Citation Nr: 20008165 Decision Date: 01/30/20 Archive Date: 01/30/20 DOCKET NO. 14-24 395 DATE: January 30, 2020 ORDER Service connection for a right wrist disorder is denied. Service connection for a right hand disorder is denied. FINDINGS OF FACT 1. The Veteran had active service from June 2002 to June 2006. 2. A right wrist disorder was not shown in service; a current right wrist disorder, diagnosed as a ganglion cyst and a right wrist sprain, is not causally or etiologically related to service. 3. A right hand disorder, claimed as a broken thumb, has not been shown. CONCLUSIONS OF LAW 1. A right wrist disorder was not incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303. (2019). 2. A right hand disorder was not incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303. (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Right Wrist Disorder As to a current disorder, the Veteran was diagnosed with a ganglion cyst on the right wrist in 2008. At the time he sought emergency room treatment for a knot on the right wrist, he indicated to the clinician that it had been present for two months. He related that he had stopped working out and stopped doing push-ups because of pain. In a June 2014 substantive appeal, the Veteran challenged the report that the cyst had been present for only two months and asserted that the finding had been fabricated; however, a clear reading of the clinical record is that the cyst had been present for two months, not years. At that time of the emergency room visit, he was diagnosed with a ganglion cyst and told that it would resolve. He was also diagnosed with a right wrist sprain in January 2019. Therefore, the first element of service connection – a current disorder – is met. As to an in-service incurrence, accepting the Veteran’s assertions that the ganglion cyst had been present since 2006 after injuring the right wrist when he hit the right hand on a medal pole, the service treatment records (STRs) are absent of any complaints, diagnoses, or treatment related to the right wrist or any other right wrist disorder. In addition, the Veteran did not report a cyst or any problems with his wrist at a February 2006 post-deployment health assessment or in the April 2006 Report of Medical History (although he did report back pain, ankle problems, and cellulitis). Therefore, the second element of service connection – an in-service incurrence – is not shown in the treatment records. To the extent that the Veteran asserts a nexus between the right wrist sprain and/or right wrist cyst, the evidence does not support the claim. Specifically, in a January 2019 VA examination, he complained of swollen wrists. The examiner reviewed the clinical records, including the STRs and the Veteran’s challenge to the 2008 finding that the cyst had been present for only 2 months rather than 2 years. Upon examination, the examiner found that a right wrist was less likely than not incurred in service reasoning that there was no treatment for a ganglion cyst on the right wrist or any other right wrist disorder in service. This evidence weighs against the claim and there is no contradictory medical opinion. Therefore, the medical evidence does not support the claim for service connection. Right Hand Disorder As to a current disorder, in an October 2011 primary care initial evaluation, the Veteran reported running and hitting his hand against an unknown object in service, resulting in a fractured right thumb. The clinical assessment was stable fracture of the thumb; however, it does not appear that X-rays were taken at that time. Rather, the clinical finding was based on the Veteran’s reported history. Significantly, the STRs do not reflect complaints of, treatment for, or a diagnosis of a fractured right thumb. Although the Veteran had X-rays of the ankles and a facial CT scan related to facial trauma, the evidence does not show a fractured right thumb. Specifically, he did not report any broken bones at the February 2006 post-deployment physical or at the April 2006 separation examination. Also significant, January 2019 X-rays do not show the residuals of a fractured thumb. Specifically, the examiner noted that there was “no definite radiographic evidence of a prior thumb fracture.” Moreover, the examiner found that there was no treatment for a broken right thumb or any other right hand disorder in service. There is no contradictory medical opinion. Therefore, the medical evidence does not support the claim for service connection as no current disorder is shown. The Board has considered the Veteran’s lay statements that a right wrist disorder and right hand disorder began in service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorders due to the medical complexity of the matters involved. Such competent evidence has been provided by the various reports and memorandum regarding radiation dose estimates, the medical evidence, and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above discussion, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Ragofsky, Attorney Advisor 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.