Citation Nr: 20006484 Decision Date: 01/28/20 Archive Date: 01/27/20 DOCKET NO. 16-46 432 DATE: January 28, 2020 ORDER Entitlement to service connection for paresthesia of the left hand injury is granted. REMANDED An initial disability rating in excess of 0 percent for multiple fracture of the left hand with residual deformity of the left fourth finger is remanded. FINDINGS OF FACT Resolving reasonable doubt in the Veteran’s favor, paresthesia of the left hand injury is etiologically related to active service. CONCLUSIONS OF LAW The criteria for entitlement to service connection for paresthesia of the left hand injury has been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from June 2005 to November 2011. In February 2019, the Veteran was notified that a hearing was scheduled for March 2019. The Veteran did not report to his hearing or contact the VA about the scheduled hearing. When an appellant elects not to appear at the prescheduled hearing date, the hearing request is considered withdrawn. 38 C.F.R. § 20.704(d). Therefore, the appeal will be adjudicated without further delay based upon the evidence currently of record. 1. Entitlement to service connection for paresthesia of the left-hand injury is granted. The Veteran seeks entitlement to service connection for paresthesia, as a result of his left-hand injury during active service. Service connection may be granted for a current disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The requirement that a current disability exist is satisfied if the claimant had a disability at the time the claim for VA disability compensation was filed or during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran was afforded an examination in March 2014. The examiner opined that the claimed condition is less likely than not incurred or caused by service. In the rationale, the examiner stated the following: “there is no evidence of radiculopathy, there is no evidence of neuropathy, there is no evidence of active denervation phenomemon based on the needle EMG examination.” However, the examiner failed to address the nature and etiology of his service connection claim for paresthesia. See Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007) (“a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision as to what weight to assign to a doctor's opinion”). Therefore, the March 2014 VA examination is of minimal probative value. In contrast, the Board places probative value on the Veteran’s in-service treatment records, post-service treatment records, as well as the Veteran’s competent and credible lay statements of record. According to the Veteran’s medical records, the Veteran’s suffered an in-service injury in December 2005, which resulted in surgery on his left hand. In the Veteran’s emergency room notes, the treating physician stated that the Veteran suffered from a “decreased sensation ulnar” as a result of the injury. See December 2005 Private Treatment Records. During the Veteran’s March 2014 clinic visit, the treating physician stated that as a result of the Veteran’s laceration of the left hand during active duty, he is not able to flex or extend his fourth finger, left hand fully. The physician also noted that the Veteran has a diagnosis of “paresthesias at the base of 4th finger, palmas aspect.” See March 2014 VA Treatment Record. The Veteran has also consistently complained of chronic pain in his left hand, fourth finger, since service and throughout the appeal period, that has amounted to functional loss with his daily activities. See December 2005 and February 2006 Service Treatment Records; March 2014 VA Examination; September 2016 Form 9. As such, the Veteran is competent to report symptoms of pain as they are subject to his observation. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). In conjunction with the Veteran’s medical records and lay statements, the Board finds that the evidence of record is sufficient to establish a nexus between his in-service left-hand injury and his paresthesia disability. The issue of whether the Veteran’s newly service-connected disability is compensable or not is not currently before the Board and should be determined by the AOJ. Therefore, service connection for paresthesia of the left-hand injury is granted. REASONS FOR REMAND 1. An initial disability rating in excess of 0 percent for multiple fracture of the left hand with residual deformity of the left fourth finger is remanded. The Board finds that since this issue is intrinsically intertwined with the above-noted issue, the Veteran should be afforded a new VA examination to determine the current severity of his service-connected disability. Additionally, the Veteran’s claims file only includes post-service VA treatment records from March 2014. To ensure there are not any outstanding VA treatment records, the RO must obtain such records and associate them with the electronic claims record, should they be made available. The matters are REMANDED for the following action: 1. Obtain all available private and VA treatment records and associate them with the claims file. This should include VA treatment records prior to and after March 2014. 2. Thereafter, schedule the Veteran for a VA finger and hand examination to determine the current severity of his multiple fracture of the left hand with residual deformity of the left fourth finger. The examiner must review the claims file and should note that review in the report. A complete history of symptoms should be elicited from the Veteran. Any tests and studies deemed necessary, including x-rays, should be conducted and all findings should be reported in detail. The examination should include range of motion testing for the left hand and fingers, including in active motion, passive motion, weight-bearing, and non weight-bearing. The examiner should include a statement as to the impact of the Veteran's disability on occupational functioning and daily activities. A rationale for any opinion expressed should be provided. 3. Thereafter, readjudicate the claim. If any benefit sought on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and allow an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Adeleke, 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.