Citation Nr: 20039962 Decision Date: 06/11/20 Archive Date: 06/11/20 DOCKET NO. 15-38 529 DATE: June 11, 2020 ORDER Service connection for a bilateral hand disability is granted. FINDING OF FACT The probative evidence of record is at least in equipoise as to whether the Veteran’s Raynaud’s disease is etiologically related to her service-connected systemic lupus erythematosus. CONCLUSION OF LAW With resolution of reasonable doubt in the Veteran’s favor, the criteria for a grant of service connection for Raynaud’s disease have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Army from January 1991 to November 1992. The Veteran testified before the undersigned Veterans Law Judge during a July 2018 hearing. This matter is on appeal from a March 2015 rating decision. In April 2020, the Veteran was notified that the Veterans Law Judge who held the July 2018 hearing is no longer available to participate in the decision. She was provided the opportunity to appear at another Board hearing. This letter was sent in error; the undersigned Veterans Law Judge remains available to participate in the decision. The Board will therefore consider the claim on the evidence of record. The issue listed on the title page was previously remanded by the Board in February 2019 to afford the Veteran an advisory opinion from an independent medical expert. See 38 U.S.C. § 5109 (2012); 38 C.F.R. § 3.328 (2018). Because the Board is granting the Veteran’s claim, any errors in compliance with remand directives with regard to this claim are harmless. See Stegall v. West, 11 Vet. App. 268 (1998). The Board also remanded the issue of entitlement to service connection for systemic lupus erythematosus. In a February 2020 rating decision, VA granted service connection for systemic lupus erythematosus. As this represents a full grant of the benefit sought with respect to this issue, it is no longer before the Board. Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997) 1. Bilateral Hand Disability Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted for a disability that is proximately due to, the result of, or aggravated by a service-connected disability. 38 C.F.R. § 3.310. In such an instance, the Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310 (b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995). The benefit of the doubt rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when (1) the weight of the evidence supports the claim or (2) when the evidence is in equipoise. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran was afforded a VA examination by a physician assistant in July 2019. The examiner diagnosed Raynaud’s disease and opined that it was at least as likely as not caused by her systemic lupus erythematosus. The Veteran was afforded an additional VA examination by an orthopedic surgeon in August 2019. The examiner diagnosed Raynaud’s phenomena and also opined that it was at least as likely as not caused by her lupus erythematosus. The examiner cited literature from the Lupus Resource Center stating that “Lupus-related Raynaud’s usually results from inflammation of nerves or blood vessels and is triggered by stress or by cold temperatures.” The Veteran was afforded an additional VA medical opinion by a rheumatologist in January 2020. The rheumatologist also opined that it was at least as likely as not that the Veteran’s bilateral hand disability was proximately due to or the result of her service-connected systemic lupus erythematosus. The record contains three medical opinions favorable to the Veteran’s contention that her Raynaud’s disease was caused by her service-connected systemic lupus erythematosus and no medical evidence to the contrary. In light of the totality of the circumstances, and after resolving all reasonable doubt in the Veteran’s favor, the evidence of record supports a finding that it is at least as likely as not that the Veteran’s Raynaud’s disease was caused by her service-connected systemic lupus erythematosus. Accordingly, the Board finds that granting service connection for Raynaud’s disease is the decision that is the most consistent with VA’s policy to administer the law under a broad and liberal interpretation consistent with the facts of the case. 38 C.F.R. §§ 3.303 (a), 3.310. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Ryan Frank, 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.