Citation Nr: 21025505 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 16-32 528 DATE: April 28, 2021 REMANDED Entitlement to service connection for a left hand, ring finger disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1992 to December 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision. In November 2018, the Board remanded the case for further development. The case has since been returned to the Board for appellate review. Entitlement to service connection for a left hand, ring finger, disorder In a November 2019 VA examination report, the examiner diagnosed the Veteran with a left ring finger residual scar with subjective pain. The examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. Unfortunately, the Board finds that this opinion does not substantially comply with the Board’s November 2018 remand instructions. Stegall v. West, 11 Vet. App. 268 (1998); see also Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (affirming that a medical opinion is adequate if it provides sufficient detail so that the Board can perform a fully informed evaluation of the claim). In this regard, the examiner relied largely on the lack of documented treatment during service. Moreover, although the examiner stated that she reviewed a March 2015 lay statement from the Veteran’s friend, she did not provide a meaningful discussion of the lay statements of record regarding the Veteran’s symptoms and reported in-service injury. Therefore, a remand is necessary to obtain an additional opinion. In addition, the Veteran reported that he was hospitalized during service for a left hand or finger injury at a hospital in Hanau, Germany. See, e.g., March 2015 notice of disagreement. The Veteran’s service treatment records document that he received treatment for other conditions at a U.S. Army Hospital located in Hanau, Germany. On remand, the Agency of Original Jurisdiction (AOJ) should afford the Veteran an opportunity to clarify whether he received treatment for a left hand or finger injury at an “off-base” civilian hospital or a military facility. In November 2018, the Board directed the AOJ to obtain any outstanding medical records pertaining to treatment for a left hand or finger injury at a hospital located in Hanau, Germany. In July 2019, the AOJ submitted a Personal Information Exchange System (PIES) request to the National Personnel Records Center (NPRC) for the Veteran’s complete service treatment records and personnel file. However, there is no indication that the AOJ made further efforts to obtain any outstanding hospital records. Therefore, a remand is necessary. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Ask the Veteran to clarify whether he received treatment for a left hand or ring finger injury at a civilian hospital or a military hospital located in Hanau, Germany. 2. Contact the appropriate facilities to request any outstanding treatment records dated in 1994 pertaining to treatment for a left hand or finger injury at a hospital located in Hanau, Germany, to include any military treatment facilities. The Veteran reported that he injured his left hand or finger while repairing a Humvee when he was stationed with the 127th Aviation Support Battalion at the Fliegerhorst Kaserne in Hanau, Germany. See, e.g., March 2015 notice of disagreement. A September 1995 service treatment record noted that the Veteran complained of back pain due to a Humvee accident that occurred in August 1994. If any records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file and the Veteran must be properly notified. 3. Obtain a VA medical opinion from an appropriate clinician regarding the etiology of any current left hand or ring finger disorders. The entire claims file must be made available to the examiner. (a) The examiner should identify all current left hand ring finger disorders. Evidence of pain alone that causes functional impairment, even without a specific diagnosis or identifiable disease, may constitute a disability for VA purposes. (b) For each disorder identified, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the disorder had its onset in service or is otherwise causally or etiologically related to the Veteran’s active service, to include his reported injury. In providing this opinion, the examiner must address the lay statements from the Veteran and his friend regarding a left finger injury that he sustained while repairing a Humvee during service. See March 2014 statement in support of claim; March 2015 statement in support of claim; and March 2015 notice of disagreement. He or she should also consider the Veteran’s lay statements regarding his symptoms since service, including pain and swelling. See, e.g., March 2014 statement in support of claim; March 2015 notice of disagreement; and November 2019 VA examination report. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered. If there is a medical reason to doubt the history as reported, the examiner should so state. All opinions must be supported by detailed rationale. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Wulff, 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.