Citation Nr: 21063897 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 18-23 899 DATE: October 18, 2021 REMANDED Entitlement to a rating in excess of 10 percent for right hand strain is remanded. Entitlement to service connection for a right upper extremity disability as secondary to right hand strain is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 2014 to September 2015. This matter comes before the Board of Veterans' Appeals (Board) from a February 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2021, the Veteran testified before the undersigned Veterans Law Judge at a virtual Board hearing. Based on the Veteran's Board hearing testimony, to be discussed below, the Board finds that the issue of entitlement to service connection for a right upper extremity as secondary to service-connected right-hand strain is raised by the record and requires further development on remand. See Morgan v. Wilkie, 31 Vet. App. 162 (2019). The Veteran's last VA examination addressing his service-connected right-hand strain was conducted in December 2015. At the April 2021 Board hearing, the Veteran testified that his right-hand disability has progressively worsened and now pain radiates up his arm. See Hearing transcript (Tr.) at 2-5. In addition, his testimony suggests that there may be outstanding relevant private and VA treatment records. Tr. 4-6. Furthermore, based on the Veteran's testimony that pain radiates from his right hand up into his arm, an examination and etiology opinion should be obtained to determine a diagnosis for the condition and to address whether such condition is secondary to his service-connected right-hand strain. See Morgan, supra. For these reasons, remand is warranted to obtain updated VA examinations and opinions. Outstanding VA and private treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, secure any relevant outstanding private treatment records, to include from Dr. M. 3. Then schedule the Veteran for a VA examination to address the nature and severity of his right hand strain. The entire claims file must be made available to and reviewed by the examiner, to include a copy of the April 2021 Board hearing transcript. The examiner must state that such review was completed. All findings must be reported in detail. The examiner is then asked to address the following: (a.) Please provide the full range of motion of the Veteran's right hand in (1) active motion, (2) passive motion, (3) in weight-bearing (4) in nonweight-bearing, and (5), if applicable, with range of motion of the opposite undamaged joint. Please specify range of motion measurements in all areas outlined above. If the examiner cannot provide an opinion without resorting to speculation, s/he should explain why an opinion cannot be provided (e.g., lack of sufficient information/evidence, the limits of medical knowledge, etc.). (b.) Considering the Veteran's reported history, please provide an opinion describing functional impairment of the Veteran's right hand disability, accounting for pain, incoordination, weakened movement, and excess fatigability on use, and, to the extent possible, report such impairment in terms of additional degrees of limitation of motion. If unable to provide such an opinion without resorting to speculation, please provide a rationale for this conclusion, with specific consideration of the instructions in the VA Clinician's Guide to estimate, "per [the] veteran," what extent, if any, flare-ups affect functional impairment. The examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation. 4. Obtain a VA examination to address the nature and etiology of any right upper extremity neurological disability, to include any disability affecting the right elbow and shoulder. The entire claims file must be made available to and reviewed by the examiner, to include a copy of the April 2021 Board hearing transcript. The examiner must state that such review was completed. All findings should be reported in detail. The examiner must elicit from the Veteran a detailed description of his right upper extremity symptoms and functional impact of the same. The examiner is then asked to address the following: (a.) Identify all neurological disabilities affecting the right upper extremity based on physical examination of the Veteran and his treatment records. Please consider the Veteran's report of pain radiating from his right hand to his elbow and up to his shoulder. (b.) For each disability so diagnosed, please opine whether it is at least as likely as not (50 percent probability or greater) that such disability: (1) is proximately due to the Veteran's service-connected right hand and/or right wrist disabilities; or (2) has been aggravated (worsened) by the Veteran's service-connected right hand and/or right wrist disabilities. Please render separate opinions on questions (b)(1) and (b)(2) for each diagnosed disability. A robust rationale must be provided for all opinions expressed. If unable to opine without speculation, please provide a rationale for this conclusion. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. deBruyn, 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.