Citation Nr: A21017522 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 190719-24676 DATE: October 29, 2021 REMANDED Entitlement to service connection for a left hand disability, to include as secondary to a left hand scar, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1987 to July 1990 and from January 1991 to March 1991. This matter is before the Board of Veterans' Appeals (Board) on appeal from a supplemental claim decision issued in March 2019 by a Department of Veterans Affairs (VA) Regional Office (RO). By way of background, the RO denied entitlement to service connection for a left hand disability, among others, in a legacy rating decision issued in August 2017. The Veteran then subsequently perfected an appeal of that issue only to the Board. 38 C.F.R. § 20.302 (2018). On August 23, 2017, the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA), was signed into law. Pub. L. No. 115-55 (codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017). This law created a new framework for Veterans dissatisfied with VA's decision on their claim to seek review. The Veteran chose to participate in VA's test program for the AMA, the Rapid Appeals Modernization Program ("RAMP"), by submitting a RAMP election form in January 2019, which was accepted by the RO in February 2019 correspondence. In accordance with the Veteran's RAMP election form, the Agency of Original Jurisdiction (AOJ) issued a supplemental claim RAMP rating decision in March 2019. 38 C.F.R. §§ 3.2400(a)(2), (c)(1), 19.2(d). In July 2019, the Veteran appealed the denial of service connection to the Board and requested a hearing before a Veterans Law Judge (VLJ). 38 C.F.R. §§ 3.2500(a)(1)(ii), 20.202, 20.203. The Veteran testified at a hearing before the undersigned VLJ in June 2021, and a transcript of that hearing is of record. As the Veteran requested a hearing, the Board will base its decision on the evidence of record at the time of the rating decision on appeal as well as all evidence received from the Veteran either at the hearing or within 90-days after the hearing. 38 C.F.R. §§ 20.300, 20.302. As a final matter, the Board notes that during his hearing the Veteran asserted that he wanted to be compensated for loss of motion and stiffness in the left hand as symptoms of his left hand scar, and that he never intended to file a claim for arthritis. However, ultimately the current claim on appeal is one for service connection, and as a claim for service connection requires the presence of a diagnosed disability the Board must continue to address the only other diagnosed left hand disability, i.e. arthritis. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). If the Veteran believes that his already service-connected left hand scar is manifested by additional symptoms which should be compensated, the appropriate action would be to file a claim for an increased rating claim for the left hand scar. Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is remanding the claim on appeal for further development, this additional evidence will be considered by the RO in the adjudication of those claims. 1. Entitlement to service connection for a left hand disability. Prior to the issuance of the March 2019 decision on appeal, VA obtained an opinion concerning the etiology of the Veteran's left hand disability in August 2017. While the opinion clearly addressed whether the diagnosed hand disability was directly related to the in-service laceration or caused by the currently service-connected left hand scar, the examiner did not specifically address whether the left hand disability was aggravated by the Veteran's left hand scar. El-Amin v. Shinseki, 26 Vet. App. 136, 14041 (2013); see also Allen v. Brown, 7 Vet. App. 439 (1995). As the obtained opinion was inadequate, the Board finds that a pre-decisional duty to assist error occurred and therefore a remand is required so that a new opinion may be obtained. 38 C.F.R. § 20.802(a). The matters are REMANDED for the following action: 1. Obtain an addendum opinion from the examiner who provided the August 2017 VA hand examination, or another appropriate medical professional if the examiner is unavailable. The examiner should answer the following: Is it at least as likely as not (a fifty percent probability or greater) that the left hand disability was aggravated (worsened) by the left hand scar? A detailed rationale for the opinion must be provided. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Wendell, 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.