Citation Nr: 21001044 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 17-48 285 DATE: January 6, 2021 REMANDED Entitlement to service connection for a right-hand disability with finger deformity is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1968 to June 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. In January 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. Entitlement to service connection for a right-hand disability with finger deformity is remanded. The Veteran contends that his right-hand disability with finger deformity is related to service. He contends that the finger deformity was a broken knuckle, which happened while he was still on active duty. He testified that he injured his hand during service and has experienced pain since the removal of an in-service cast. He submitted a photograph showing his hand in a cast during service. He stated that he sought treatment following service and has self-medicated and treated with topical ointments. He testified that he has not injured his hand in any other way since service. See January 2020 Statement of Accredited Representative and January 2020 Hearing Transcript. The Veteran underwent a June 2017 VA examination, wherein he was diagnosed with a right-hand mallet finger deformity, described as a malunion of previous finger fracture. The examiner opined that the Veteran’s right-hand disability with finger deformity was less likely than not incurred in or caused by a cast being located during service. The examiner stated that there are no treatment records found during active service which indicate that the Veteran was treated while on active duty for this condition or within one year afterward. Upon reviewing photographs of the cast from service, the examiner stated that a cast of that nature would not cause the Veteran’s injury. The examiner further noted that during the application of any cast, providers instruct the wearer of a cast to report immediately any signs of the cast causing any restriction of circulation, movement or sensation and the cast would have also been checked regularly by medical personnel. Therefore, the examiner explained, if it were causing any of these symptoms, the Veteran failed to report them at that time. The examiner stated that the February 1968 enlistment examination indicates that the Veteran was healthy and free from any medical conditions upon entry into the service. Separation exam could not be located. Additionally, the examiner stated that there are no active duty treatment records pertaining to hand, finger, thumb or wrist injuries and available treatment records do not link the condition to service. The Board regrets the further delay but finds that a remand is necessary in this appeal to afford the Veteran the greatest possible consideration. Specifically, the Board finds that the VA opinion of record does not consider nor discuss the Veteran’s lay reports of in-service symptoms, and instead dismisses them because they were not documented during service. Overall, the examiner relies too heavily on the lack on in-service documentation and the lack of notation within a separation exam, which could not be located. Therefore, a remand is necessary because the examination is, in part, based on an inaccurate factual background. The matter is REMANDED for the following action: 1. Update VA treatment records. 2. Upon completion of the above, schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology of his right-hand disability with finger deformity. The examiner should opine on the following: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right-hand disability with finger deformity is related to service? The examiner should be based on an accurate medical history and specifically address the Veteran’s lay reports of in-service symptoms. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Wilson, 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.