Citation Nr: 21069235 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 16-05 064 DATE: November 17, 2021 REMANDED Entitlement to service connection for a right upper extremity disability is remanded. INTRODUCTION The Veteran had active service from June 29, 1976 to March 26, 1985; March 19, 2007 to April 27, 2008; January 3, 2011 to June 19, 2011; and March 20, 2012 to November 5, 2012. In November 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that proceeding is of record. When this case was previously before the Board in June 2019, June 2020, and July 2021, the above-noted issue was remanded for additional development. The case has since been returned to the Board for further appellate review. REASONS FOR REMAND The Veteran recently underwent a VA peripheral nerves examination in August 2021, wherein the examiner found insufficient evidence to warrant a diagnosis of a right upper extremity neurological disorder. This finding was consistent with the prior February 2021 VA examination. However, as noted in the Board's June 2019 remand, the RO has not properly developed the claim to determine whether the Veteran may have a service-connected right arm musculoskeletal disability. In this respect, the Board notes that during his November 2018 hearing, the Veteran reported experiencing injuries to his right elbow as a result of both a July 2012 fall, and numerous injuries incurred during his time loading and unloading aircraft. A review of the Veteran's outpatient treatment notes from the Pueblo VA Community Based Outpatient Clinic shows the Veteran underwent an x-ray in November 2015, at which time he was diagnosed with right elbow degenerative joint disease. Likewise, the Veteran was diagnosed with right elbow degenerative joint disease, as well as epicondylitis following a November 2015 VA examination. Unfortunately, to date the RO has not obtained a medical opinion addressing the Veteran's contention that his current right arm disability was caused by injuries sustained in service. Therefore, the Board finds a remand is again required. Accordingly, the case is REMANDED for the following action: Obtain a VA elbow and forearm conditions examination by an Orthopedic Specialist with sufficient experience and expertise to address the etiology of the Veteran's claimed right upper extremity disability. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether any diagnosed right upper extremity disability, to specifically include right elbow degenerative joint disease or epicondylitis, at least as likely as not (a 50 percent probability or greater) originated during his period of active service or are otherwise etiologically related to his active service. Following a review of the relevant records and lay statements, the appropriate examiner should also state an opinion with respect to whether the Veteran's right upper extremity disability at least as likely as not (a 50 percent probability or greater): a) was caused by his cervical spine disability; or b) was worsened to any degree by his cervical spine disability. The examiner must provide a complete rationale for all proffered opinions. In this respect, the examiner must discuss and consider the Veteran's competent lay statements. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Fraser, 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.