Citation Nr: 21065887 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 15-01 570 DATE: October 27, 2021 REMANDED Entitlement to service connection for arthritis of multiple joints is remanded. Entitlement to service connection for an elbow disability is remanded. Entitlement to service connection for a bilateral shoulder disability is remanded. Entitlement to service connection for a bilateral wrist disability, including carpal tunnel syndrome (CTS), is remanded. Entitlement to service connection for a right-hand disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1959 to September 1961. The issues come before the Board of Veterans' Appeals (Board) on appeal from a June 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2013, the Veteran testified at a Decision Review Officer (DRO) hearing. A transcript of the hearing is of record. The Veteran was scheduled for a Board hearing before a Veterans Law Judge (VLJ) in November 2016 but did not report. As the record does not contain an explanation regarding his absence or a request to reschedule the hearing, the Board deems the Veteran's request for a Board hearing to be withdrawn. 38 C.F.R. § 20.704 (d). The issues were previously before the Board in July 2017 and January 2021 and were remanded. In January 2021, the Board found that the Veteran had good cause for his failure to report to his scheduled VA examination. Thus, the Board remanded the issues for the RO to reschedule the Veteran for VA examinations in New Jersey, close to where he relocated. The Veteran was afforded examinations in July 2021. As is explained further below, the Board finds the examinations inadequate, and therefore, there has not been substantial compliance with the remand directive. Stegall v. West, 11 Vet. App. 268, 271 (1998). As an aside, in its July 2017 remand, the Board noted that the Veteran filed claims for service connection for arthritis in specific parts of the body, i.e., the elbow, right hand, and shoulders, as well as a claim for arthritis generally. The current claims for the elbow, right hand, shoulders, and wrists encompass claims for arthritis in those respective joints and the Board interpreted the Veteran's general arthritis claim to encompass all other joints of the body not specifically mentioned. 1. Entitlement to service connection for arthritis of multiple joints is remanded. 2. Entitlement to service connection for an elbow disability is remanded. 3. Entitlement to service connection for a bilateral shoulder disability is remanded. 4. Entitlement to service connection for a bilateral wrist disability, to include CTS, is remanded. 5. Entitlement to service connection for a right-hand disability is remanded. The Veteran contends that he has arthritis of multiple joints and disabilities of the elbow, bilateral shoulder, right hand, and bilateral wrist, including CTS, all of which were incurred in service from his working with heavy equipment, including the lifting thereof. During his DRO hearing, he competently and credibly testified that he hid "his pain or injury in service, as he was young and just tried to his job." The Veteran post-service treatment record shows arthritis in the elbow, subacromial impingement, degenerative acromioclavicular changes of the right shoulder, degenerative joint disease of the left shoulder, CTS of the wrists and right hand, and arthritis in the bilateral knees, the left hand, both feet, and bilateral ankles. The Veteran was afforded VA examinations in July 2021. For each claimed disability, the examiner proffered a negative nexus to service and explained that there was "[n]o chronic diagnosis [for the disabilities]. [The] objective exam is normal. Symptoms are subjective only. A nexus has not been established." The Board finds this examination incomplete. The examiner failed to consider the evidence of record, including the Veteran's diagnosis of arthritis of the bilateral shoulders, right hand, elbow arthritis, shoulders, and CTS of the right hand, which were rendered during the period on appeal. The requirement of a current disability is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of that claim. McClain v. Nicholson, 21 Vet. App. 319 (2007). As there is yet no current adequate medical opinion of record, supplemental opinions are warranted. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). Accordingly, the matters are REMANDED for the following action: 1. Provide the Veteran's claims file to a qualified clinician to provide a supplemental opinion addressing the nature and etiology of arthritis of multiple joints, whether it may have been resolved or not, during the appeal period. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician's attention to the Veteran's September 2013 DRO hearing testimony. The clinician is asked to opine as to whether the Veteran has arthritis of multiple joints that is at least as likely as not (50 percent or greater probability) began during active service or related to any incident therein or began within one year of service. The clinician must provide a complete rationale for his or her opinion(s) in the examination report that reflects consideration of all pertinent evidence of record, including the Veteran's lay statements. If any of the above-requested opinions cannot be made without resorting to speculation, the clinician must state this and provide a rationale for such a conclusion. 