Citation Nr: 21012413 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 13-09 472A DATE: March 4, 2021 ORDER Entitlement to service connection for bilateral carpal tunnel syndrome to include as due to service-connected sleep apnea is denied. FINDING OF FACT The Veteran’s currently diagnosed bilateral carpal tunnel syndrome is not secondary to service-connected disability and is not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for bilateral carpal tunnel syndrome due to service or service-connected disease or injury are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from November 1967 to November 1970. This matter comes before the Board of Veterans’ Appeals (Board) from a July 2012 rating decision (RD) issued by a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded by the Board in December 2020 for the issuance of a supplemental statement of the case (SSOC). Upon review of the record, the Board finds that one was subsequently issued in December 2020, and therefore its remand directive has been substantially complied with. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for bilateral carpal tunnel syndrome to include as due to service-connected sleep apnea The Veteran contends that his currently diagnosed bilateral carpal tunnel syndrome is somehow related/secondary to his service-connected sleep apnea disability. See March 2012 Statement in Support of Claim (relaying that the Veteran suffers from wrist pain due to his sleep posture); September 2012 Statement in Support of Claim. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). 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). Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Secondary service connection requires evidence of: (1) a current disability; (2) a service-connected disability; and (3) a causal relationship between the current disability and a service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). As there is no evidence of an in-service injury, event, or disease, and since the Veteran has only ever claimed that his currently diagnosed bilateral carpal tunnel syndrome condition is related to service-connected disability, the Board will not address direct service connection. See Robinson v. Mansfield, 21 Vet. App. 545, 553 (2008). Per the April 2019 VA examination report, the Veteran has a current diagnosis of bilateral carpal tunnel syndrome, and therefore the Board finds that his claim meets the first element of secondary service connection. Additionally, the Veteran is service-connected for sleep apnea, and therefore his claim also meets the second element of secondary service connection. See February 2018 RD. As to whether the Veteran’s currently diagnosed bilateral carpal tunnel syndrome condition is proximately due to and/or aggravated by his service-connected sleep apnea condition, the Board finds that there is no medical evidence of record weighing in favor of the Veteran’s claim. Weighing against the Veteran’s claim is the April 2019 VA examiner’s medical opinion that his condition is not proximately due to service-connected disability, to include sleep apnea, residuals of injury to nose with deviated septum, and residuals of fracture to the infraorbital rim and front zygomatic suture, as those disabilities have no systemic influence so as to predispose an individual to develop the right and left carpal tunnel syndrome, and that they exert their effects locally which is far removed from the Veteran’s wrists. See also July 2016 VA medical opinion (“The Veteran’s carpal tunnel syndrome is due to overuse of hands.”). On the issue of aggravation, the April 2019 VA examiner opined that the currently diagnosed carpal tunnel syndrome is not aggravated by service-connected disability, as the condition is stable and only reflects findings expected from the disorder, and that as a result, a substantial deterioration cannot be demonstrated. The Board notes the Veteran’s contentions that his claimed for condition could also be due to his cervical spine condition; however, upon review of the record, the Board finds that as the cervical spine condition is not service-connected, secondary service connection may not be granted. Specifically, service connection on a secondary basis must be denied due to lack of legal merit. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (where the law is dispositive, the claim must be denied due to a lack of legal merit). The Board acknowledges the Veteran's belief that he should be service connected for bilateral carpal tunnel syndrome; however, the record does not support a finding that he is competent to provide a nexus opinion in this case as the issue is medically complex, in that it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence of record, namely the April 2019 VA medical examiner's opinion, and there are no medical opinions to the contrary. The Board concludes that, while the Veteran has a currently diagnosed condition, the preponderance of the evidence is against finding that the condition is proximately due to or the result of, or aggravated beyond its natural progression, by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). Therefore, entitlement to service connection for bilateral carpal tunnel syndrome to include as due to service-connected sleep apnea must be denied. Saudiee Brown Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.R. Fey, Associate 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.