Citation Nr: 21065202 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 19-21 699 DATE: October 25, 2021 REMANDED The issue of entitlement to service connection for the residuals of cold injuries to the right and left hands is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1975 to November 1978. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Jurisdiction is currently with the RO in Montgomery, Alabama. The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) in December 2020. A transcript of the hearing is of record. The Board notes that the Veteran previously filed claims of entitlement to service connection for neuropathy and residuals of cold injury of right hand and entitlement to service connection for neuropathy and residuals of cold injury of left hand that were denied in a December 2012 Statement of the Case. The Veteran was notified of that denial in December 2012 and, as the Veteran neither submitted a VA Form 9 or other correspondence containing necessary information for an appeal within the expiration of the year following the rating decision or within 60 days of the Statement of the Case, it became final. Pursuant to 38 C.F.R. § 3.156, a claimant may reopen a finally adjudicated claim by submitting new and material evidence. The Board finds that such evidence has been received and it will reopen the pending claim for service connection. As such, the case is in a posture such that the Veteran's claim may be addressed on its merits. Entitlement to service connection for the residuals of cold injuries to the right and left hands is remanded. The Veteran contends that he has residuals of cold injuries to the right and left hands as a result of exposure to extremely cold weather while on guard duty. In this regard, the evidence of record includes an October 2010 VA Peripheral Nerves Examination report in which the examiner diagnosed the Veteran with bilateral upper extremity carpal tunnel syndrome and ulnar nerve entrapment. However, the examiner did not adequately address the issue of whether the Veteran has residuals of cold injuries to the right and left hands related to service. The Veteran's service treatment records (STRs) document the Veteran's complaints of his hands hurting in the cold, and treatment for warts, growths, legions, and keloids, including nitrogen cryotherapy. VA treatment records document a history of cold injury residuals. The Veteran testified during the December 2020 Board hearing that he has continued to have symptoms including numbness, tingling, sweating, and pain since service. As the October 2010 VA examination was inadequate and the medical evidence suggests that the Veteran may have cold injuries to the right and left hands related to service, the Board finds that an additional VA examination should be provided on remand. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (stating that, when VA undertakes to provide a veteran with an examination, that examination must be adequate for VA purposes). See also McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). (VA must provide an examination when there is competent evidence of a disability, or persistent or recurrent symptoms of a disability, that may be associated with an in-service event, injury, or disease, but there is insufficient information to make a decision on the claim.) The matters are REMANDED for the following action: 1. Request that the Veteran provide or authorize VA to obtain records of his relevant treatment that have not yet been associated with the claims file, to include a positive nexus opinion from Dr. Ingraham the Veteran referenced during his Board hearing, and associate with the claims file any outstanding VA treatment records. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of his residuals of cold injuries to the right and left hands. The claims file (including any additional medical evidence obtained as a result of this Remand) should be made available to the examiner and review of the file should be noted in the requested report. The examiner should record the full history of the identified disability, including the Veteran's competent account of his symptoms. Following review of the claims file and examination of the Veteran the examiner should respond to the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran has residuals of cold injuries to the right and left hands that had its onset during active service or within one year of the Veteran's separation from active service, or is otherwise related to service? Please address all current diagnoses. The examiner is asked to discuss the Veteran's contention that he has residuals of cold injuries to the right and left hands as a result of exposure to extremely cold weather while on guard duty and his contention that he has had numbness, tingling, sweating, and pain since service. The examiner is also asked to discuss complaint of hands hurting in the cold; and offer an opinion as to whether the treatment the Veteran has undergone for warts, growths, legions, and keloids, including nitrogen cryotherapy documented in the STRs, is at least as likely as not related to cold injuries the Veteran asserts he sustained. If feasible, the examiner is asked to differentiate the symptoms attributable to carpal tunnel syndrome from those attributable to a history of cold injuries. All findings and conclusions should be supported with a complete rationale and set forth in a legible report, which should reflect the examiner's consideration and analysis of both the medical and lay evidence of record. If it is not possible to provide an opinion without resort to speculation, the reason that is so should be explained, indicating whether there is additional evidence that could enable an opinion to be provided or whether the inability to provide an opinion is based on the limits of medical knowledge. S.C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith-Jennings, 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.