Citation Nr: 21072019 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 16-48 300 DATE: December 2, 2021 ORDER Entitlement to service connection for a left hand condition is granted. Entitlement to service connection for a left wrist condition is granted. FINDINGS OF FACT 1. The Veteran's left hand symptoms started during active service and continued to present. 2. The Veteran's left wrist symptoms started during active service and continued to present. CONCLUSIONS OF LAW 1. The criteria to establish service connection for a left hand condition have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria to establish service connection for a left wrist condition have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1972 to September 1984. The Veteran appealed a March 2015 rating decision by the Agency of Original Jurisdiction (AOJ). In November 2018 and June 2021, the Board of Veterans' Appeals (Board) remanded the Veteran's claims to the AOJ for further action consistent with the Board's remand directives. The claims are back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The June 2021 Board decision expanded the claims to encompass a left wrist condition. The Board notes that an October 2021 rating decision granted service connection for right thumb IP and MCP joint chronic strain. The Board notes the MCP joint pertains to the hand. The grant was based on the September 2021 opinion finding the Veteran's "right hand and thumb/CMC condition at least as likely as not" had its onset during service. The Board finds this a full grant of benefits regarding service connection for a right hand condition. The Veteran has not expressed further disagreement with the October 2021 rating decision. As such, the Board finds that the issue regarding the right hand is no longer on appeal. A veteran is entitled to Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). As an initial matter, the previous Board decision noted that the evidence suggested a possibility that the Veteran's conditions pre-existed service. However, the November 1972 entrance examination in the Veteran's service treatment records (STRs) did not note any then-current hand or wrist condition. Although the entrance report of medical history noted a previous left wrist fracture, the examiner ultimately found that the condition healed and did not note an existing residual condition. As such, the Board finds that the presumption of soundness is not rebutted and attaches. The Veteran has osteoarthritis of the left hand and left wrist. See September 2021 examination reports. The Veteran stated that his military duties entailed maintenance and supply, and that he had to constantly utilize his hands while copying up to 100 documents a day over a decade. See August 2016 VA Form 9; November 2019 and July 2020 correspondence. The Veteran was treated for various injuries to the left finger and hand during service. See, e.g., April 1974 and March 1979 STRs. The Veteran's July 1984 report of medical history in the STRs noted swollen and painful joints. As to nexus, the January 2020 examination reports noted an onset date in the 1970s and that the pain progressed and worsened until the Veteran had to get left wrist surgery in 2001. The Veteran also stated that he noted swollen and painful joints upon discharge and that he continued to have constant pain to present. See August 2016 VA Form 9. The Veteran stated he put off seeing a doctor until the pain became unbearable and that his post-service job did not require extensive use of his hands. See March 2015 notice of disagreement (NOD). Overall, the Veteran entered service without any left hand or left wrist condition. The Veteran would injure his left hand during service and constantly used his hands to complete daily duties for many years during service. The Veteran competently stated his pain started during service and continued to present. The Board finds the Veteran's statements credible. Medical evidence indicates that the Veteran's left hand and left wrist conditions started during service, continued to worsen after service, and eventually led to surgery. The Board finds that the evidence is at least in equipoise as to whether the Veteran's left hand and left wrist conditions had their onset in service. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's left hand and left wrist conditions originated during service and continued to present. Accordingly, service connection for left hand and left wrist conditions is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Zheng, 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.