Citation Nr: 21067020 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 15-08 356 DATE: November 3, 2021 ORDER Entitlement to service connection for a right elbow disability is granted. FINDING OF FACT The Veteran's disability manifested by right elbow pain had its onset in service. CONCLUSION OF LAW The criteria for service connection for right elbow pain have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1987 to April 1999. This matter is on appeal from an April 2013 rating decision issued by a Veterans Affairs (VA) Rating Office (RO) in St. Louis, Illinois. The Veteran testified before the undersigned Veterans Law Judge during a May 2018 hearing; a transcript of the hearing is of record. The Board remanded this claim in September 2018 and February 2021 for additional evidence, to include addendum opinions. Service Connection Service connection may be granted for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish service connection for a claimed disability, there must be evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship ("nexus") between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Certain chronic diseases (including arthritis) will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptoms since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). 1. Entitlement to service connection for degenerative joint disease (DJD) of the right elbow The Veteran claims entitlement to service connection for an elbow disorder. The evidence of record shows that the Veteran was diagnosed with medial epicondylitis and degenerative arthritis of the elbow. See September 2019 VA Examination. Accordingly, the first element of service connection has been met. Second, the Board finds there was an in-service injury. The Veteran testified his elbow pain began simultaneous with his wrist pain during service but medical focused only on the wrist pain. See May 2018 Hearing Transcript at p. 12. The Board finds the Veteran statements competent and credible because they are consistent with service treatment records (STRs). See February 1996 STRs. The Veteran was afforded several examinations during the period on appeal, each finding that the Veteran's elbow disability was less likely than not due to service. The June 2021 VA examiner found that the Veteran's elbow disability was referred pain from the Veteran's service-connected right carpal tunnel syndrome and found no aggravation of the elbow disability. The Federal Circuit held that "pain in the absence of a presently-diagnosed condition can cause functional impairment," which may qualify as a "disability" for VA compensation purposes. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Federal Circuit in Saunders, however, cautioned against the notion that "a veteran could demonstrate service connection simply by asserting subjective pain" because, to establish that a disability is present, the veteran "will need to show that... pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. "Functional impairment," the Federal Circuit noted, is defined as the inability of the body or a constituent part of it "'to function under the ordinary conditions of daily life including employment.'" Id. at 1363 (quoting 38 C.F.R. § 4.10). Notwithstanding, the Board finds that service connection for right elbow pain is warranted. Service treatment records corroborate the Veteran's reports of in-service elbow pain. The Board finds this testimony regarding the onset and continuation of symptoms to be competent and credible. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) ("A lay witness may testify as to his or her observations of the features or symptoms that a claimant exhibited."). In this matter, the Veteran has continuously asserted that he has experienced elbow pain during, and following, his service. The post-service medical records document the Veteran's reports of having a history of elbow pain during and since service. The Veteran filed for service connection for a right elbow disability just over one year from separation from service but failed to report to the examination. Resolving doubt in the Veteran's favor, the Board finds that the Veteran's right elbow pain, which constitutes functional impairment of earning capacity, had its onset in service. 38 C.F.R. § 3.303(a); Flynn v. Brown, 6 Vet. App. 500, 503 (1994) (noting that "the element of cause and effect has been totally by-passed in favor of a simple temporal relationship between the incurrence of the disability and the period of active duty"). Service connection is warranted for right elbow pain. As the Board finds that the criteria for service connection for this disability have been met, service connection for an elbow disability characterized as degenerative joint disease of the elbow is granted. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kelsey Love, 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.