Citation Nr: 21002809 Decision Date: 01/15/21 Archive Date: 01/15/21 DOCKET NO. 12-33 855A DATE: January 15, 2021 ORDER Service connection for a left wrist disorder, claimed as rheumatoid arthritis and reflex sympathetic dystrophy, is denied. FINDINGS OF FACT 1. The Veteran had active service between February 1970 and June 1971. 2. The Veteran is service connected for left wrist, status/post dislocation with post-traumatic carpal instability and degenerative arthritis, as well as carpal tunnel syndrome of the left wrist. 3. Rheumatoid arthritis and reflex sympathetic dystrophy of the left wrist has not been shown. CONCLUSION OF LAW A left wrist disorder, claimed as rheumatoid arthritis and reflex sympathetic dystrophy, was not incurred in service. 38 U.S.C. §§ 1101, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION As an initial matter, in November 2020, the Board remanded the Veteran’s claim for additional development. The case has now been returned to the Board for further appellate action. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). In addition to the above, for a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the appeal. Romanowsky v. Shinseki, 26 Vet. App. 289 (2013); McClain v. Nicholson, 21 Vet. App. 319 (2007). The record does not show that the Veteran had a diagnosis of rheumatoid arthritis or reflex sympathetic dystrophy of the left wrist, or any other left wrist disorder independent of his already service-connected left wrist dislocation with arthritis and carpal tunnel syndrome at any time during or contemporary to the pendency of his claims. To that end, the Veteran reported pain, swelling and stiffness in his left wrist in multiple medical treatment notes and examinations since February 2003, and said that he was under the impression that he had rheumatoid arthritis in a November 2015 treatment note. He is competent to describe his observations because this requires only personal knowledge as it comes to him through his senses; however, the medical evidence does not support his assertions. Specifically, while April 2012 and May 2014 treatment notes raised the possibility of rheumatoid disease and reflex sympathetic dystrophy, the clinicians did not diagnose the two disorders. Subsequently, a November 2015 clinician observed that rheumatoid arthritis was an inflammatory disease and found no clinical indication that the Veteran had rheumatoid arthritis. A November 2019 VA examiner did not diagnose rheumatoid arthritis or reflex sympathetic dystrophy, explaining that prior diagnostic testing was negative for the disorders and that the medical records did not otherwise support the diagnoses. In sum, the medical evidence does not reflect a diagnosis of either rheumatoid arthritis or reflex sympathetic dystrophy of the left wrist at any time during or contemporaneous to the pendency of the appeal. The Veteran has asserted that his left wrist disorder, to include rheumatoid arthritis and reflex sympathetic dystrophy, stemmed from his service-connected left wrist disorders. However, while he has been service connected for a left wrist dislocation with arthritis and carpal tunnel syndrome, service connection, including secondary service connection, may only be granted for a current disability. Brammer v. Derwinski, 3 Vet. App. 223 (1992). As there is no current diagnosis of rheumatoid arthritis, reflex sympathetic dystrophy, or any other left wrist disorder separate from that already service-connected at any time during the pendency of the appeal, the medical evidence does not support service connection. The Board has considered the lay statements submitted by the Veteran regarding the etiology of his left wrist complaints. He is competent to report symptoms and describe his observations because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of any current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the medical personnel who have examined the Veteran during his current appeal and by service and medical records obtained and associated with the claims file. Here, the Board attaches greater probative value to the clinical findings than to the lay statements and testimony that have been submitted. Based on the above, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Spigelman, 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.