Citation Nr: 21009645 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-10 568 DATE: February 23, 2021 ORDER Entitlement to service connection for right wrist osteoarthritis and tendonitis is granted. Entitlement to service connection for left wrist osteoarthritis and tendonitis is granted. FINDINGS OF FACT 1. The evidence is in at least relative equipoise as to whether the Veteran’s right wrist osteoarthritis and tendonitis, was incurred in or otherwise related to service. 2. The evidence is in at least relative equipoise as to whether the Veteran’s left wrist osteoarthritis and tendonitis, was incurred in or otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for right wrist osteoarthritis and tendonitis have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a). 2. The criteria for entitlement to service connection for left wrist osteoarthritis and tendonitis have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1982 to June 1985, and September 1988 to May 1998. This appeal to the Board of Veterans’ Appeals (Board) arose from a July 2011 rating decision issued by the Department of Veterans Affairs (VA). See October 2011 Notice of Disagreement (NOD); February 2014 Statement of the Case (SOC); March 2014 Substantive Appeal (VA Form 9). In September 2015, the Board remanded the claims for further development. September 2015 Board decision. In June 2019, the Board remanded the claims again for further development. June 2019 Board decision. The Agency of Original Jurisdiction developed the evidence and continued the denial of the Veteran’s claims. June 2020 Supplemental Statement of the Case. The claims are now back before the Board. Service Connection 1. Entitlement to service connection for a right wrist disability. 2. Entitlement to service connection for a left wrist disability. The Veteran asserts having aches and pains in his joints due to service. October 2011 NOD; January 2021 Appellate brief. Service connection may be established for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1112, 1133; 38 C.F.R. § 3.303. Service connection is established when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Certain chronic diseases, such as osteoarthritis, which are manifested to a compensable degree within one year of discharge from active duty, shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such diseases during the period of service. See 38 U.S.C. §§ 1101(3), 1112; 38 C.F.R. §§ 3.307(a)(3), 3.309. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Alternatively, if a chronic disease listed at 38 U.S.C. § 1101(3) and 38 C.F.R. § 3.309(a) is noted during service or the presumptive period, but not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). As an initial matter, the Board notes that no service treatment records for the Veteran’s period of service from September 1988 to May 1998 were found, including the Report of Medical Examination during enlistment and separation. See February 2003 VA Memo; May 2016 Military Personnel Record. When, as here, these service records are lost or missing, through no fault of the Veteran, the VA has a heightened duty to consider the applicability of the benefit of the doubt rule. Cromer v. Nicholson, 19 Vet. App. 215, 217-18 (2005) (citing Russo v. Brown, 9 Vet. App. 46, 51 (1996)). See also Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). However, while indeed unfortunate, missing service records does not obviate the need for the Veteran to have medical nexus evidence supporting his claims. See Milostan v. Brown, 4 Vet. App. 250, 252 (1993) (citing Moore v. Derwinski, 1 Vet. App. 401, 406 (1991) and O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991)). In resolving any reasonable doubt in favor of the Veteran, the Board finds that the evidence supports that the Veteran has a current right and left wrist disability that was incurred in or otherwise related to service. The evidence supports that the Veteran has current right and left wrist disabilities, diagnosed as osteoarthritis and tendonitis. See June 2016 VA examination for wrist conditions; December 2019 VA examination for wrist conditions. The evidence also shows that the Veteran had duties as infantry during service that impact his upper extremities, including training as a jumpmaster and parachutist. May 1998 DD Form 214. The question remaining for the Board is whether the evidence supports a medical link between the Veteran’s current left and right wrist disabilities and service. The Veteran reported having joint and wrist pain since his last period of active service. See April 2010 VA Form 21 4138, May 2010 VA Form 21 0820. The Veteran’s service treatment records show no complaint or treatment for his wrists during service, but the Veteran did complain of transient arthritis pain in his “hands” just a few years after separation. See May 2003 VA treatment evidence. The Veteran was afforded several VA examinations for his wrists. The June 2016VA examination for wrist conditions shows the Veteran has mild to moderate degenerative changes in his left and right wrists. In the December 2016 VA examination addendum opinion, the examiner opined that the Veteran’s in-service activities of jumping, repelling, and parachuting put more stress on larger and weight-bearing joints, but it could not be said with 100 percent certainty that they did not impact on the onset of his wrist osteoarthritis. The Board finds that the Veteran’s lay statements and the medical treatment records and VA examination findings discussed above support that his current right and left wrist disabilities were incurred in or otherwise due to service. The Board recognizes that a March 2011 bilateral wrist x-ray showed a normal appearance of both wrists and that the December 2016 VA examiner ultimately opined that his current wrist disabilities were less likely than not due to service. March 2011 VA treatment evidence; December 2016 VA examination addendum opinion. The December 2019 VA examiner also found the Veteran’s wrist disabilities to be less likely than not incurred in or caused by service. December 2019 VA examination medical opinion. However, the Veteran has complained of wrist pain since at least April 2010, chronic wrist pain was the reason the March 2011 x-ray was obtained, and he was found to have mild to moderate degenerative changes in both wrists just a few years later. See May 2010 VA Form 21 0820; March 2011 VA treatment evidence; June 2016 VA examination for wrist conditions. The December 2016 VA examiner could not exclude service as a cause of his current wrist osteoarthritis and December 2019 VA examiner considered wrist tendonitis, not osteoarthritis. See December 2016 VA examination addendum opinion; December 2019 VA examination medical opinion. This evidence still raises a reasonable doubt as to whether the Veteran’s left and right wrist disabilities are due to service. (Continued on the next page)   In resolving any reasonable doubt in favor of the Veteran, the Board finds that the Veteran’s left and right wrist disabilities, diagnosed as osteoarthritis and tendonitis, were incurred in or otherwise related to service. Accordingly, entitlement to service connection for the Veteran’s current left and right wrist disabilities is warranted. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lin 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.