Citation Nr: 21013571 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 20-07 611 DATE: March 9, 2021 REMANDED Entitlement to service connection for a right hand disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from April 1950 to May 1953, and in the U.S. Air Force from February 1955 to November 1959. He is the recipient of a Combat Infantryman Badge and multiple awards of the Korean Service Medal. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from a June 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In December 2020, the Board remanded the Veteran’s claim for further development. This matter is now returned to the Board for further appellate review. Entitlement to service connection for a right hand disability The Veteran asserts that he incurred a right hand disability due to frostbite or a cold injury in Korea in 1951. Service treatment records are silent as to any right hand treatment or frostbite or cold injury. Regardless, as discussed above, the Board finds cold exposure to be consistent with the circumstances of his combat service in Korea. See 38 U.S.C. §1154. The Veteran has been granted service connection for cold injury syndrome from frostbite injuries to the right and left toes. Post-service, a March 2016 VA treatment record shows the Veteran reported his fingers and feet were frozen in 1951 in Korea, and during the VA examination, he requested x-rays. See CAPRI, received June 2017 at p.181. A September 2016 VA treatment record shows x-rays revealed advanced degenerative arthritis in both hands, and significant osteoarthritis in both thumbs. See CAPRI, received October 2016at p.6, and received June 2017 at p.128. In December 2020, the Board remanded the claim for an addendum VA medical opinion because an August 2020 VA examination report included diagnoses for “cold residuals” and for degenerative arthritis, but at the same time, the VA examiner opined that the cold injury was acute only, indicating it had resolved. Therefore, the Board asked the VA examiner to clarify whether the Veteran has a current diagnosis of cold injury residuals of the right hand separate from his diagnosed right hand degenerative arthritis. Subsequently, a January 6, 2021 VA medical opinion was obtained from another examiner (Dr. T.D.), who opined the Veteran has no right hand frostbite residuals. Rather, the examiner opined that the Veteran’s right hand complaints are due to his diabetic peripheral neuropathy, with or without any arthritis. Meanwhile, the Veteran filed a new December 2020 claim for service connection for left hand frostbite residuals. A January 12, 2021 VA examination was performed (cold injuries - by C.R., N.P.) in connection with the left hand claim. The examiner examined both of the Veteran’s hands and opined that he was mis-diagnosed on VA examination in August 2020, and that the correct diagnosis is bilateral hands cold injury. The Board is cognizant, however, that she noted the last VA examination report she reviewed was dated in August 2020, indicating she did not have an opportunity to review the January 6, 2021 VA medical opinion. She also did not perform diagnostic testing or address the Veteran’s diagnosed arthritis of both hands. The Board finds that the claim should be remanded for an addendum VA medical opinion from the last VA examiner who prepared the January 12, 2021 VA examination report (cold injuries) because she indicated that that she never had an opportunity to review the January 6, 2021 VA medical opinion dated just a few days prior. She should also be asked to review the prior January 2021 VA medical opinion and clarify whether the Veteran currently has any residuals of cold injury to his right hand. She should also address the 2016 x-ray findings of degenerative arthritis in the Veteran’s bilateral hands. See, e.g., CAPRI, received October 2016 at p.6; and received June 2017 at p.128. The matters are REMANDED for the following action: 1. Obtain an addendum VA medical opinion from the same VA examiner who provided the January 12, 2021 VA examination report (cold injuries) to clarify whether the Veteran has a current diagnosis of “cold injury residuals” of the right hand (separate from his diagnosed right hand degenerative arthritis), and if so, whether it is “at least as likely as not” (50 percent or greater probability) related to his active service, including his reported frostbite or cold injury due to not wearing gloves overnight in Korea (which the Board concedes is consistent with the circumstances of his service). The claims folder must be provided to the examiner for review, including a copy of this remand. Ask the VA examiner to review the most recent January 6, 2021 VA medical opinion, as well as her January 12, 2021 VA examination report (by two different examiners). It appears the January 6, 2021 VA medical opinion was not available previously for her review. Also ask the VA examiner to address the etiology of the right hand degenerative arthritis shown on x-rays at the VA medical center in September 2016, to include but not limited to whether it was caused by a cold injury in service. An examination is necessary if required by the examiner to form an opinion. If the same VA examiner who prepared the January 12, 2021 VA examination report is not available, then the opinion should be sought from a similarly qualified examiner. Any opinion must be accompanied by a complete rationale. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Juliano, 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.