Citation Nr: 21077471 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 17-39 867 DATE: December 29, 2021 REMANDED Entitlement to an initial compensable evaluation for right shoulder scar status post laceration is remanded. Entitlement to a compensable evaluation for right shoulder Muscle Group II injury is remanded. Entitlement to an evaluation in excess of 20 percent for right shoulder Muscle Group III injury is remanded. Entitlement to a compensable evaluation for right shoulder Muscle Group VI injury is remanded. Entitlement to service connection for right hand disorder, to include as secondary to service-connected right shoulder disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1973 to December 1975. This appeal comes before the Board of Veterans' Appeals (Board) from a September 2016 rating decision. In August 2021, the Veteran failed to report for his scheduled Board hearing and has not submitted a motion to request another hearing. Therefore, the Board will proceed with consideration of the case on the merits. 1. Entitlement to an initial compensable evaluation for right shoulder scar status post laceration is remanded. 2. Entitlement to a compensable evaluation for right shoulder Muscle Group II injury is remanded. 3. Entitlement to an evaluation in excess of 20 percent for right shoulder Muscle Group III injury is remanded. 4. Entitlement to a compensable evaluation for right shoulder Muscle Group VI injury is remanded. In the December 2021 Appellant's Brief, the Veteran and his representative asserted that his previous examinations in July 2016 and September 2016 were inadequate. The Veteran's representative asserted that VA examiners did not adequately assess the Veteran's right shoulder disabilities, relying more on past examinations and reports to continue the current ratings, albeit warranting an increased rating due to inadequate assessment and inadequate acknowledgement of the worsening of the disability. Based on the foregoing, the Veteran should be provided an opportunity to report for VA examinations to ascertain the current severity and manifestations of his service-connected right shoulder disabilities. 5. Entitlement to service connection for right hand disorder, to include as secondary to service-connected right shoulder disabilities, is remanded. The Veteran has asserted that his claimed right hand disorder was related to a documented in-service right upper extremity knife injury as well as caused or aggravated by his service-connected right shoulder disabilities. Service treatment records revealed that the Veteran suffered a right upper extremity knife injury with damage to the right arm. In a July 2016 VA examination report and medical opinion, the examiner diagnosed right hand pain, weakness, and numbness due to severe right upper extremity knife injury. However, the examiner then opined that the claimed right hand condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury. In the cited rationale, the examiner simply noted that the Veteran's asserted right hand weakness and numbness started two years ago when the in-service knife injury to the upper arm was 42 years ago and there was no nexus to those two conditions. In light of the cumulative record and the inadequate rationale in the July 2016 VA medical opinion, the Board will not proceed with final adjudication of the claim until a competent VA medical opinion is provided in order to fully address the Veteran's contentions and clarify the nature and etiology of his claimed right hand disorder on appeal. Evidence of record further reflects that the Veteran received VA medical treatment for his claimed right hand disorder and service-connected right shoulder disabilities from the Las Vegas VA HCS. As evidence of record only includes treatment records dated up to November 2021 from those facilities, all pertinent VA treatment records should be obtained and properly associated with the record. 38 U.S.C. § 5103A(c) (2012); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following actions: 1. Obtain updated treatment records pertaining to the Veteran's service-connected right shoulder disabilities and claimed right hand disorder from Las Vegas VA HCS dated from November 2021 to present. 2. Schedule the Veteran for VA examinations by appropriate clinicians to determine the current severity of his service-connected right shoulder muscle injury and scar disabilities. The examiner should provide a full description of each disability and report all signs and symptoms necessary for evaluating the Veteran's disabilities under the applicable rating criteria. 3. Obtain a VA medical examination to clarify the nature and etiology of the Veteran's claimed right hand disorder from an appropriate examiner. The electronic claims file and a copy of this REMAND must be made available to the examiner, and the examiner must specify in the report that the file has been reviewed. Based on a review of the electronic claims file and the Veteran's lay assertions, the examiner must provide an opinion as to whether any previously or currently diagnosed right hand disorder was at least as likely as not (50 percent or greater probability) causally related to his active military service, to include the documented in-service knife wound injury. The examiner should also provide an opinion as to whether any previously or currently diagnosed right hand disorder was at least as likely as not (50 percent or greater probability) caused or aggravated (worsened) by the Veteran's service-connected right shoulder disabilities. The examiner is advised that permanent worsening of the condition beyond its natural progression need not be shown. The possibility of temporary worsening should be addressed. Aggravation refers to any incremental increase in disability, any additional impairment of earning capacity in non-service-connected disabilities resulting from service-connected conditions, above the degree of disability existing before the increase regardless of its permanence. The examiner should acknowledge and discuss the Veteran's lay assertions as well as the findings in the January 2004 and July 2016 VA examination reports/medical opinions. Rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). The Veteran is hereby advised that failure to report for any scheduled VA examination without good cause shown may have adverse effects on his claims. 38 C.F.R. § 3.655. 4. After completing the above actions and any other necessary development, the claims on appeal must be re-adjudicated, taking into consideration all relevant evidence associated with the record since the June 2017 SOC. If any benefit on appeal remains denied, a SSOC must be provided to the Veteran and his representative. After the Veteran has had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. D. Deane, 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.