Citation Nr: 21007042 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 17-04 403 DATE: February 8, 2021 REMANDED Entitlement to service connection for a left shoulder condition is remanded. Entitlement to service connection for a left upper extremity disability is remanded. Entitlement to service connection for a right upper extremity disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 2003 to January 2010, with verified service in Southwest Asia. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a September 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). A September 2019 Board decision denied the claims of entitlement to service connection for a left shoulder condition, left upper extremity disability, and right upper extremity disability. 09/24/2019, BVA Decision. The Veteran appealed the Board’s decision as to both issue to the United States Court for Veterans Claims (CAVC). In an August 2020 CAVC-approved Joint Motion for Remand (JMR), CAVC remanded the Board’s decision and found the duty to assist had not been satisfied with respect to the adequacy of the January 2017 VA examination. The examiner’s opinion was based on an inaccurate factual premise. Specifically, the January 2017 VA examiner stated that there is no documented mononeuropathy, despite an August 2016 VA examination documenting a diagnosis of bilateral mononeuropathy. Additionally, the January 2017 VA examination did not consider the Veteran’s explanations of why certain evidence did not exist, to include a September 2016 buddy statement indicating the Veteran was afraid to get surgery and a November 2016 lay statement from the Veteran indicating that he avoided medical treatment and learned to work around his limitations. The JMR then indicated that the Board shall obtain a VA examination that provides a clear conclusion, supported by a reasoned medical explanation connecting the examiner’s conclusion to supporting data. Additionally, the new examination must accurately address the Veteran’s complete medical history and statements regarding the lack of documented treatment. 08/18/2020, CAVC Decision. As such, the Board remands these issues for another examination. Additionally, the Veteran’s representative in a January 2020 brief notes that the Veteran handled fuel and cited an except from an article. However, the full text of the article was not provided. On remand, the representative is to be contacted and asked to provide the full text of the article so that it may be appropriately considered. These matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. Additionally, request the Veteran to submit any relevant private treatment reports or provide VA with authorization to obtain any such records. 2. Contact the Veteran’s representative and request that they submit the full text of the article cited in the January 2021 written brief presentation. 1/07/2021 Appellate Brief, at 2. Allow appropriate time for a response. 3. After completing directives #1 and #2, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his left shoulder, left upper extremity, and right upper extremity conditions. For all of the aforementioned conditions, the examiner is to provide an opinion whether it is at least likely as not related to an in-service injury, event, or disease. The examiner is asked to review the claims file to become familiar with the relevant medical history, obtaining a full history from the Veteran. See, e.g. 08/19/2016, C&P Exam (documenting a diagnosis of bilateral ulnar mononeuropathy). Additionally, the examiner is to consider the lay statements regarding the lack of documented treatment. See 11/16/2016, Buddy Statement (statement from T.S.); see also11/14/2016, NOD (statement from Veteran). (CONTINUED ON THE NEXT PAGE)   A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board David Han 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.