Citation Nr: 20021706 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 13-14 140 DATE: March 26, 2020 ORDER Entitlement to service connection for left-hand trigger finger is granted. FINDING OF FACT The Veteran’s left-hand trigger finger is related to his service-connected diabetes. CONCLUSION OF LAW The criteria to establish service connection for left-hand trigger finger have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1966 to April 1967. In July 2018, the Board remanded the Veteran’s claim to the AOJ for further action consistent with the Board’s remand directives. The claim is back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a Veteran must show: (1) a present disability; (2) an 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 or aggravated during service, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Veteran was originally diagnosed with trigger finger of the left 4th finger. See July 2011 VA Treatment Record. The Veteran contends his trigger finger is due to his service-connected diabetes. See August 2011 Veteran Statement. The Veteran is already service-connected for diabetes. See May 2019 RD Codesheet. As to nexus, the September 2019 VA clinician rendered various nexus opinions as instructed by the July 2018 Board remand. The VA opinions laid out the evidence of record and detailed articles that noted relationships between trigger finger and diabetes. However, the VA opinions include little analysis. The VA clinician reiterated the procedural and medical history, cited articles that relate diabetes to trigger finger, and concluded “available evidence is insufficient to demonstrate” a nexus as to direct and secondary theories of entitlement. Therefore, the Board affords the VA clinician’s opinions little probative weight. Additionally, the October 2011 VA examiner’s opinion was similarly conclusory with no analysis. See August 2011 Article. As such, the Board affords the October 2011 VA opinion little probative weight. Nevertheless, the various referenced medical journal articles support that the Veteran’s trigger finger is related to his diabetes. The Veteran has been service-connected for diabetes since December 2008. As noted above, less than three years later, the Veteran was diagnosed with his trigger finger in the left hand. Other service-connected conditions, as peripheral neuropathy of the left upper extremity, have been associated with the Veteran’s service-connected diabetes. See May 2019 RD Codesheet. The August 2011 article was specifically noted diabetes increases the risk of trigger finger. The articles referenced in the September 2019 VA opinions noted that trigger finger is a common complication of diabetes and emphasized the importance of trigger finger in diabetic patients. The Board finds that the evidence is at least in equipoise as to whether the Veteran’s left-hand trigger finger is related to his service-connected diabetes. (Continued on the next page)   Resolving reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s left-hand trigger finger is related to his service-connected diabetes and the claim is granted. 38 U.S.C. §§ 5107(b); 38 C.F.R. §§ 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Zheng, 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.