Citation Nr: 21022322 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 16-27 488 DATE: April 15, 2021 ORDER Service connection for left carpal tunnel syndrome is granted. Service connection for left cubital tunnel syndrome is granted. FINDINGS OF FACT 1. The Veteran’s left carpal tunnel syndrome was caused by his active service. 2. The Veteran’s left cubital tunnel syndrome was caused by his active service. CONCLUSIONS OF LAW 1. The criteria for service connection for left carpal tunnel syndrome have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for service connection for left cubital tunnel syndrome have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty service from May 1984 to August 2007. His awards and decorations include the Combat Action Ribbon. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision. These issues were previously before the Board in October 2018 when they were remanded for further development. SERVICE CONNECTION Service connection may be granted for a disability resulting from disease or injury incurred in, or aggravated by, active military service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2019). Service connection may also be granted for any disease initially diagnosed after service when the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d) (2019). To establish direct service connection for such a disability, the record must reflect: (1) competent evidence of the current existence of the disability for which service connection is being claimed; (2) competent evidence of a disease contracted, an injury suffered, or an event witnessed or experienced in active service; and (3) competent evidence of a nexus or connection between the disease, injury, or event in service and the current disability. Shedden v. Principi, 381 F.3d 1163 (2004). 1. Service connection for carpal tunnel syndrome is granted. 2. Service connection for cubital tunnel syndrome is granted. First, the Board notes the record shows the Veteran has been diagnosed with left carpal tunnel syndrome and left cubital tunnel syndrome. See October 2019 Peripheral Nerves Conditions Disability Benefits Questionnaire. Accordingly, the first Shedden element has been met. The record also contains competent evidence of an in-service event. The Veteran asserts his military duties as a field artillery cannon crewman caused his carpal tunnel syndrome and cubital tunnel syndrome. See June 2016 VA Form 9. The Veteran’s military records reflect his primary specialty was that of a field artillery cannon crewman for almost 20 years. The Board finds the Veteran’s military record supports his assertion. Accordingly, the second Shedden element has been met. Finally, the record contains competent evidence of a nexus between the Veteran’s carpal tunnel and cubital tunnel syndrome and his active service. An August 2015 positive nexus opinion states that considering the Veteran’s military occupational specialty, i.e., as a field artilleryman for most of his military career, it is very likely his left carpal tunnel and left cubital tunnel were the result of repetitive-stress injuries sustained during active service. Furthermore, in April 2015, a VA examiner states, “Both cubital tunnel and carpal tunnel syndrome are etiologically related to entrapment of nerves due to fibrous tissue formation from either repetitive use, ergonomically incorrect posturing of the wrist and hands during a repetitive use activity and both are correctable by surgical removal of the entrapment of the nerve involved.” While the April 2015 VA opinion does not mention the Veteran’s military career, it does have some probative value. The April 2015 examiner’s explanation of what causes cubital tunnel and carpal tunnel syndrome bolster the Veteran’s assertions and the August 2015 positive nexus opinion. The Board acknowledges the October 2019 negative VA opinion of record. However, the Board declines to accept the findings. The examiner found the Veteran’s claimed conditions were less likely than not incurred in or caused by his active service. For their rationale, the examiner notes that during active service, the Veteran reported working in the field artillery crew, and they note his assertion that his left hand sustained a lot of repetitive stress. The examiner further notes the Veteran stated that the onset of his carpal tunnel and cubital tunnel syndrome was “about 2015.” They state the year 2015 is outside the Veteran’s service period, and the record does not reflect objective evidence or treatment such as documented fractures of the left hand or wrist during active service. The Board does not find the opinion sufficient. While the examiner notes there is no objective evidence such as documented fractures from active service, the examiner did not address the April 2015 VA examiner’s opinion that both cubital tunnel and carpal tunnel syndrome are etiologically related to entrapment of nerves due to fibrous tissue formation from either repetitive use or ergonomically incorrect posturing of the wrists and hands during repetitive-use activity. Regarding this, the VA examiner also did not address the Veteran’s contention that his military duties as a field artillery cannon crewman caused his carpal tunnel syndrome and cubital tunnel syndrome. See June 2016 VA Form 9. The April 2015 VA examiner’s opinion and the Veteran’s assertions, taken together, are supported by his military record. (Continued on the next page)   Furthermore, while the examiner states that the onset of the Veteran’s carpal tunnel and cubital tunnel syndrome was “about 2015,” the evidence of record does not support this statement. For example, the Veteran’s private treatment records note that he was diagnosed with carpal tunnel syndrome and cubital canal syndrome in November 2014. Furthermore, the Veteran has reported complaints of symptoms related to his carpal tunnel syndrome and cubital canal syndrome prior to 2015. See October 2015 Notice of Disagreement. Accordingly, the Board finds the evidence supports a finding that the Veteran’s left carpal tunnel syndrome and left cubital tunnel syndrome are related to his active service. As such, service connection for left carpal tunnel syndrome and service connection for left cubital tunnel syndrome are warranted. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Emily Tamlyn Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Denton, Buck 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.