Citation Nr: 21025659
Decision Date: 04/28/21	Archive Date: 04/28/21

DOCKET NO. 19-20 390
DATE: April 28, 2021

REMANDED

Entitlement to an initial compensable disability rating prior to February 21, 2020, and in excess of 20 percent from October 1, 2020, for service-connected left wrist carpal tunnel syndrome, status post carpal tunnel release (left wrist condition) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from September 1964 to October 1990 in the United States Army.

Entitlement to an initial compensable disability rating prior to February 21, 2020, and in excess of 20 percent from October 1, 2020, for the service-connected left wrist condition

The claim must be remanded for furhter development because the most recent VA examination is inadequate. Stegall v. West, 11 Vet. App. 268, 271 (1998).

In a January 2021 rating decision, the Agency of Original Jurisdiction (AOJ) increased the rating for the left wrist condition to 20 percent, effective February 21, 2020; granted a temporary total rating from August 6, 2020 to October 1, 2020, and; a 20 percent rating from October 1, 2020.  

The Board previously remanded the claim for an examination to determine the current severity and all manifestations of the Veteran’s left wrist condition. The Board specifically asked for an opinion on whether the service-connected left wrist condition should include diagnoses of scaphoid lunate advanced collapse (SLAC) and arthritis.  

The January 2021 VA examiner concluded that the more specific diagnosis for this Veteran’s condition is SLAC wrist, left carpal tunnel syndrome and arthritis. However, in the separate peripheral neuropathy examination the same examiner stated that left writst SLAC represents a new diagnosis separate and unrelated to left wrist carpal tunnel syndrome.  A new medical opinion is needed to determine the nature and severity of all manifestions of the service-connected left wrist disability.  

The matters are REMANDED for the following action:

1. Schedule the Veteran for an examination with an appropriate clinician to determine the current nature and severity of the service-connected left wrist disability. Copies of all pertinent records must be made available to examiner for review. The examiner must specifically identify all manifestations, orthopedic and neurological, related to the left wrist. 

Based on the examination and review of the record, the examiner must address the following: 

(a) Specifically identify all manifestations, orthopedic and neurological, related to the left wrist; including the SLAC and arthritis diagnoses noted on December 2020 examination.

(b) Do the SLAC and arthritis diagnoses represent separate disabilities, distinct from CTS? 

(c) The examiner must conduct all indicated testing and complete the appropriate DBQ to evaluate all identified residuals. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.

2.  After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal, with specific consideration as to (a) whether a Diagnostic Code other than for carpal tunnel syndrome would better reflect the Veteran’s left wrist condition and (b) whether there is any separately ratable disability associated with the left wrist.  

 

 

M.E. Larkin

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	P.S. McLeod

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.