Citation Nr: 20007482 Decision Date: 01/29/20 Archive Date: 01/29/20 DOCKET NO. 17-19 205 DATE: January 29, 2020 REMANDED Entitlement to service connection for a right-hand disability, to include as secondary to the residual effects of a right wrist disability, is remanded. Entitlement to service connection for a dental disability is remanded. REASONS FOR REMAND The Veteran served as a member of the United States Air Force with active duty service from January 1974 to January 1980. This appeal comes to the Board of Veterans’ Appeals (Board) from a rating decision, dated November 2015, issued by a Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma (hereinafter Agency of Original Jurisdiction (AOJ)). In its decision, the RO denied service connection for a right hand injury with residuals and a residuals of a dental injury because these conditions neither occurred in nor were caused by service. 1. Entitlement to service connection for a right-hand disability, to include as secondary to the residual effects of a right wrist disability, is remanded. Although the Board regrets the additional delay, the Veteran’s remaining claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran’s claim. The Veteran reported that in while in service, in 1975, at Keesler Air Force Base he tripped and fell on his right hand. See Hearing Transcript dated December 2019. He was sent to the Base Hospital where they took X-rays. The Veteran was informed that he had broken a bone, so he was put in a cast. An orthopedic surgeon at Vernon Childers in Tulsa informed him that arthritis was beginning to form in his hand as well. Following the original injury, he went back to Medical for it to be looked at again about six or seven years ago. He had never had a doctor relate his right-hand injury to his service-connected right wrist. Since his in-service fall, the Veteran’s right hand had been steadily becoming worse. At the time of the hearing, he received treatment for his right hand at Vernon Childers in Tulsa. On a normal day, his pain level was a seven or eight out of ten. He took Advil for pain treatment. He was given an option to remove the bones in his hand and put tendons in, which he declined. The Veteran also contended that his right-hand condition is the residual of his service-connected right wrist disability. A review of the Veteran’s CAPRI records show that the Veteran consistently received treatment for a right-hand disability. However, while the Veteran has submitted extensive medical records regarding treatment for his right-hand disability, the Veteran has not undergone a VA examination specifically addressing his right-hand disability. The Board finds that a remand is required in order to obtain a VA examination which fully addresses the etiology of any current right-hand disability and any relationship between his current right-hand disability and his service-connected right wrist disability. As the Veteran’s claim is being remanded, the Board requests that the AOJ contact the Veteran to ensure all available medical records have been obtained and associated with the claims file. The VA’s duty to assist includes obtaining records of relevant VA medical treatment. 38 U.S.C. § 5103A(c)(2); 38 C.F.R. § 3.159(c)(2), (c)(3). See also Bell v. Derwinski, 2 Vet. App. 611 (1992) (The VA is charged with constructive, if not actual, knowledge of evidence generated by the VA). Therefore, the AOJ should obtain and associate with the claims file any outstanding VA medical records, assuming they are adequately identified by the Veteran after any necessary clarification. 2. Entitlement to service connection for a dental disability is remanded. Although the Board regrets the additional delay, the Veteran’s remaining claim must be remanded before the Board is able to make a determination on the merits. Specifically, the Board finds that additional supporting evidence is required in developing the Veteran’s claim. The Veteran reported that while in service, he hit the side of his face on Keesler Airforce Base. See Hearing Transcript dated December 2019. He was sent to the dentist on base because one of his teeth was knocked out. A review of the Veteran’s CAPRI records show that the Veteran consistently received treatment for a dental disability. However, while the Veteran has submitted extensive medical records regarding treatment for his dental disability, the Veteran has not undergone a VA examination specifically addressing his dental disability. The Board finds that a remand is required in order to obtain a VA examination which fully addresses the etiology of any current dental disability. As the Veteran’s claim is being remanded, the Board requests that the AOJ contact the Veteran to ensure all available medical records have been obtained and associated with the claims file. The VA’s duty to assist includes obtaining records of relevant VA medical treatment. 38 U.S.C. § 5103A(c)(2); 38 C.F.R. § 3.159(c)(2), (c)(3). See also Bell v. Derwinski, 2 Vet. App. 611 (1992) (The VA is charged with constructive, if not actual, knowledge of evidence generated by the VA). Therefore, the AOJ should obtain and associate with the claims file any outstanding VA medical records, assuming they are adequately identified by the Veteran after any necessary clarification. Accordingly, the matters are REMANDED for the following action: 1. The AOJ should contact the Veteran, and, with his assistance, identify any additional outstanding records of pertinent medical treatment for any right-hand disability, to include as secondary to the residual effects of a right wrist disability and any dental disability. In obtaining these records, the AOJ is instructed to follow the procedures for obtaining the records set forth by 38 C.F.R. § 3.159(c). If the AOJ’s attempts to obtain any outstanding records results in a finding that such records are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). 2. After any additional records are associated with the claims file, the AOJ should schedule the Veteran for a VA medical examination with an appropriate qualified physician. All necessary diagnostic testing and evaluation should be performed, and all findings set forth in detail. Based upon a review of the entirety of the claims file, the history presented by the Veteran, and the examination results, the examiner is requested to provide an opinion as to the following questions: (a.) Please identify any right-hand disability that is currently manifested. (b.) For any right-hand disability identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service? (c.) For any right-hand disability, is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was caused or aggravated by the Veteran’s right wrist disability? (d.) Please identify any dental disability that is currently manifested. (e.) For any dental disability identified is it at least as likely as not (i.e. probability of 50 percent or greater) that the disability was incurred during the Veteran’s active military service to include as a residual of inservice dental trauma? Explanations for all opinions must be provided. In providing the requested rationale, the examiner is asked to cite to the pertinent evidence of record, including clinical records and the Veteran’s statements regarding the onset of his symptoms. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Bristor 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.