Citation Nr: 21068167 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 16-27 344 DATE: November 9, 2021 REMANDED Entitlement to service connection for right wrist carpal tunnel syndrome is remanded. Entitlement to service connection for left wrist carpal tunnel syndrome is remanded. Entitlement to service connection for a back disability, to include as secondary to the service-connected right ankle sprain and left ankle sprain/left sinus tarsi syndrome, is remanded. REASONS FOR REMAND The Veteran had active duty in the Naval Reserve from April 1977 to January 1980, and active service in the Navy from May 1981 to May 1983. These issues come before the Board of Veterans' Appeals (Board) on appeal from March 1995 and October 2014 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. Additional prior procedural history is set forth in the Board's September 2019 remand. In June 2019, the Veteran testified at a hearing before a Veterans Law Judge. A transcript of that hearing is of record. The Veterans Law Judge who conducted the June 2019 hearing is no longer with the Board. In September 2021, the Veteran was offered the opportunity to testify at another hearing but did not respond within 30 days as requested. The Board thus assumes that the Veteran does not want another hearing and proceeds accordingly. VA Examinations In September 2019, the Board remanded the Veteran's claims for additional development, to include VA examinations to determine the likely etiology of his bilateral wrist and back disabilities. However, the record reflects that the Veteran did not report for the scheduled examinations. See Exam Scheduling Request Contention Cancellations dated December 9, 2019. When entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, the claim shall be reviewed based on the evidence of record. See 38 C.F.R. § 3.655(b). Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, or death of an immediate family member. Id. Additionally, VA's established procedure for notifying claimants of VA examinations entitles it to the presumption of regularity that VA employees properly discharged their official duty to notify a veteran of the VA examinations. See Khyn v. Shinseki, 24 Vet. App. 228 (2011). Nevertheless, the Veteran's representative asserts that because notice of the examinations was insufficient, remand is warranted to reschedule the examinations with sufficient notice provided to the Veteran. See Appellate Brief received August 23, 2021 at pg. 2. It is unclear from the record whether the Veteran was provided adequate advance notice of his VA examinations. The evidence in that regard consists only of an examination scheduling request and a summary sheet indicating that the Veteran did not report for the examinations, with no other details. As advance notice of the examinations has not been associated with the electronic claims file, the Board is unable to determine the sufficiency thereof. Accordingly, the claims are remanded to afford the Veteran VA examinations and to obtain medical opinions addressing the likely etiology of the Veteran's bilateral wrist and back disabilities. The Board emphasizes that the Veteran maintains the ultimate burden to establish entitlement to service connection. See Fagan v. Shinseki, 573 F.3d 1282, 1287-88 (2009). The Veteran is advised that the failure to report for a VA examination or fully participate in the examinations could negatively affect his claims. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (VA's duty to assist is a two-way-street; an appellant who wants help cannot passively wait for it). The matters are REMANDED for the following actions: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Then, schedule the Veteran for a VA examination to determine the likely nature and etiology of his bilateral wrist disabilities. The claims file, and a copy of this Remand, must be made available to and be reviewed by the examiner. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner must address the following: (a) Provide a diagnosis for each right and/or left wrist disability demonstrated during or proximate to the claim period. (b) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a right and/or left wrist disability related to his active service. The examiner must address the Veteran's diagnoses of right wrist carpal tunnel syndrome and cubital tunnel syndrome. The examiner must also address the Veteran's testimony that he was a teletype operator in his military occupational specialty (MOS) as a Radioman, which he asserts caused his bilateral wrist disability. A complete rationale must be provided for all opinions rendered. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of his back disability. The claims file, and a copy of this Remand, must be made available to and be reviewed by the examiner. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner must address the following: (a) Provide a diagnosis for each back disability demonstrated during or proximate to the claim period. (b) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a back disability that is related to the Veteran's active service. (c) If not, whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a back disability that was CAUSED by the service-connected disabilities, to specifically include his service-connected right ankle sprain and left ankle sprain/left sinus tarsi syndrome. (d) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a back disability that was AGGRAVATED by the Veteran's service-connected disabilities, to specifically include his service-connected right ankle sprain and left ankle sprain/left sinus tarsi syndrome. *Any increase/aggravation is sufficient; permanent aggravation is NOT required. See Ward v. Wilkie, 31 Vet. App. 233, 239-240 (2019) (permanent worsening is not a requirement for secondary service connection of a non-service-connected injury or disease). The VA examiner must provide separate findings and rationales relating to causation and aggravation. A complete rationale must be provided for all opinions rendered. 4. Thereafter, ensure that the examiner(s) has substantially responded to the questions posed by the Board, and if not, take corrective action. Then, readjudicate the remanded claims. L. Chu Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Farrell, 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.