Citation Nr: 21061511 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 14-19 959 DATE: October 4, 2021 REMANDED Entitlement to service connection for a left wrist disability is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1980 to April 1984. As discussed below, the Veteran died in May 2020 and the Appellant has been granted substitution. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2012 rating decision which, in pertinent part, denied entitlement to service connection for a left wrist disability. In May 2016 and February 2018, the Board remanded the matter for further development. In November 2019, the Board denied service connection for a left wrist disability. The Veteran appealed to the U.S. Court of Appeals for Veterans Claims (Court) and in a February 2021 order, the Court granted the parties' Joint Motion for Remand (Motion). Subsequently, the Court was notified that the Veteran died in May 2020. In a May 2021 order, the Court granted substitution to the Appellant, effective May 24, 2020. This decision is binding on the Board. The case has now returned to the Board for adjudication consistent with the Motion. Entitlement to service connection for a left wrist disability is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a left wrist disability at this time. The Veteran was afforded VA examinations and medical opinions in December 2016 and January 2019. In February 2018, the Board found that the December 2016 medical opinion was inadequate and remanded for a new VA examination and medical opinion. Pursuant to the Motion, the opinion obtained in January 2019 is also inadequate as the examiner relied on continuity of care, or lack thereof, when providing a negative nexus opinion. Chronicity of care is not required to establish a positive nexus and the examiner did not properly address the Veteran's lay statements of suffering left wrist symptoms since service. The Board notes that the January 2019 VA examiner also indicated that previous imaging studies associated with the December 2016 examination were unavailable for review. As such, the Board finds that a remand is warranted for an addendum medical opinion. The entire record, including the December 2016 and January 2019 VA examination reports and associated December 2016 imaging study, should be provided to the examiner. The matter is REMANDED for the following actions: 1. Obtain the Veteran's VA treatment records from March 2019 to his death in May 2020. 2. Obtain an addendum opinion from an appropriate clinician as to the Veteran's left wrist disability. The examiner must review the claims file, including the December 2016 left wrist imaging study. The examiner should identify all left wrist disabilities diagnosed since November 2011, to include degenerative arthritis and atherosclerosis calcification. If any previously made diagnoses cannot be confirmed, please reconcile these findings with the diagnoses of the same in the December 2016 VA examination report. In providing all applicable diagnoses, please specify whether the calcifications visible on x-ray examination are best classified as artifacts or the result of old trauma. The examiner is asked to provide a response to the following: For each diagnosed left wrist disability, is it at least as likely as not that the disability (1) began during active service, to include related to October 1980, March 1982, August 1983, and October 1983 complaints of left wrist pain and ganglion cysts, (2) arthritis manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service, to include the Veteran's lay statements that he continued to have left wrist pain since service? If atherosclerosis calcification is diagnosed, the examiner should determine whether such diagnosis is related to any current left wrist symptomatology. Provide a rationale to support the opinion(s). 3. After completing the above, and any other development as may be indicated, the Veteran's claim should be readjudicated based on the entirety of the evidence. If the claim remains denied, the Appellant should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Owen, 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.