Citation Nr: 21070121 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 15-45 699 DATE: November 23, 2021 REMANDED Entitlement to service connection for a left wrist disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1977 to July 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board last remanded the issue on appeal in May 2021. However, the Board finds that remand is necessary for additional development as discussed below. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for a left wrist disability is remanded. The Veteran seeks service connection for a left wrist disability. See November 2014 VA Form 21-526. Specifically, the Veteran contends he injured his left wrist in service when he fell from a bicycle and has experienced left wrist pain since service. See January 2016 statement of accredited representative; December 2019 VA examination. Unfortunately, the Board finds that additional development must be undertaken before this claim can be adjudicated on the merits. Stegall, 11 Vet. App. at 271. The Veteran was afforded VA examinations in June 2015 and December 2019. However, the Board previously determined the June 2015 and December 2019 VA medical opinions inadequate for decision-making purposes. Specifically, the Board found the June 2015 and December 2019 VA examiners did not address the Veteran's competent and credible lay statements indicating he has experienced left wrist pain since his separation; and that the VA examiners failed to explain why the Veteran's left wrist disability was due to his post-service occupation given he has reduced range of motion of the left wrist, while the right wrist has range of motion within normal limits Most recently, in its May 2021 remand, the Board directed the RO to obtain an addendum medical opinion to address whether it is at least as likely as not that the Veteran's left wrist disability had its onset in service or is otherwise etiologically related to active service. The Board also directed the examiner to address the Veteran's lay statements indicating he has experienced left wrist pain since service and that his right wrist does not have reduced range of motion. The Veteran was afforded an addendum VA examination and medical opinion in July 2021. The VA examiner noted the Veteran has a current diagnosis of a chronic left wrist sprain. See July 2021 VA examination. The VA examiner opined that it was less likely than not that the Veteran's left wrist disability was incurred in or caused by the claimed in-service, injury, or illness. Id. As rationale, the VA examiner acknowledged the Veteran injured his left wrist in April 1978 during service while riding his bicycle; however, the VA examiner noted there was no fracture indicated upon X-ray at the time. Id. The VA examiner noted the injury was 43 years ago and there were no subsequent complaints or continuity of care. Id. However, the VA examiner did not address the Veteran's statements regarding experiencing left wrist pain since service as directed in the prior Board's remand directives. Moreover, a December 2014 VA treatment record notes the Veteran's report of a history of wrist pain since service and "residual distal Radio Ulnar pain off and on." Additionally, the Board notes that while pain alone may not constitute a disability, pain may rise to a level of functional impairment that impacts earning capacity, which would then qualify pain as a disability. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). In this case, there is competent evidence of chronic left wrist pain, and therefore potential presence of a disability under Saunders that is related to the Veteran's in-service left wrist injury. As such, remand is necessary to obtain an addendum medical opinion. Stegall, 11 Vet. App. at 271. The matters are REMANDED for the following action: 1. Forward the record a copy of this Remand to the examiner who provided the July 2021 medical opinion, or, if that examiner is unavailable, to another suitably qualified examiner for completion of an addendum opinion to determine the nature and etiology of the Veteran's left wrist disability. If the examiner determined that a new examination is necessary to provide the requested opinion, such examination should be scheduled. The examiner should address whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's left wrist disability is related to an in-service injury, event, or disease, to include the Veteran's in-service left wrist injury for a bicycle accident. A complete rationale should be given for all opinions and conclusions expressed. The examiner must address the Veteran's in-service left wrist injury. See April 1978 service treatment records. The examiner must also address the Veteran's lay statements and December 2014 VA treatment record, indicating the Veteran's report of experiencing left wrist pain since service. The examiner must address the findings that demonstrate the Veteran's left wrist had more limitation of motion and pain on examination, as compared to the uninjured right wrist. In responding to the above, the examiner should state whether there is any medical reason to accept or reject the proposition that the in-service left wrist injury could have led to the current left wrist disability. Please explain your answer. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Carlin 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.