Citation Nr: 20031202 Decision Date: 05/04/20 Archive Date: 05/04/20 DOCKET NO. 17-25 437 DATE: May 4, 2020 REMANDED Entitlement to service connection for a right arm disability, initially claimed as right carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran had active service from June 1983 to March 2011. The issue comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), which denied the claim. The Veteran testified at a videoconference Board hearing in February 2020, before the undersigned Veterans Law Judge (VLJ). The record was held open for an additional 60 days to allow the Veteran time to supplement the record. At the time of this decision, no further records have been received. A copy of the transcript is of record. Entitlement to service connection for a right arm disability, initially claimed as right carpal tunnel syndrome is remanded. The Veteran has credibly and competently testified at his Board hearing that he started to experience pain in his right arm toward the end of his tenure in the Air Force, around November/December 2010. He also testified that he sought treatment in service for it at the Hingham Clinic, and was then sent to Tipplers Prosthetics Department to get an appliance to hold one muscle in place while strengthening other muscles. The brace did not work, and he continued to have forearm pain, which has now worsened to include “shooting [pains] down to [his] trigger finger, too.” The Veteran also testified that in his current job involves a lot of typing and his disability impairs that ability for he is forced to stop work, get up, and leave. When it gets really bad, he takes Ibuprofen and rubs the arm with Deep Blue, an organic oil treatment. The Veteran’s service treatment records (STRs) dated in December 1984 notes that he was evaluated for an injury to the right index finger while at work. Upon X-ray testing, the clinician noted no fracture. He was assessed with a laceration to the right index finger, which was repaired with sterile strips and a splint. The Veteran’s post-service treatment records indicate treatment in April 2016 treatment from HC Family Health System. The attending clinician noted the Veteran’s chronic right forearm carpal tunnel syndrome, with his complaint of pain level 4 to 6 on a scale of 10, shooting pain, and tingling sensation. It was also reported that the Veteran does a lot of typing, and the pain is getting worse because of the typing, and he was previously given a forearm brace to help with the pain. Although the record, however, is absent a diagnosis of any right hand disability, it does show the Veteran’s complaint of right arm pain with functional impairment. Further, the Veteran competently and credibly testified of having pain and functional impairment while at work, especially with typing. Thus, he has a current disability. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018) (holding that “pain in the absence of a presently-diagnosed condition can cause functional impairment”). The Veteran’s testimony provides an indication that his condition may be related to service. As there is no etiology of record and the low threshold of McLendon is triggered, and an examination is required to resolve the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Accordingly, the matter is REMANDED for the following action: 1. Schedule the Veteran for an examination with a qualified clinician so that an opinion may be provided assessing the nature and etiology of his right hand disability. The entire claims file and a copy of this remand must be made available to the examiner for review. A physical examination of the Veteran or telehealth examination is only required if deemed necessary by the clinician. Although an independent review of the claims file is required, the Board calls the clinician’s attention to: a. STR entry dated in December 1984, noting injury to the right index finger. b. April 2016 treatment notes showing complaint of chronic/worsening right forearm carpal tunnel syndrome with shooting pain and tingling sensation, and reports of having had a forearm brace to help with the pain. c. February 2020 hearing testimony of the incurrence and the continuation of his right hand disability. The examiner must then provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a right hand disability that began during active service, or is related to an incident of service; and if carpal tunnel syndrome and/or arthritis is diagnosed, within one year thereof. The examiner must provide all findings, along with a complete rationale for his or her opinion(s), in the examination report. If any of the above-requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such a conclusion. The examiner is reminded that, even if there is no diagnosable pathology of the right hand, complaints of pain plus functional impairment is akin to a diagnosed physical disability. 2. Then, readjudicate the claim. If any decision is adverse to the Veteran, issue a supplemental statement of the case, and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Stevens, 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.