Citation Nr: 21064871 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-49 866 DATE: October 21, 2021 ORDER Entitlement to service connection for a left hand disorder is granted. Entitlement to service connection for a right hand disorder is granted. FINDINGS OF FACT 1. The Veteran's left hand osteoarthritis was incurred in, or caused by, his active duty service. 2. The Veteran's right hand osteoarthritis was incurred in, or caused by, his active duty service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left hand disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 3.303. 2. The criteria for entitlement to service connection for a right hand disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1978 to June 1998. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the submission of a July 2019 private medical opinion is properly considered by the Board in the first instance as his VA Form 9 substantive appeal was filed on or after February 2, 2013. 38 U.S.C. § 7105(e). Regarding the VA treatment records that have been added to the record following the issuance of the most recent supplemental statement of the case, and after this matter had been certified to the Board, those records are not pertinent to the Veteran's issues addressed below and remand for initial AOJ review is not required. See 38 C.F.R. § 19.37(a) (requiring remand for a supplemental statement of the case, unless the additional evidence duplicates evidence previously of record which was discussed in the statement of the case or supplemental statement of the case, or the additional evidence is not relevant to the issue on appeal). The Veteran was previously represented in this appeal by the Military Order of the Purple Heart (MOPH); however, in April 2020, MOPH advised VA and the Veteran that it was no longer able to provide representation due to a reorganization that occurred within MOPH due to lack of funding. In August 2021, the Veteran was advised that he could obtain representation from another Veterans Service Organization or from an accredited attorney or claims agent. The process for obtaining such representation was explained in detail. The Veteran has not appointed a new representative and is therefore now considered to be unrepresented in this appeal. 1. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent medical or lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). The Veteran asserts that his hand disorders are the result of his active duty service. For the following reasons and bases, the Board finds that entitlement to service connection for bilateral hand arthritis is warranted. The Veteran has been diagnosed with osteoarthritis of the left and right hands. He reported experiencing painful and aching hands since his active duty service, which he attributed to his in-service repetitive hand use as an airplane mechanic. See August 2017 Hand and Fingers Conditions Disability Benefits Questionnaire (DBQ). The Veteran's DD Form 214 indicates that his military occupational specialty (MOS) was a maintenance technician. Therefore, the Board finds the Veteran's report of repetitive use of his hands during active duty consistent with the circumstances of his service and MOS. See 38 U.S.C. § 1154(a). In support of his claim, the Veteran submitted a July 2019 statement by his treating orthopedic surgeon. The surgeon stated that the Veteran had advanced osteoarthritis of the left thumb CMC joint. He explained that the cause osteoarthritis is a multi-factor issue seen commonly in laborers that perform manual grasp tasks. The surgeon opined that it was more likely than not that the Veteran's in-service high use hand tasks caused him to develop osteoarthritis. See July 2019 Orthopedic Associates of Central Texas Statement. Although the July 2019 private opinion was limited to the etiology of the Veteran's left hand osteoarthritis, the Board also finds it applicable to the etiology of his right hand osteoarthritis. In this regard, the Veteran's dominant hand has been consistently identified as his right hand. See August 2017 Hand and Fingers Conditions DBQ; April 2019 Peripheral Nerves Condition DBQ. From this fact the Board infers that the high use left hand tasks referenced in the July 2019 opinion also applies to the same degree, if not more, to the Veteran's right hand. Accordingly, the Veteran's in-service high use hand tasks required by his MOS of maintenance technician also caused his right hand osteoarthritis. The Board notes that there are two negative etiological opinions of record in VA opinions of June 2016 and August 2017. The June 2016 opinion was based on a lack of diagnosis. The August 2017 opinion found that the Veteran's left hand osteoarthritis and right hand osteoarthritis were more than likely age-related. In sum, the Board finds that it is as least as likely as not that the Veteran's arthritis of the bilateral hands was incurred during active service. In this regard, the Board finds the medical evidence submitted by the Veteran to be competent, credible, and highly probative of the fact that the Veteran's hand symptomatology is related to his in-service MOS. Although there are conflicting medical opinions, the Board finds that, at the least, the evidence for and against the claims is in relative equipoise. When the evidence for and against a claim is in relative equipoise, by law, the Board must resolve all reasonable doubt in favor of the Veteran. See 38 U.S.C. § 1154(b); 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Therefore, the benefit of the doubt must be resolved in favor of the Veteran and entitlement to service connection for arthritis of the bilateral hands is warranted. P.M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. M. Stedman, 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.