Citation Nr: 20030554 Decision Date: 04/30/20 Archive Date: 04/30/20 DOCKET NO. 08-37 093A DATE: April 30, 2020 REMANDED The claim for service connection for bilateral carpal tunnel syndrome is remanded. REASONS FOR REMAND In April 2011, the Veteran was afforded a hearing before the undersigned at the RO. 38 U.S.C. § 7102 (b). In June 2014, the Board denied the claim. The Veteran appealed to the U.S. Court of Appeals for Veterans Claims (Court). In May 2015, the Court issued an Order vacating the June 2014 Board decision and remanding the case for compliance with a Joint Motion for Remand (JMR). In December 2015 and October 2017, the Board remanded the claim. In June 2018, the Board denied the claim. In August 2019, the Court issued an Order vacating the June 2014 Board decision and remanding the case for compliance with a JMR. 1. The claim for service connection for bilateral carpal tunnel syndrome is remanded. The JMR notes that the Board’s June 2018 denial of the claim was partly based upon a May 2017 VA medical opinion, in which the examiner concluded that that a post-service fracture sustained by the Veteran in 1999 had caused his carpal tunnel syndrome. However, the JMR shows that it was agreed that a remand was required because the “Board erred when it failed to resolve conflict between a VA examination’s finding of causation and evidence indicating that carpal tunnel syndrome may have pre-existed an injury sustained in 1999.” Citing reports from Kansas University Physicians, Inc. (“KUP”), dated October 20, 1999 (noting “The reason that [Appellant] may have more numbness on his right side may be from this most recent injury, so that the exacerbation of his carpal tunnel syndrome on the right would be the result of this fall”), and December 22, 1999 (noting that a fractured bone in Appellant’s hand “would make carpal tunnel syndrome worse because of the swelling associated with the nonunion”). The JMR states that the Board’s decision did not resolve the conflict between the VA examination that concluded that the work-related injury “caused the carpal tunnel” and the private treatment notes that indicated that the injury exacerbated or made the Appellant’s carpal tunnel syndrome worse. As a factual matter, the JMR does not cite to any previous diagnosis of carpal tunnel syndrome, or any other wrist disorder, and it is unclear whether or not the cited references in the KUP reports involve residuals of an injury that the Veteran sustained at his job in 1992. See KUP report, dated October 22, 1999. In any event, on remand, a supplemental opinion should be obtained. The Board further notes that, contrary to the Veteran’s testimony, the KUP records include multiple notations indicating that the Veteran’s 1999 injury, which occurred at his job, involved a claim with the state workers’ compensation administration. On remand, an attempt should be made to obtain these records. The matters are REMANDED for the following action: 1. Attempt to obtain the Veteran’s worker's compensation decision(s), and any supporting medical records, pertinent to the Veteran's claim for benefits. 2. Thereafter, return the file to the examiner who provided the May 2017 VA opinion, or, if she is not available, to another examiner. If an opinion cannot be provided without an examination, one should be provided. After review of the record, the examiner should address the following question: Is it at least as likely as not (a 50 percent or better probability) that the Veteran's carpal tunnel syndrome of either upper extremity had its clinical onset during the Veteran's active duty service? Why or why not? The examiner is requested to specifically discuss reports from the Kansas University Physicians, Inc. (“KUP”), dated October 20, 1999 (noting “The reason that [Appellant] may have more numbness on his right side may be from this most recent injury, so that the exacerbation of his carpal tunnel syndrome on the right would be the result of this fall”), and December 22, 1999 (noting that a fractured bone in Appellant’s hand “would make carpal tunnel syndrome worse because of the swelling associated with the nonunion”) and to discuss whether or not this is sufficient to show a preexisting carpal tunnel syndrome during service, between June 1972 to November 1977. T. STEPHEN ECKERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Carole Kammel, 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.