Citation Nr: 21008809 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 10-40 108 DATE: February 18, 2021 REMANDED Entitlement to service connection for a right wrist disability is remanded. Entitlement to service connection for a right thigh/hip disability is remanded. REASONS FOR REMAND The Veteran had active service from February 2003 to April 2004, including in the Southwest Asia theater of operations for the Persian Gulf War, with additional service in the Reserves. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from December 2008 rating decisions of the Department of Veterans Affairs (VA) Regional Office in Houston, Texas. The Veteran testified at a Board videoconference hearing in July 2015 and a copy of that transcript is of record. This matter was previously remanded by the Board in November 2015 and January 2019 for further development. An August 2019 Board decision denied entitlement to service connection for a right wrist condition and a right thigh/hip condition. The Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). In a September 2020 Order, the Court granted the parties’ Joint Motion for Remand (JMR). The JMR vacated the August 2019 Board decision and remanded the claims to the Board for action consistent with the terms of the joint motion. Prior to the August 2019 Board decision now vacated by the Court, a June 2019 rating decision granted entitlement to service connection for left and right knee disabilities. As this constitutes a full grant of the benefit sought on appeal in regard to the bilateral knee conditions, there remains no issue of controversy for adjudication by the Board on those claims. See Grantham v. Brown, 114 F.3d 1156, 115859 (Fed. Cir. 1997). 1. Entitlement to service connection for a right wrist condition and a right thigh/hip condition is remanded. The JMR deemed the May 2019 VA medical opinion regarding the right wrist condition inadequate due to the examiner’s use of speculative language. Specifically, when opining on the etiology of the right wrist disability, the May 2019 VA examiner noted a diagnosis of tendonitis, but opined this was not related to the Veteran’s active service, but rather “seem[ed] related to his current work as a welder.” Similarly, the JMR deemed the May 2019 VA medical opinion regarding the right thigh/hip condition inadequate based upon the examiner’s use of speculative language. The May 2019 examiner opined that the Veteran had right hip groin pain “which could be due [to a] ligament” and that review of the medical records showed “multiple etiologies.” Accordingly, remand is warranted to obtain further medical opinions on the nature and etiology of the claimed right wrist and right thigh/hip conditions. The matters are REMANDED for the following action: 1. Schedule the Veteran for VA examinations to determine the nature and etiology of the right wrist and right hip/thigh complaints. The entire claims file, to include a copy of this REMAND, must be made available to the examiner. (a.) Right Hip/Thigh i. The examiner should diagnose all current disabilities of the right hip/thigh. If a diagnosis cannot be provided but the Veteran’s condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinion(s) below. ii. The examiner should determine whether it is at least as likely as not (50 percent probability or greater) that any such diagnosed disabilities are related to the Veteran’s service, to include in-service complaints such as reporting a hip injury and related physical therapy in a February 2004 Report of Medical Assessment and concerns about his hip in a March 2004 Self-Assessment Questionnaire. iii. If the Veteran’s right hip/thigh pain cannot be attributed to a known clinical diagnosis, the examiner must indicate whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s symptoms are the result of an undiagnosed illness or medically unexplained chronic multi-symptom illness etiologically related to service in Southwest Asia. (b.) Right Wrist i. The examiner should diagnose all current disabilities of the right wrist. If a diagnosis cannot be provided but the Veteran’s condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinion(s) below. ii. The examiner should then determine whether it is at least as likely as not (50 percent probability or greater) that any such diagnosed disabilities are related to the Veteran’s service, to include the in-service wrist complaints documented in February 2004, March 2004, and April 2004. (c.) The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. Bloom v. West, 12 Vet. App. 185, 187 (1999) (noting that the use of the term “could,” without other rationale or supporting data, is speculative); Obert v. Brown, 5 Vet. App. 30, 33 (1993) (noting that a medical opinion expressed in terms of “may” also implies “may or may not” and is too speculative to establish a causal relationship). i. If the examiner is unable to offer a requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to mere speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jamison, E. 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.