Citation Nr: 20004013 Decision Date: 01/16/20 Archive Date: 01/16/20 DOCKET NO. 17-49 049 DATE: January 16, 2020 REMANDED Entitlement to service connection for bilateral carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran served in the Air Force from December 1978 to September 1984 and was a Member of the Army National Guard from July 1998 to April 2000. Entitlement to service connection for bilateral carpal tunnel syndrome is remanded. The Veteran seeks entitlement to service connection for bilateral carpal tunnel syndrome. She contends that her bilateral carpal tunnel was caused by her active military service. The Veteran’s service treatment records reveal a complaint of pain in the left ulnar styloid into the forearm and elbow during active service in October 1982 as well as a complaint of carpal tunnel symptoms and testing in November 1999 while in the Army National Guard. The results of said testing are not clear in the Veteran’s service treatment records. The Veteran’s post-service medical records indicate that she has been diagnosed and treated by a private provider for bilateral carpal tunnel syndrome and recurrent trigger thumb beginning in 1999. She underwent a bilateral carpal tunnel release procedure in March 2003. The records concerning all these treatments are not on file, and could be probative as to the onset of the pathology. To date, the Veteran has not been afforded a VA examination to determine if her bilateral carpal tunnel syndrome is related to service. Given the low threshold for obtaining a VA examination, the Board finds that this evidence is sufficient to warrant a VA examination to ascertain the nature and etiology of the Veteran's bilateral carpal tunnel syndrome. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). Upon remand, an appropriate VA examination must be scheduled. This matter is REMANDED for the following action: 1. With the Veteran’s assistance as needed, attempt to obtain all records of private treatment for carpal tunnel, including those that would note the onset as well as any surgery or other records that could be obtained. Appropriate release forms should be requested as needed. 2. Thereafter, but whether or not records are obtained, schedule the Veteran for a VA examination with an examiner of appropriate expertise in order to determine the nature and etiology of the Veteran's claimed bilateral carpal tunnel syndrome. The examiner is to be provided access to the Veteran's electronic claims file. He/she is requested to review all pertinent records associated with the claims file, the Veteran's service treatment records, post-service medical records, and the Veteran's own assertions. Any indicated diagnostic tests and studies should also be accomplished. It should be noted that the Veteran is competent to attest to factual matters of which she had first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The VA examiner must opine whether it is at least as likely as not (50 percent or higher degree of probability) that any bilateral carpal tunnel syndrome, if found, manifested in service or is otherwise causally or etiologically related to his military service. All examination findings/testing results, along with complete, clearly-stated rationale for the conclusions reached, must be provided. All prior reports should be addressed and/or reconciled, as necessary. If an opinion cannot be provided without resort to speculation, the specialist should explain why it is not possible to provide an opinion. 3. After the development requested has been completed, the Agency of Original Jurisdiction (AOJ) should review any report to ensure that it is in complete compliance with the directives of this remand. If the report is deficient in any manner, the AOJ must implement corrective procedures at once. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Sneeringer, 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.