the Board remanded the claim for a VA examination and medical opinion. The Veteran was afforded a VA examinations in June 2019. While the examiner opined that the Veteran’s right hand disability was less likely than not incurred in or caused by service, it appears that the examiner’s opinion was based solely on the absence of evidence of an in-service blast or shrapnel injury. As the June 2019 VA examiner did not provide an opinion that was responsive to the Board’s September 2018 remand directives, to include whether the Veteran’s right hand disability was incurred in or related to service, to include the December 1968 laceration, the Board finds that a remand is warranted for a new VA examination and medical opinion as to the nature and etiology of the Veteran’s claimed right hand disability. The matter is REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from June 2019 to present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any right hand disability, to include osteoarthritis, scarring, or presence of metal fragments. The examiner must opine whether any current right hand disability, to include osteoarthritis, scarring, or presence of metal fragments, at least as likely as not (1) began during active duty or a period of ACDUTRA/INACDUTRA, to include related to an in-service injury, event, or disease, including a December 1968 laceration to the right thumb and hand, the Veteran’s reports of swelling in his hands on an April 1999 Army National Guard periodic examination, or a September 2009 screening note in which the Veteran complained of numbness in his right ring finger, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. 3. After completing the above, and any other development as may be indicated, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the claim remains denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Owen, Associate Counsel 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.