Citation Nr: 21062516 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 09-47 751 DATE: October 7, 2021 REMANDED Entitlement to service connection for bilateral ulnar nerve disability is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1989 to May 1993. The Veteran testified at a hearing before the undersigned in July 2021; a transcript of that hearing is associated with the record. The Board most recently remanded the claim in October 2016 for further development. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran contends that his bilateral ulnar nerve disability is either directly related to his service or secondary to his service-connected disabilities. The claim must be remanded again for an adequate medical opinion and for the Agency of Original Jurisdiction (AOJ) to review evidence added to the record since the April 2020 supplemental statement of the case (SSOC); specifically, an August 2021 VA examination. The July 2017 and August 2021 VA examinations are inadequate as to both direct and secondary service connection. The July 2017 findings are based upon an incomplete file. Specifically, the examiner referred to evidence that the Veteran was seen at the Martinsburg VAMC in 1994 but could not locate or review the related treatment records. In August 2021, the examiner diagnosed bilateral ulnar nerve impingement, but did not offer any etiology opinion. In January 2020 correspondence, VA notified the Veteran that treatment records regarding (1) physical therapy in the 1990s at a military hospital; and (2) Martinsburg VAMC since 1994, were not part of his electronic file. The Veteran was incarcerated from April 2010 to April 2021 and did not receive that notice. On remand, VA should resend the January 2020 correspondence. It appears there may be other outstanding treatment records that should be obtained on remand. At the hearing, the Veteran testified that he was treated as a military dependent from 1995 to 2003. He said those records include diagnoses of carpal tunnel syndrome (CTS) and opinions from his doctors that the CTS was probably related to his service. Those records must be obtained on remand. The matters are REMANDED for the following action: 1. Contact the Veteran and resend him a copy of the January 2020 Correspondence. With the Veteran's assistance identify and obtain copies of any pertinent medical or VA treatment records regarding his (1) physical therapy in the 1990s at a military hospital; and (2) Martinsburg VAMC since 1994 and add them to the claims file. If VA attempts to obtain any outstanding records which are unavailable, the Veteran should be notified. 2. Ask the Veteran to identify where he was treated as a military dependent from 1995 to 2003. Take all appropriate action to obtain related records. 3. After completion of the above, obtain an addendum opinion from an appropriate clinician to determine the likely etiology of the Veteran's ulnar nerve disability. Copies of all pertinent records must be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) one should be scheduled. The examiner is asked to answer the following: Is it at least as likely as not (50 percent probability) that any currently diagnosed ulnar nerve disability was incurred in or is otherwise related to service? Why or why not? In providing the opinion, the examiner must specifically consider the Veteran's testimony that during service he used high-powered tools, such as a needle gun, and the effects of those tools on his hands, wrist and arms. The examiner must provide reasons for each opinion given. If the examiner is unable to provide an opinion without resort to speculation, they should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. E. Bresler 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.