Citation Nr: 21065187 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 17-22 008 DATE: October 25, 2021 REMANDED Entitlement to service connection for a right shoulder disability is remanded. Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a right elbow disability is remanded. Entitlement to service connection for a left elbow disability is remanded. Entitlement to service connection for a right wrist disability is remanded. Entitlement to service connection for a left wrist disability is remanded. Entitlement to service connection for a right hand disability is remanded. Entitlement to service connection for a left hand disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from March 1972 to April 1974. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in Waco, Texas. The issues presently on appeal were previously before the Board in March 2019, when they were remanded to the agency of original jurisdiction (AOJ) for additional development. After taking further action, the AOJ confirmed and continued the prior denials and returned the case to the Board. 1. Entitlement to service connection for a right shoulder disability. 2. Entitlement to service connection for a left shoulder disability. 3. Entitlement to service connection for a right elbow disability. 4. Entitlement to service connection for a left elbow disability. 5. Entitlement to service connection for a right wrist disability. 6. Entitlement to service connection for a left wrist disability. 7. Entitlement to service connection for a right hand disability. 8. Entitlement to service connection for a left hand disability. Although the Board regrets the additional delay, further development is necessary to ensure substantial compliance with the prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). When this case was remanded in March 2019, the Board requested that the Veteran be afforded a VA examination for purposes of obtaining a medical opinion with respect to the likelihood that he had disabilities of the shoulders, elbows, wrists, and/or hands that had their onset in service, were otherwise related to service, or were manifested within one year of his separation from service. The Veteran was afforded a VA examination in October 2019. After examining the Veteran and reviewing the record, the examiner opined that it was less than 50 percent likely that the Veteran had a diagnosis of "elbow," left wrist disability, right wrist disability, bilateral shoulder disability, left hand disability, or right hand disability that was incurred in or caused by his MOS (military occupational specialty) during service. In so doing, the examiner noted, in part, that the Veteran "clearly and unmistakably stated that his problems in the shoulders, elbows, hands and fingers began approximately 12 years ago." In July 2020, following the issuance of a supplemental statement of the case (SSOC), the Veteran objected to the examiner's findings. The Veteran noted, in part, that he never told the examiner that his problems started 12 years ago. Rather, he informed the examiner that that was when he started to complain about the unbearable agony he was experiencing. Because it appears that the examiner's opinion was premised, at least in part, on an inaccurate factual predicate, further development is necessary. In addition, the Veteran reported in October 2020 correspondence that he had had four new treating physicians in the past year. Because the records of that treatment could bear on the outcome of his appeal, efforts must be made to procure them. See, e.g., 38 C.F.R. § 3.159(e)(2) (if VA becomes aware of the existence of relevant records before deciding a claim, VA will, among other things, request that the claimant provide a release for the records). These matters are REMANDED for the following action: 1. Ask the Veteran to provide releases for relevant records of treatment from any new treating physicians. If he provides the necessary release(s), assist him in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact, and the Veteran and his representative should be notified. 2. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 3. After the foregoing development has been completed to the extent possible, make arrangements to have the Veteran scheduled for examinations of his shoulders, elbows, wrists, and hands. To the extent feasible, the examinations should be conducted by an examiner other than the examiner who evaluated the Veteran in October 2019. The entire claims file, including a copy of this remand, must be made available to the examiner, and the examiner should confirm that such records were reviewed. The examiner should identify any shoulder, elbow, wrist, and/or hand disabilities that have been present since approximately December 2014, when the Veteran filed his claim for service connection. The examiner should then indicate whether it is at least as likely as not (50 percent or greater probability) that any shoulder, elbow, wrist, and/or hand disabilities had their onset in service, are otherwise related to service, or manifested within one year of the Veteran's separation from service. The examiner must provide reasons for each opinion given. 4. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a SSOC. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Smith, 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.