Citation Nr: 21022513 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 14-29 834 DATE: April 16, 2021 REMANDED Entitlement to service connection for bilateral carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1999 to June 2006, to include service in Southwest Asia. This issue has a long and extensive procedural history. Most recently, in December 2019, the Board denied the Appellant’s claim for service connection for bilateral carpal tunnel syndrome (CTS). Thereafter, the Appellant appealed to the United States Court of Appeals for Veterans Claims (Court). In a November 2020 Joint Motion for Remand (JMR), the parties moved the Court to vacate the December 2019 decision with respect to the issues pertaining to service connection for bilateral CTS. The remand on the issue of entitlement to service connection for a respiratory condition was not disturbed. Entitlement to service connection for bilateral carpal tunnel syndrome is remanded. In its December 2019 decision, the Board failed to ensure its duty to assist the Veteran was satisfied when it relied on an inadequate December 2018 VA examination for its finding that service connection for bilateral CTS was not warranted. In a March 2018 remand, the Board requested a VA examination provide an etiology opinion on whether the Veteran’s bilateral hand disability was at least as likely as not incurred during active service, to include his duty as a helicopter mechanic, and whether it was aggravated by his service-connected cervical spine disability. The Board directed the examiner “must consider the evidence showing that the Veteran has complained of experiencing decreased grip strength and stiffness, as well as right wrist pain, when his neck pain is present. The examiner did not address the Veteran’s contentions as to his symptoms and whether they are aggravated by his service-connected disabilities or his military MOS as an aircraft mechanic. The examiner also failed to address VA treatment records from June 11 reflecting a diagnosis of borderline mild CTS. The examiner’s opinion was also in contradiction of two prior VA examiners who indicated the Veteran’s nerve conduction studies showing subclinical borderline CTS. Accordingly, remand is warranted for a new VA opinion to address the etiology of the Veteran’s symptoms and whether the June 2011 NCS diagnosis of borderline mild CTS is due to his MOS as a helicopter mechanic or was aggravated by his service-connected cervical spine disability. The examiner must consider the VA treatment records from March 2009 and July, August, September, and October 2010, as instructed in the Board’s March 2018 remand directives. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician, or, if necessary, a new VA examination regarding whether the Veteran’s bilateral CTS is at least as likely as not related to his military occupational specialty as a helicopter mechanic or proximately due to a service-connected disability, or aggravated beyond its natural progression by service-connected disability, to include the Veteran’s service-connected cervical spine condition. The examiner must consider the following: (a.) VA treatment records from March 2009, and July, August, September, and October 2010, as instructed in the Board’s March 2018 remand directives; (b.) The Veteran’s lay statements regarding his bilateral CTS; and (c.) The February 2013 and March 2013 VA examiners’ opinions that the Veteran had subclinical electrophysiologic CTS. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.D. Taylor, 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.