Citation Nr: 21072547 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 15-34 676 DATE: December 3, 2021 REMANDED Entitlement to service connection for a right shoulder condition is remanded. Entitlement to service connection for carpal tunnel syndrome of the right wrist is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1982 to June 1989. These matters are before the Board of Veterans' Appeals (Board) on appeal from a March 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in January 2019. A transcript of the hearing is of record. These matters were previously before the Board in July 2019 when they were remanded for further development. Although the additional delay is regrettable, the Board finds an additional remand is required before a decision can be made on the Veteran's claims. 1. Entitlement to service connection for a right shoulder condition is remanded. In December 2019, a VA examiner opined that the Veteran's right shoulder condition was not related to her active service. The examiner noted that the Veteran sustained an acute right shoulder contusion during service due to a motor vehicle accident but indicated that there were no further or ongoing right shoulder complaints or diagnoses during service. The examiner indicated that the Veteran's in-service right shoulder contusion resolved without sequelae and involved only soft tissue. Additionally, the examiner noted that there were no complaints of right shoulder pain until 2005, when the Veteran sustained a right shoulder rotator cuff tear due to injury at that time. The Board, however, finds the opinion inadequate as the examiner failed to address pertinent evidence of record. Specifically, although the examiner indicated that the Veteran did not have any ongoing complaints of right shoulder pain during service, the Veteran's March 1989 separation examination report reflects that the Veteran reported persistent right shoulder pain. As this evidence was not addressed, the Board finds remand for a new medical opinion is required. 2. Entitlement to service connection for carpal tunnel syndrome of the right wrist is remanded. During the January 2019 Board hearing, the Veteran's representative argued that carpal tunnel syndrome first appears with symptoms of numbness and tingling in the fingers, noting that the Veteran's service treatment records contain such reports. A January 1984 service treatment record reflects that the Veteran reported intermittent tingling and weakness in the right hand and thumb. In addition, the Veteran complained of pain and numbness in the right wrist and digits two and three. She was diagnosed with recurrent ganglion cyst. In December 2019, a VA examiner opined that the Veteran's carpal tunnel syndrome was not related to her active service. In support of the opinion, the examiner noted that the Veteran had recurrent right wrist ganglion cyst in service but no documented symptoms or diagnosis of right carpal tunnel syndrome during service, including immediately after the Veteran's training as a powerlifter, or within one year of discharge. However, the examiner did not adequately address whether the Veteran's reports of numbness and tingling during service were early signs of carpal tunnel syndrome. In light of this, the Board finds remand for a new medical opinion is required. The matters are REMANDED for the following action: 1. Obtain any updated VA treatment records for the period from February 2021 to the present. 2. After obtaining any additional records, obtain an addendum opinion from a VA examiner other than the December 2019 examiner addressing the etiology of the Veteran's right shoulder condition. The Veteran's electronic claims file should be made available to the examiner for review in connection with this request. An examination should only be scheduled if the examiner deems one is necessary for providing the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) the Veteran's right shoulder condition is related to her active service, to include a right shoulder contusion diagnosed during service following a motor vehicle accident and her duties as a powerlifter during service. In providing the requested opinion, the examiner should consider the Veteran's report of persistent pain in the right shoulder noted on March 1989 separation examination. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. After obtaining any additional records, obtain an addendum opinion from a VA examiner other than the December 2019 examiner addressing the etiology of the Veteran's carpal tunnel syndrome of the right wrist. The Veteran's electronic claims file should be made available to the examiner for review in connection with this request. An examination should only be scheduled if the examiner deems one is necessary for providing the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) the Veteran's carpal tunnel syndrome of the right wrist is related to her active service, to include her duties as a powerlifter during service. In providing the opinion, the examiner is asked to address the Veteran's reports of numbness and tingling of the wrist and fingers noted in service treatment records and whether they were early signs of carpal tunnel syndrome. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.