Citation Nr: 21067281
Decision Date: 11/03/21	Archive Date: 11/03/21

DOCKET NO. 12-14 401
DATE: November 3, 2021

REMANDED

Entitlement to service connection for a right middle finger disability is remanded.

REASONS FOR REMAND

The Veteran served on active duty from August 1990 to August 1991 and from October 2001 to September 2002, with additional Reserve service.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2009 rating decision.  The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in September 2018.  A transcript of that hearing is of record.  This matter has remanded by the Board several times, most recently in July 2021.  

1. Entitlement to service connection for a right middle finger disability is remanded.

The August 2021 VA examination provided a negative opinion, stating that no chronic diagnosis is made for right middle finger disability, the objective exam is normal, and the Veteran's symptoms are subjective only. The examiner noted that a diagnosis was not rendered for either the left or right middle finger, and that physical exam did not reveal significant abnormal findings on either side. The examiner noted that all abnormal data was subjective only. This opinion is not consistent with the March 2021 examination, which noted that while the Veteran does not have a left middle finger disability, he had reduced range of motion in the right long finger, and noted that the right hand exhibited pain with range of motion. The Veteran reported that ever since his right middle finger was fractured during service, the range of motion of his right middle finger has been reduced. Upon remand, a new examination should be obtained that considers the findings in March 2021 examination, as well as the possibility of the Veteran's finger pain causing functional impairment that constitutes a disability even if there is no underlying diagnosis. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018).

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination to obtain an opinion as to the nature and likely etiology of any right middle finger disability. Copies of all pertinent records must be made available to the examiner for review.

The examiner is asked to provide a response to the following: 

(a.) Identify all diagnosed right middle finger disabilities. Reconcile any findings regarding a right middle finger disability with the March 2021 VA examination finding reduced range of motion of the right middle finger and painful range of motion of the right hand. 

(b.) If no specific right middle finger disability is diagnosed, the examiner whether any related pain results in functional impairment of earning capacity. Reconcile any findings regarding a right middle finger disability with the March 2021 VA examination finding reduced range of motion of the right middle finger and painful range of motion of the right hand.

(c.) For each diagnosed right middle finger disability or identified functional impairment of the right middle finger, is it at least as likely as not (50 percent or greater probability) related to service, to include fracturing his right middle finger in June 1982 in the line of duty during a period of active duty for training (ACDUTRA)?

The opinion offered must be supported by a complete rationale. The Board recognizes that the Veteran has at times reported a left middle finger disability related to a left middle finger injury in service, and at other times has reported a right middle finger injury caused by a right middle finger injury in service. The Board has characterized this claim as for a right middle finger disability as an injury of the right middle finger is most supported by the medical record. 

 

M.E. Larkin

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Budd, 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.