Citation Nr: 21076955 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-26 621 DATE: December 28, 2021 REMANDED Entitlement to service connection for left wrist carpal tunnel syndrome is remanded. Entitlement to service connection for right hand small finger limitation is remanded. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1992 to July 1996. This case comes to the Board of Veteran's Appeals (Board) on appeal from July 2014 and May 2016 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In October 2014 and November 2016, the Veteran disagreed with these rating decisions. In October 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the claims file. REASONS FOR REMAND 1. Entitlement to service connection for left wrist carpal tunnel syndrome is remanded. 2. Entitlement to service connection for right hand small finger limitation is remanded. As there is considerable overlap in the applicable evidence for the Veteran's claims, the Board will discuss them together. In a February 2016 statement, the Veteran wrote that she was unable to attend her June 2015 Compensation and Pension examinations because she had had major surgery at that time. The Veteran requested that her examinations be rescheduled, but from the claims file, it does not appear as if the RO ever tried to reschedule them. Because of this, new VA examinations are necessary to determine if the Veteran's left wrist carpal tunnel syndrome and right hand small finger limitation are related to active service. Concerning the Veteran's left wrist carpal tunnel syndrome, the Board notes that she is already service-connected for right wrist carpal tunnel syndrome. Additionally, in the Veteran's service treatment records (STRs) carpal tunnel syndrome is listed multiple times without indication as to which wrist the notations referred. In her October 2021 hearing, the Veteran testified that she developed bilateral carpal tunnel syndrome during active service "flipping burgers and fries" as a cook. The Veteran asserted that the carpal tunnel syndrome notations in her STRs was for bilateral carpal tunnel syndrome, not just for her right wrist. The Board notes that the Veteran has never had a VA examination to determine whether her left wrist carpal tunnel syndrome is related to active service. Because of this, a new examination is necessary to determine if the Veteran's left wrist carpal tunnel syndrome is etiologically related to active service. Concerning the Veteran's right hand small finger limitation, the Board notes that the Veteran has never had a VA examination to determine if this condition is related to active service. In her October 2021 hearing, the Veteran testified that the numbness in her right hand small finger was nerve-related and caused by the rifle strap on her shoulder. She noted that in service, this was called "sling palsy." The Veteran further testified that her VA physician told her that her right hand condition was caused by active service, but there is no written notation of this. As a result, a VA examination is necessary to determine whether the Veteran's right hand small finger limitation is etiologically related to active service. The matters are REMANDED for the following actions: 1. Please note that this Veteran's case has been advanced on the docket and, by law, ALL remanded claims must be processed expeditiously. 2. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), contact the Veteran for additional information about treatment for her condition and make efforts to obtain all VA and private treatment records concerning these claims. 3. Schedule the Veteran for VA examinations to determine the identity and cause of any left wrist carpal tunnel syndrome and right hand small finger limitation. Prior to the examination, the claims folder and a copy of this remand must be made available to the examiner for review of the case. A notation to the effect that this record review took place should be included in the report. The examiner should address whether it is at least as likely as not (a 50 percent or greater probability) that any left wrist carpal tunnel syndrome and right hand small finger limitation are causally related to active service, or represent the initial manifestations of the Veteran's current disabilities. In reaching any conclusion, the examiner should consider the possibility that the carpal tunnel notations in the Veteran's STRs could refer to both her right and left wrists. Additionally, the examiner should consider the Veteran's October 2021 testimony where she stated that she developed bilateral carpal tunnel syndrome during active service in her capacity as a cook, and that her right hand small finger limitation was a result of her nerve being affected by "sling palsy," or carrying her service rifle strap over her shoulder. 4. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Abrams, 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.