2. Provide the Veteran's claims file to a qualified clinician to provide a supplemental opinion addressing the nature and etiology of the Veteran's elbow disability, whether it may have been resolved or not, during the appeal period. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician's attention to the following: a. The Veteran's September 2013 DRO testimony. b. August 2014 VA treatment record noting X-ray results indicated arthritis of the elbow. c. December 2014 VA treatment record noting the Veteran's history of olecranon bursitis. The clinician is asked to opine as to whether the Veteran has an elbow disorder that is at least as likely as not (50 percent or greater probability) began during active service or related to any incident therein or if arthritis is diagnosed whether it was within one year of service. The clinician must provide a complete rationale for his or her opinion(s) in the examination report that reflects consideration of all pertinent evidence of record, including the Veteran's lay statements. If any of the above-requested opinions cannot be made without resorting to speculation, the clinician must state this and provide a rationale for such a conclusion. 3. Provide the Veteran's claims file to a qualified clinician to provide a supplemental opinion addressing the nature and etiology of the Veteran's bilateral shoulder disability, whether it may have been resolved or not, during the appeal period. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician's attention to the following: a. The Veteran's September 2013 DRO testimony. b. June 2014 VA treatment record noting X-ray results indicated arthritis of the bilateral shoulders. c. November 2014 VA treatment record noting imaging revealed the degenerative joint disease of the left shoulder. The clinician is asked to opine as to whether the Veteran has a bilateral shoulder disability that is at least as likely as not (50 percent or greater probability) began during active service or related to any incident therein or if arthritis is diagnosed whether it was within one year of service. The clinician must provide a complete rationale for his or her opinion(s) in the examination report that reflects consideration of all pertinent evidence of record, including the Veteran's lay statements. If any of the above-requested opinions cannot be made without resorting to speculation, the clinician must state this and provide a rationale for such a conclusion. 4. Provide the Veteran's claims file to a qualified clinician to provide a supplemental opinion addressing the nature and etiology of the Veteran's bilateral wrist disorder, whether it may have resolve or not, during the appeal period. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician's attention to the following: a. STR dated in September 1961, noting the Veteran's complaint of pain in his left wrist. b. August 2006 VA treatment record noting osteoarthritic changes of the left. c. December 2009 VA treatment record noting that the Veteran had been wearing bilateral carpal tunnel braces for his wrists at night. d. The Veteran's September 2013 DRO testimony. e. November 2014 VA treatment record noting a history of severe right wrist degenerative joint disease. f. August 2014 VA treatment record noting X-ray results indicated arthritis of the right wrist. The clinician is asked to opine as to whether the Veteran's bilateral wrist disability is at least as likely as not (50 percent or greater probability) began during active service or related to any incident therein or if arthritis is diagnosed, whether it was within one year of service. The clinician must provide a complete rationale for his or her opinion(s) in the examination report that reflects consideration of all pertinent evidence of record, including the Veteran's lay statements. If any of the above-requested opinions cannot be made without resorting to speculation, the clinician must state this and provide a rationale for such a conclusion. 5. Provide the Veteran's claims file to a qualified clinician to provide a supplemental opinion addressing the nature and etiology of the Veteran's right-hand disability, whether it may have been resolved or not, during the appeal period. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician's attention to the following: a. The Veteran's September 2013 DRO testimony. b. July 2014 VA treatment record noting the Veteran's diagnosis of CTS of the right hand c. September 2014 VA treatment record noting complaints of numbness in his right hand and the clinician's note of severe atrophy of the right thenar eminence. The clinician is asked to opine as to whether the Veteran's right-hand disability is at least as likely as not (50 percent or greater probability) began during active service or related to any incident therein or if arthritis is diagnosed, whether it was within one year of service. The clinician must provide a complete rationale for his or her opinion(s) in the examination report that reflects consideration of all pertinent evidence of record, including the Veteran's lay statements. If any of the above-requested opinions cannot be made without resorting to speculation, the clinician must state this and provide a rationale for such a conclusion. DUSTIN L. WARE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Stevens, 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.