Citation Nr: A21016646 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 200518-84404 DATE: October 13, 2021 ORDER Service connection for bilateral carpal tunnel syndrome is denied. FINDING OF FACT The preponderance of the evidence weighs against finding that the Veteran has bilateral carpal tunnel syndrome that is causally related to his service. CONCLUSION OF LAW The criteria for service connection for bilateral carpal tunnel syndrome have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served during the Gulf War Era in the Army from November 2001 to November 2017. This matter was appealed to the Board from a March 2020 rating decision via a May 2020 VA Form 10182 (Notice of Disagreement) under the Direct Review appeal lane. Service connection for bilateral carpal tunnel syndrome Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a disability, the veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The April 2020 rating decision contains the favorable finding that the Veteran has a current disability of bilateral carpal tunnel syndrome. The Veteran's service treatment records (STRs) include no complaints of or treatment for carpal tunnel syndrome nor do they show that there was any manifestation of symptoms during service. The Veteran has not identified a specific in-service event or incidence which caused his bilateral carpal tunnel syndrome. The Veteran has not submitted any evidence that either posits or substantiates a causal relationship (nexus element) between his bilateral carpal tunnel syndrome and his service. No medical professional has attributed the Veteran's carpal tunnel syndrome to his service, nor is the Veteran or his representative competent to assert such a link. See Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007). In sum, as there is no evidence of an in-service incurrence of this disability or of a causal relationship between this disability and the Veteran's service, service connection cannot be granted on a direct basis and this claim must be denied. 38 C.F.R. § 3.303. The Board observes that the Veteran has not been afforded a VA examination in connection with this claim. However, the low threshold that triggers VA's duty to provide a VA examination has not been met. A VA examination is only required when necessary to decide a claim. Despite the permissive language of VA's duty to assist, the Court has stated that "[i]f Congress had wanted the Secretary to automatically provide an examination on all possible theories, then section 5103A would not read the way it does." Robinson v. Peake, 21 Vet. App. 545, 553 (2008); see also Waters v. Shinseki, 601 F.3d 1274, 1278-79 (Fed. Cir. 2010) (a claimant's mere "conclusory generalized statement" that an in-service illness caused his current disability did not trigger VA's requirement to obtain an examination, and it rejected the theory "that medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues"). The Veteran has only generally asserted that direct service connection is warranted for bilateral carpal tunnel by filing a claim for benefits and pursuing this appeal to the Board. He has provided no evidence to include lay testimony pertaining to the in-service incurrence or nexus elements of his service connection claim. Therefore, the Regional Office did not err in its duty to assist by failing to provide a VA examination in connection with this claim. McLendon v. Nicholson, 20 Vet. App. 79, 8186 (2006). See also 38 U.S.C. § 5103A (d)(2); 38 C.F.R. § 3.159 (c)(4)(i). Considering the foregoing, the Board finds that the preponderance of the evidence is against the service connection claim for bilateral carpal tunnel syndrome and the claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kyle McKone 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.