Citation Nr: 21006668 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 15-33 053 DATE: February 4, 2021 REMANDED Entitlement to service connection for a left-hand disability, to include arthritis, is remanded. Entitlement to service connection for a right-hand disability, to include arthritis, is remanded. REASONS FOR REMAND The Veteran had active service from November 1959 to April 1960 and from August 1972 to May 1974. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). All matters are remanded. In April 2020, the Board requested an addendum medical opinion from the June 2019 VA examiner (or an appropriate medical professional skilled in diagnosing cold injuries). The Board requested that the examiner provide an opinion on the etiology of the Veteran’s claimed right and left-hand disabilities. Specifically, the Board requested that the examiner address any potential cold injuries or frostbite that may be related to the Veteran’s current claimed disabilities. In an April 2020 medical opinion, the clinician provided an inadequate medical opinion. In August 2020, the Board again remanded the matter to obtain an adequate medical opinion with supporting rationale. In November 2020, the clinician did not provide the requested opinion. Specifically, the Board requested that the clinician cite to appropriate medical principles in support of the opinion and address medical evidence that the Veteran had been diagnosed with frostbite of bilateral hands and primary osteoarthritis of bilateral hands. The clinician did not address the Veteran’s frostbite diagnosis and no such citation to medical principles was provided. The Agency of Original Jurisdiction (AOJ)did not comply with the Board’s remand in this regard. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that a Board remand “confers on the veteran or other claimant, as a matter of law, the right to compliance with the remand orders”). Therefore, the Board finds that a remand is necessary to obtain a medical opinion from a clinician other than the one who provided opinions in April 2017, April 2020 and November 2020. The matters are REMANDED for the following action: Obtain an addendum opinion from a clinician (a medical professional skilled in diagnosing cold injuries) other than the one who provided opinions in April 2017, April 2020 and November 2020 regarding the etiology of the Veteran’s claimed bilateral hand disabilities. A copy of the Veteran’s electronic claims folder must be provided to the examiner, including a copy of the remand. The clinician is requested to provide an opinion as to the following: Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s left hand disability was incurred in or otherwise related to service, to include due to any cold injury related to the Veteran’s report of a cold injury/frostbite during service or in-service complaints of injury to his bilateral hands. Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s right hand disability was incurred in or otherwise related to service, to include due to any cold injury related to the Veteran’s report of a cold injury/frostbite during service or in-service complaints of injury to his bilateral hands. The examiner is requested to specifically address the following: (a) March 1973 service treatment records which indicate that the Veteran complained of a rope burn to the third digit of both hands; (b) December 1973 service treatment records which indicate that the Veteran complained of pain to the left hand when he hit it on the edge of the table; (c) Statements the Veteran made at the April 2017 VA examination that during service he worked in a frozen cargo hold and developed frozen hands and also developed frozen hands post-service; and (d) Medical treatment records from FirstLight Health System in Pine City that note that the Veteran had diagnoses of frostbite of bilateral hands and primary osteoarthritis of bilateral hands. A complete rationale (which includes appropriate citation to medical principles) for all opinions reached must be provided. The Board is returning the matter because the previous clinicians did not address all relevant evidence (particularly those which show diagnoses of frostbite of bilateral hands); merely cited some evidence and stated a conclusion without citation to appropriate medical principles. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Baskerville, LaRita 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.