Citation Nr: 20044934 Decision Date: 07/06/20 Archive Date: 07/06/20 DOCKET NO. 17-15 158 DATE: July 6, 2020 REMANDED Entitlement to service connection for the birth defects of the fingers of the right hand is remanded. Entitlement to service connection for the birth defects of the fingers of the left hand is remanded. Entitlement to service connection for arthritis is remanded. Entitlement to service connection for a heart condition, to include as secondary to birth defects of the fingers of both hands, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1967 to February 1968. These matters come before the Board of Veterans’ Appeals (Board) from a June 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran and his wife testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. REASONS FOR REMAND 1-2. Entitlement to service connection for birth defects of the fingers of both hands 3. Entitlement to service connection for arthritis 4. Entitlement to service connection for a heart condition, to include as secondary to birth defects of the fingers of both hands The Board finds a VA opinion is warranted to address the claimed birth defects of the fingers of both hands and a VA examination and opinion is warranted to address the claimed arthritis. With respect to the fingers claim, service treatment records show the congenital deformity of the fingers of both hands existed prior to service and that the Veteran was discharged four months after induction due to physical disability. At the March 2020 Board hearing and in statements on appeal, the Veteran asserted that his finger disability was aggravated by service due to physical activity during basic training. The Board finds a VA examination with opinion is needed. With respect to the claimed arthritis, at the Board hearing, the Veteran clarified that he was claiming service connection for arthritis of the whole body. He also attributed his arthritis to the wear and tear of activities performed during basic training. The medical evidence reflects a diagnosis of osteoarthritis unspecified. A VA examination and opinion addressing the claimed arthritis is not of record. A VA examination with opinion should be obtained. As the Veteran has asserted that his diagnosed heart condition was caused or aggravated by his finger disability, the claimed heart condition is intertwined with the finger claim. Updated medical records should also be requested. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed conditions. After securing any necessary releases, request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran should be notified of such. 2. After records development is completed, schedule the Veteran for a hand examination to address the claim for service connection. After review of the claims file and examination of the Veteran, the examiner should respond to the following: (a.) Please indicate whether the claimed finger disability is a congenital defect (static condition), or congenital disease (capable of getting better or worse). The examiner should explain why or why not. (b.) If not a congenital defect, did the condition permanently worsen during active service? If so, was the permanent worsening undebatably the result of the natural progression of the condition (versus being the result of an event/injury/disease during service)? The examiner should explain why or why not, to include addressing whether the finger condition was permanently worsened by physical activity during basic training. (c.) If considered a congenital defect, was it subject to a superimposed disease or injury during service with a resulting disability? The examiner should explain why (with an explanation as to what the resulting disability is) or why not, to include addressing physical activity and stress during basic training. (d.) For a currently diagnosed bilateral hand condition that is not a congenital disease or defect, is it at least as likely as not (50 percent probability or greater) that the condition arose during active service or is otherwise related to service? Please explain why or why not, to include addressing physical activity and stress during basic training. A rationale for all opinions expressed should be provided. 3. Schedule the Veteran for a VA joint examination to address the claim for generalized arthritis and obtain an opinion as to whether such is related to service. The claims file should be reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted, and the results reported. After reviewing the claims file and examining the Veteran, the examiner should provide an opinion on whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s current arthritis arose during service or is otherwise related to service? The examiner should explain why or why not, to include addressing whether the condition is a delayed post-traumatic reaction to the wear and tear of activities performing during basic training.   4. If the claims remain denied, issue a supplemental statement of the case, as appropriate. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. C. Birder 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.