Citation Nr: 21003950 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 04-42 466 DATE: January 25, 2021 ORDER Service connection for a right hand disorder, to include polymyositis, rheumatoid arthritis, osteoarthritis and osteoporosis is granted. Service connection for a left hand disorder, to include polymyositis, rheumatoid arthritis, osteoarthritis and osteoporosis is granted. FINDINGS OF FACT 1. With resolution of the doubt in his favor, the Veteran’s right hand disorder was caused by his exposure to cold weather during service. 2. With resolution of the doubt in his favor, the Veteran’s left hand disorder was caused by his exposure to cold weather during service. CONCLUSIONS OF LAW 1. The criteria to establish entitlement to service connection for a right hand disorder have been met. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303(d) (2019). 2. The criteria to establish entitlement to service connection for a left hand disorder have been met. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303(d) (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from April 1944 to April 1946. He died in 2017. The Appellant has been substituted as the Veteran’s surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2004 rating decision of the Jackson, Mississippi Regional Office (RO). In March 2006, the Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ engaged in a colloquy with the Veteran toward substantiation of the claims. Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A hearing transcript is in the record. In December 2006, the Board denied the claims. The Veteran appealed the Board decision to the U.S. Court of Appeals for Veterans’ Claims (Court). In a January 2008 Joint Motion for Partial Remand (JMPR), the Court vacated the Board decision and remanded the Veteran’s appeal to the Board. In September 2009, the Board remanded the appeal to the RO for additional action. There was substantial compliance with the Board’s remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Service Connection – Bilateral Hand Disorder Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110 (2012). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2019). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran asserts that his bilateral hand disorder resulted from his exposure to cold weather during service in Korea due to inadequate heat in his barracks, inadequate clothing and his hands having been consistently wet and frozen from washing clothes for approximately fourteen hours per day due to his duty specialty. The claims will be granted. The report of separation from the armed forces (DD Form 214) reflects that Veteran’s duty specialty was Laundry Machine Operator in the 340th Quartermaster Laundry Detachment. A military personnel record (MPR) titled “Historical Record” indicated that the Veteran’s unit arrived in Seoul, Korea on November 17, 1945. A MPR record titled “Final Payment – Work Sheet” reflects that the Veteran departed Seoul, Korea on March 23, 1946. In February 2017, the Veteran submitted a National Climate Review dated December 2013 from the Korea Meteorological Administration indicating that the average temperature in 1945 in Seoul, Korea was approximately negative eight degrees celsius. Service treatment records (STRs) are silent for complaints or contemporaneous reports pertaining to a cold weather injury as to the Veteran’s hands. In the Veteran’s April 1946 separation medical examination report, no skin or neurological abnormalities were noted and the Veteran answered in the negative to the question of whether he then had any wound, injury or disease that was disabling or incurred during service. Due consideration shall be given to the places, types, and circumstances of such veteran’s service as shown by such veteran’s service record, the official history of each organization in which such veteran served, such veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154(a) (2012). Resolving all reasonable doubt in favor of the Veteran, the Veteran served in Seoul, Korea for approximately four months and was exposed to cold weather due to his duty specialty as a Laundry Machine Operator. An October 1990 private treatment record reflects the Veteran’s report of experiencing stiffness in his fingers. In a May 2003 private treatment record, the Veteran reported having been exposed to cold weather during his service in Korea and that he experienced bilateral hand stiffness and numbness. The Veteran reported then-experiencing bilateral hand stiffness, numbness, finger deformity and trouble picking items up. A physical examination revealed marked deformity of the hands and numbness of the fingers. The Veteran’s private medical provider assessed the Veteran with numbness and deformity of the hands secondary to previous cold exposure. A November 2004 private right-hand radiograph revealed osteoarthritic changes. In a January 2005 private treatment record, the Veteran reported experiencing bilateral hand weakness, numbness and stiffness. Electrophysiological testing revealed myositis. A May 2005 private treatment record reflects the Veteran’s diagnosis of bilateral hand polymyositis. It was noted that the Veteran “may have” a mild degree of rheumatoid arthritis. In a March 2006 private treatment record, the Veteran reported experiencing bilateral hand weakness and swelling. The Veteran was diagnosed with bilateral hand rheumatoid arthritis and polymyositis. In his March 2006 Board hearing, the Veteran testified to having been exposed to cold weather during service and experiencing bilateral hand stiffness, numbness and swelling. The Veteran is competent to report having undergone residuals of a cold-weather injury. See Goss v. Brown, 9 Vet. App. 109, 113 (1996). The Veteran’s testimony is credible. In an April 2006 letter, the Veteran’s private medical provider indicated having treated the Veteran for approximately forty years and noted that the Veteran experienced symptoms of Raynaud’s phenomenon and arthralgia that was diagnosed as polymyositis and rheumatoid arthritis. The medical provider opined that it was “certainly likely” that the Veteran’s cold weather exposure during service contributed to the Veteran’s bilateral hand disorder. The private medical opinion is highly probative because the examiner personally examined the Veteran, had an accurate and complete understanding of the Veteran’s medical history and provided a medical opinion with supporting rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). VA treatment records dated September 2007 and February 2017 reflect the Veteran’s diagnosis of polymyositis and rheumatoid arthritis. The November 2018 VA examiner opined that the Veteran’s bilateral hand disorder was not caused by his exposure to cold weather during service because although the Veteran’s long history of myalgia, arthralgias, osteoporosis and Raynaud’s syndrome could explain his rheumatoid arthritis and polymyositis, due to the Veteran’s death, the examiner could not examine the Veteran for symptoms of a cold injury and it would be speculative to indicate the presence of residuals of a cold injury. The VA medical opinion is of low probative value because although the examiner had not personally examined the Veteran for signs or symptoms of a cold injury. Nieves-Rodriguez, supra. The Board will grant the claims based on the benefit-of-the-doubt doctrine. The Veteran served in Seoul, Korea for approximately four months and was exposed to cold weather due to his duty specialty as a Laundry Machine Operator. The April 2006 private examiner opined that the Veteran’s bilateral hand disorder was caused by his exposure to cold weather during service. Although the November 2018 VA examiner opined otherwise, the VA medical opinion was of low probative value. The Board will resolve all reasonable doubt in favor of the Veteran. Therefore, service connection is warranted and the claims are granted. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Cohen, 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.