Citation Nr: 21067191 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 18-37 751 DATE: November 3, 2021 REMANDED Issue of entitlement to service connection for right thumb first metacarpophalangeal joint arthritis is remanded. Issue of entitlement to service connection for bilateral tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1982 to December 1985. This appeal to the Board of Veterans' Appeals (Board) arose from an August 2015 rating decision issued by the Department of Veterans Affairs (VA). See December 2015 Notice of Disagreement (NOD); May 2018 Statement of the Case (SOC); July 2018 Substantive Appeal (VA Form 9). The Veteran testified before the undersigned Veterans Law Judge in an August 2021 hearing. See August 2021 Hearing transcript. 1. Issue of entitlement to service connection for right thumb first metacarpophalangeal joint arthritis is remanded. The Board cannot make a fully informed decision on the issue of entitlement to service connection for right thumb first metacarpophalangeal joint arthritis because additional development is needed. The Veteran testified during the August 2021 Board hearing that he received treatment for his right thumb at the Ralph H. Johnson VA Medical Center in Charleston, South Carolina, shortly after his separation in 1985. The earliest VA treatment evidence currently in the claims file is from 2005. The Board finds that an attempt to obtain the Veteran's available treatment records from the Ralph H. Johnson VA Medical Center is needed. The Board also finds that another opinion from a VA examiner is needed. The August 2015 VA examiner opined that the Veteran's current right thumb first metacarpophalangeal joint arthritis is less likely than not incurred in or caused by service. August 2015 VA Examination Medical Opinion. The examiner explained that the Veteran's in-service injury to his right thumb was to his "IP joint" and his current right thumb arthritis is on his "MCP joint." Id. The examiner found no evidence that the Veteran's injury during service is related to his current right thumb MCP joint arthritis. Id. However, the VA examiner did not have the benefit of the Veteran's August 2021 testimony in which he testified to continuing right thumb pain in service and since separation. See August 2021 Hearing Transcript. The Board, thus, finds that an addendum opinion from a VA examiner is needed to consider the Veteran's testimony and any additional VA treatment evidence obtained. 2. Issue of entitlement to service connection for bilateral tinnitus is remanded. The Board cannot make a fully informed decision on the issue of entitlement to service connection for tinnitus because further development through a VA examiner is needed. The August 2015 VA examiner found no evidence that the Veteran has or has had recurrent tinnitus. August 2015 VA Examination for Hearing Loss and Tinnitus. The VA examiner's finding is based, at least in part, on the Veteran's report of having only brief tinnitus every five months. However, during the August 2021 Board hearing, the Veteran testified that he has had ringing in his ear beginning sometime around 1997 to 1999. The Veteran testified that he would put his fingers in his ears until the ringing stopped and, more recently, the ringing lessened because he uses hearing aids. See id. In addition, the Veteran clarified that his duties during service involving being around saws and power tools on a daily basis without proper hearing protection. Id. The Board finds that an addendum opinion from a VA examiner should be obtained to consider and discuss the Veteran's testimony. In addition, the Veteran testified that he has had treatment at a VA treatment facility in 2020. Id. The most recent VA treatment records in the claims file is in 2017. An attempt to obtain any VA treatment records not already associated with the claims file is needed. The matters are REMANDED for the following action: 1. Ask the Veteran to identify the provider(s) of any evaluations and/or treatment received for his right thumb and tinnitus. The Veteran should be asked to provide authorizations for VA to obtain records of any such private treatment. If a provider does not respond to VA's request for the identified records sought, the Veteran must be so notified and reminded that it is ultimately his responsibility to ensure that private treatment records are received. The Regional Office (RO) should attempt to obtain complete clinical records of all pertinent evaluations and treatment (records of which are not already associated with the claims file) from the providers identified. The RO should specifically attempt to obtain treatment records referred to by the Veteran during the August 2021 Board hearing. This includes treatment records from the Ralph H. Johnson VA Medical Center since the Veteran's separation in 1985, and any treatment at a Myrtle Beach VA medical facility since 2015. The RO should document any efforts to obtain the evidence into the claims. If any records sought are unavailable, the reason for their unavailability must be noted in the claims file. 2. After the above development of the evidence is completed, obtain an addendum opinion from a medical professional to determine the nature and cause of the Veteran's right thumb first metacarpophalangeal joint arthritis. If the medical professional determines that it is necessary, schedule the Veteran for a VA examination. The medical professional should respond to the following: (a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's right thumb first metacarpophalangeal joint arthritis began in (or is otherwise related to) the Veteran's military service? The medical professional is also asked to discuss whether it is at least as likely as not that the circumstances of the in service injury which was severe enough to dislocate the Veteran's right thumb IP joint could also have affected his MCP joint and resulted in his current arthritis condition. A rationale is needed for any opinion given. 3. After the above development of the evidence is completed, obtain an addendum opinion to determine the nature and cause of tinnitus, if found. If the medical professional determines that it is necessary, schedule the Veteran for a VA examination. The medical professional should respond to the following: (a) Does the evidence support that the Veteran has or has had recurrent tinnitus since his March 2015 claim date? The medical professional should consider the Veteran's August 2021 testimony that his in-service duties involved being around saws and power tools on a daily basis without proper hearing protection, and that he has ringing in his ears since around 1997, which would less when he put his fingers in his ears or with use of hearing aids. (b) If the Veteran is found to have a current disability of recurrent tinnitus, is it at least as likely as not (a 50 percent or greater probability) that it began in (or is otherwise related to) the Veteran's military service? A rationale is needed. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Lin 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.