Citation Nr: 20020892 Decision Date: 03/23/20 Archive Date: 03/23/20 DOCKET NO. 17-18 284 DATE: March 23, 2020 REMANDED Entitlement to service connection for a left wrist disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1963 to December 1967. This appeal comes before the Board of Veterans’ Appeals (Board) from a September 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A hearing transcript is associated with the record. The Veteran’s authorized representative did not present for the hearing. Instead, he was represented in the proceedings by Michael Hoffman. During the prehearing conference, Michael Hoffman, affiliated with the Veteran’s representative, Adam G. Werner, was requested to submit written consent, signed by the Veteran, to reflect the Veteran’s willingness to allow his representation in lieu of Mr. Werner at the Board hearing. He refused to provide written authorization. The Veteran, however, provided verbal consent during the Board hearing, which is reflected in the hearing transcript. See Hearing Transcript at 2 (February 2020). It is noted that an appellant may choose to be represented by an attorney affiliated with a law firm; he or she, however, cannot validly execute a power of attorney (VA Form 21-22a) appointing an entire law firm, or more than one attorney, as his or her representative. 38 C.F.R. § 14.631(e)(1). Moreover, a representative must be accredited for practice before VA and a VA Form 21-22a in favor of a non-accredited individual has no effect. 38 C.F.R. § 14.631(a). Additionally, 38 C.F.R. § 20.701 provides that only the appellant and his authorized representative may appear and present argument in support of an appeal. Moreover, 38 C.F.R. § 14.629(c) provides that, if a claimant consents in writing, an attorney associated with the claimant’s attorney of record may assist in the representation of the claimant. In this case, the Veteran appeared willing to provide written consent but through the actions of the attorney associated with the claimant’s attorney of record was precluded from doing so. 38 C.F.R. § 14.629(c). In this case, the Board is satisfied that the Veteran, in fact, desired to be represented in the hearing by Mr. Hoffman who is an attorney associated with the claimant’s attorney of record as evidenced by his verbal consent at the Board hearing. Entitlement to service connection for a left wrist disability is remanded. The Veteran contends that his current left wrist disability is related to an in-service injury he sustained while in Florida. See Hearing Transcript at 6 (February 2020); see also NOD (October 2013). The Veteran’s representative, on the other hand, argues that the Veteran is entitled to service connection because of the “combat presumption.” See Hearing Transcript at 3, 5 (February 2020). For reasons explained below, the Board finds that remand is necessary. The record reflects that the Veteran has a current left wrist disability. See VA Examination (September 2012). Next, there is competent and credible evidence that the Veteran sustained a left wrist injury while in service. In this regard, VA examination report, dated in September 2012, reflects that the Veteran reported experiencing left wrist pain when he wringed out a dish cloth, in a Mess Hall kitchen, while stationed in Florida. He additionally stated that he was seen by medical personnel and was diagnosed with a left wrist strain. This statement is consistent with other lay statements of record, and is also corroborated by other circumstantial evidence. See Military Personnel Record (May 1967) (reflecting that the Veteran was a Messman while he was stationed in Florida). The record, however, does not reveal a medical opinion opining on whether the Veteran’s current left wrist disability is related to his in-service injury, described as a left wrist sprain. Therefore, given the above, there is sufficient competent and credible evidence to warrant remand for a VA medical opinion. See Colvin v. Derwinski, 1 Vet. App. 171 (1991). VA has not yet obtained a medical opinion in this matter. McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006). Lastly, at the hearing, the representative argued for service connection based on the “combat presumption.” The combat provisions of 38 U.S.C. § 1154(b) provide that satisfactory lay or other evidence will be accepted as sufficient proof that an injury or disease was incurred or aggravated in combat if consistent with the circumstances, conditions, or hardships of such service, even if there is no official record of such incurrence or aggravation. In other words, the provisions lighten the evidentiary burden on a combat veteran with respect to showing an in-service injury. Collette v. Brown, 82 F.3d 389, 392–93 (Fed. Cir. 1996). Here, the Veteran himself has not asserted that his disability stems from combat, as discussed above. Rather, the Veteran’s statements are incongruous with the legal argument advanced by the representative present at his hearing. Further, while the combat provisions lighten the evidentiary burden with respect to showing an in-service injury sustained during combat, service connection, still, requires evidence of a nexus between the claimed in-service injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 U.S.C. §§ 1110, 1131, 1154; 38 C.F.R. § 3.303(a), (d). The matter is REMANDED for the following actions: 1. Ask the appellant to complete a VA Form 21-4142 for all non-VA medical providers seen for symptoms of his left wrist disability, to include Floyd Medical Center. Make two requests for the authorized records from all identified sources, unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran’s VA treatment records for the period from January 2019 to the Present. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any left wrist disability. The report of examination should, among other things, include a discussion of the Veteran’s documented history and assertions. The examiner must opine on: (a) Whether any left wrist disability is at least as likely as not related to an in-service injury, event, or disease, to include the in-service left wrist sprain. (b) To the extent that there is arthritis of the left wrist, whether it at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. 4. Ensure that the VA medical opinions obtained include a complete rationale for the conclusions reached. The medical opinions must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffey, 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.