Citation Nr: A21018447 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 210317-146547 DATE: November 18, 2021 ORDER Entitlement to service connection for a left wrist disability, diagnosed as residuals of a left ulnar styloid process fracture, as secondary to service-connected residuals of a left knee injury with reconstruction and degenerative changes, is granted. Entitlement to compensation pursuant to 38 U.S.C. §1151 for a left wrist disability is dismissed as moot. FINDINGS OF FACT 1. The preponderance of the evidence supports a nexus between the Veteran's left wrist disability and the service-connected residuals of a left knee injury with reconstruction and degenerative changes. 2. As service connection for a left wrist disability is warranted, no greater benefit is available pursuant to 38 U.S.C. § 1151 for the same condition. CONCLUSIONS OF LAW 1. The criteria for service connection for a left wrist disability, diagnosed as residuals of a left ulnar styloid process fracture, as secondary to the service-connected residuals of a left knee injury with reconstruction and degenerative changes, are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 2. The appeal for compensation pursuant to 38 U.S.C. § 1151 for a left wrist disability is dismissed as moot. 38 U.S.C. §§ 7104, 7105(d). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1985 to June 1987. This current appeal to the Board of Veteran's Appeals (Board) arose from an August 2020 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In this matter, the modernized review system, also known as AMA, applies. In March 2021, the Veteran appealed the decision, requesting a hearing before the Board. The requested hearing was conducted in April 2021 by a Veterans Law Judge. A transcript of the hearing is associated with the file. The Veteran also had the opportunity to submit additional evidence during or within 90 days after her hearing. Any evidence submitted before the hearing cannot be considered. Preliminarily, the Board notes that, in the August 2020 rating decision, the Agency of Original Jurisdiction (AOJ) adjudicated the issue of entitlement to service connection for a left wrist condition on a direct and secondary basis. Based on the evidence, the Board has recharacterized the issue on appeal as entitlement to service connection for a left wrist disability, as secondary to the service-connected left knee disabilityto include entitlement to compensation under 38 U.S.C. §1151. As will be explained further below, this recharacterization is more favorable to the Veteran. Further, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C.§ 7107(a)(2). Service connection may be established on a secondary basis for a disability which is proximately due to, the result of, or aggravated by a service-connected disease or injury. 38 U.S.C. § 1131; 38 C.F.R. § § 3.303, 3.310. In order to prevail on the theory of secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). Here, the Veteran seeks compensation for a left wrist condition. The evidence of the record shows, and the AOJ favorably found, that he has a current diagnosis of residuals of a left ulnar styloid process fracture. Service connection is in effect for residuals of a left knee injury with reconstruction and degenerative changes. Throughout the appeal, the Veteran has asserted that she injured her left wrist as a result of a fall due to her left knee symptoms. She explains that she is not able to properly bend her knee. When she fell, she used her hand to brace her fall, which resulted in the fracturing her left wrist. Regarding whether there is a nexus, the June 2019 VA examiner opined that it was less likely than not that the Veteran's left wrist condition was related to her service-connected left knee condition. The examiner stated that there is no evidence that the Veteran's left knee surgery or hardware caused her to fall and explained that, if it was a hardware failure, it would be expected that the Veteran's leg would have given away without falling forward with the need to catch herself with her hands outstretched, causing the fracture. Falling forward or tripping, as Veteran described, is from a trip or catch of the feet. In a January 2020 VA Treatment Note, the Veteran's doctor noted that she sustained frequent falls due to ongoing knee pathology and that the Veteran did not use a cane or walker as instructed. When her left knee gave out, she braced herself with her hand, which resulted in left wrist fracture. This was noted to be the third such type of event. See January 2020 VA Medical Treatment Records CAPRI. Other treatment records document her reports that her falls were a result from her left knee giving out. She provided this information when she reported her left wrist injury and associated symptoms. After a thorough consideration of the evidence of the record, the Board finds that the evidence supports that the Veteran's left wrist condition is related to (and has been specifically caused by) her service-connected left knee disability. The Board is aware of the June 2019 VA medical opinion. However, the Board gives more probative weight to the treatment records, specifically the January 2020 treatment note, authored by the Veteran's treating doctor of 10 years. The Veteran's assertions regarding her falls due to her left knee problems have been consistent, credible, and supported by the medical evidence of record. Thus, the Board finds that a nexus has been established between the Veteran's left wrist condition and her left knee disability. The Board notes that the Veteran filed her current left wrist claim as one for compensation under 38 U.S.C. § 1151. The United States Court of Appeals for Veterans Claims has stated that "a section 1151 claim 'constitutes a separate and distinct claim for VA benefits.'" Anderson v. Principi, 18 Vet. App. 371, 376-77 (2004). However, 38 U.S.C. § 1151 provides that, where a veteran sustains an injury or aggravation of an injury resulting in additional disability by reason of VA medical or surgical treatment, compensation shall be awarded "in the same manner as if such disability were service-connected." As the Board has awarded service connection for the Veteran's left wrist (as secondary to her service-connected left knee disability), consideration of her claim under the provisions of 38 U.S.C. § 1151 is moot. Entitlement to VA benefits under 38 C.F.R. § 1131 is the greater benefit, and it is granted in full. No additional benefit (monetary or otherwise) can be gained under 38 C.F.R. § 1151, nor does any controversy remain. Hornick v. Shinseki, 24 Vet. App. 50, 53-57 (2010); Timberlake v. Gober, 14 Vet. App. 122 (2000). Accordingly, the Veteran's left wrist claim under the 1151 theory of entitlement must be dismissed as moot. The Board reiterates that the criteria for service connection for a left wrist disability, as secondary to the service-connected left knee disability, are met. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Middleton, Associate 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.