Citation Nr: 21001429 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 11-17 727 DATE: January 8, 2021 REMANDED Entitlement to service connection for a left hand disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1973 to September 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2010 rating decision by the Department of Veterans Affairs (VA). This case was remanded in October 2018 and in April 2020 for further development. Although the Veteran requested a BVA hearing, he subsequently withdrew this hearing request in October 2018. Entitlement to service connection for a left hand disability. This case was most recently before the Board in April 2020, when it was determined that the October 2019 VA examination obtained on remand was inadequate. An additional medical opinion was obtained in June 2020. Unfortunately, the Board once again finds that the medical opinion obtained is inadequate. Stegall v. West, 11 Vet. App. 268 (1998). Service treatment records reflect that the Veteran incurred various injuries to his left hand/wrist. For example, a May 1978 treatment record reflects complaints by the Veteran of numbness in the last two fingers of his left hand. A June 1978 treatment record reflects a laceration to his left hand. A January 1979 treatment record reflects treatment for his left index finger. A November 1979 treatment record reflects treatment for a left hand suture and a May 1980 treatment record notes a left thumb injury. An October 1991 treatment record reflects a diagnosis of rule out rheumatoid arthritis vs. probably tendonitis in the left wrist. An X-ray subsequently taken appears to reflect normal findings. However, in December 1993, a few months shortly following separation from service, the Veteran reported neurological symptoms in his left hand stating that his left hand goes numb if he sleeps on it. Treatment records in 2006 show osteoarthritis in his left wrist. In the April 2020 remand, the VA examiner was instructed to determine the nature and likely cause of any left hand disability. A June 2020 VA examiner noted that she was unable to locate a document referenced in the remand. For reference, the medical records are located in the file and clearly marked. In providing the negative opinion, the examiner does not consider the Veteran’s left hand neurological complaints and focuses her findings on an orthopedic hand condition. The Board notes that all symptoms of the claimed left hand are before the Board at this time. An additional medical opinion must be obtained to adequately address the Veteran’s concerns. The matters are REMANDED for the following actions: 1. Forward the Veteran’s claims folder to an examiner for an addendum opinion regarding the Veteran’s left hand disability. The examiner is requested to review the claims folder, to include this remand. Following review of the claims file the examiner should provide an opinion on the following: Whether it is at least as likely as not (a probability of 50 percent or greater) that any left hand disability (orthopedic/neurologic) had its clinical onset during the Veteran’s active duty service or is otherwise etiologically related to his active service. Rationale for the requested opinion shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 2. After completing the above, and any other development deemed necessary, readjudicate the issue currently on appeal with consideration of all applicable laws and regulations. If any benefit sought on appeal remains denied, issue the Veteran and his representative a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. M. Clark, 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.