Citation Nr: 20022892 Decision Date: 04/02/20 Archive Date: 04/02/20 DOCKET NO. 17-08 139 DATE: April 2, 2020 REMANDED Entitlement to service connection for carpal tunnel syndrome, left wrist, is remanded. Entitlement to service connection for peripheral neuropathy, left arm, diagnosed as cubital tunnel syndrome, is remanded. Entitlement to service connection for peripheral neuropathy, right arm, diagnosed as cubital tunnel syndrome, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1989 to August 2009. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. In November 2019, the Veteran testified at a video-conference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing has been associated with the claims file. The Veteran asserts that his carpal tunnel syndrome of the left wrist and bilateral cubital tunnel syndrome are related to his active duty service. Specifically, he has stated that the physical demands of his military occupational specialty (MOS) of ground radar system craftsman caused him to develop issues with his left wrist and both arms, which persisted throughout his service and have continued to the present. See August 2015 Statement in Support of Claim; February 2017 Correspondence; November 2019 Hearing Transcript. In support of his claim, the Veteran’s doctor submitted a statement reflecting that, according to his EMG findings, his bilateral cubital compression is chronic and has been going on for several years before his initial diagnosis in October 2014. See December 2019 VA Medical Statement. The Board notes that the Veteran is competent to report experiencing an in-service injury and resultant symptomatology. See Washington v. Nicholson, 19 Vet. App. 362 (2005) (holding that a Veteran is competent to report what occurred during service because he is competent to testify as to factual matters of which he has first-hand knowledge); Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007) (holding that lay testimony is competent to establish the presence of observable symptomatology); see also Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A February 2016 VA examination report opined that the Veteran’s ulnar neuropathies of the left arm and right arm were less likely than not related to his active duty service. The examination report also reflected that the Veteran did not have a current diagnosis of left carpal tunnel syndrome. See February 2016 Peripheral Nerves Disability Benefits Questionnaire (DBQ). The Board finds the February 2016 opinion inadequate, as it did not address the Veteran’s assertion that his conditions were related to the physical demands of his MOS. See Barr, 21 Vet. App. at 312; Dalton v. Nicholson, 21 Vet. App. 23 (2007) (an examination was inadequate where the examiner relied on the absence of evidence in the Veteran’s service medical records to provide a negative opinion). Moreover, the examiner did not address the December 2014 EMG studies which showed mild carpal tunnel syndrome of the left wrist. See December 2014 Neurology Consult; see also McClain v. Nicholson, 21 Vet. App. 319 (2007). Given the above, the Board finds that an additional VA examination and opinion is required, as described below. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). Finally, as this matter is being remanded the Veteran’s updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Make arrangements to obtain the Veteran’s VA treatment records, dated from December 2016, forward. 2. Thereafter, schedule the Veteran for an appropriate VA examination to ascertain the etiology of his left wrist carpal tunnel syndrome and bilateral cubital tunnel syndrome. Any necessary tests or studies must be conducted, and all clinical findings should be reported in detail and correlated to a specific diagnosis. The entire claims file, to include a copy of this REMAND, must be reviewed by the examiner in conjunction with the examination. The examiner should confirm in the examination report that he or she has reviewed the folder in conjunction with the examination. The Veteran has been diagnosed as having carpal tunnel syndrome of the left wrist and bilateral cubital tunnel syndrome. See EMG, dated December 2, 2014, showing severe demyelinating left ulnar neuropathy around the elbow with conduction block and moderate demyelinating right ulnar neuropathy at the elbow (diagnosed as bilateral cubital tunnel syndrome); and mild demyelinating left median neuropathy at the wrist (carpal tunnel syndrome). The examiner is asked to address the following: (a) Is it at least as likely as not that the Veteran’s carpal tunnel syndrome of the left wrist and/or bilateral cubital tunnel syndrome had its onset during service or is related to any incident of service, to include his duties as a ground radar system craftsman which required carrying and lifting heavy equipment, as well as building equipment and working with his arms and hands. In providing this opinion, the examiner should consider and address the following: • the service treatment records showing that the Veteran complained of left elbow pain on July 8, 1996 and of right elbow pain in June 1998 and on August 4, 2004; • the Veteran’s statements regarding the physical demands of his MOS as a ground radar system craftsman, as well as his statements regarding his in-service wrist and arm symptomatology, such as arm pain and numbness in his hands. See Veteran’s Statement, dated February 7, 2017 (labeled Correspondence, received on February 8, 2017); Hearing Transcript, dated November 15, 2019; and Notice of Disagreement (NOD), dated April 7, 2016; and • the statement from the VA Attending Orthopedic Physician received on December 20, 2019, stating that according to the Veteran’s EMG findings, his bilateral cubital compression was chronic and had been going on for several years before his initial diagnosis in October 2014. (Continued on the next page)   A complete rationale should be provided for all opinions rendered. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. M. Stedman, 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.