Citation Nr: 21026929 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 16-33 359 DATE: May 4, 2021 REMANDED Entitlement to service connection for Raynaud's disease of the bilateral upper extremities is remanded. REASONS FOR REMAND The Veteran had active service with the Army from June 1974 to September 1974 and October 1974 to August 1983. This matter is before the Board of Veterans' Appeals (the Board) on appeal from an April 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the Veteran's July 2016 Form 9 she indicated she was only appealing her claim for Raynaud's disease. She did not perfect her appeal of service connection for left knee strain with degenerative joint disease or right knee strain with degenerative joint disease. Therefore, these claims are not before the Board. The Board notes the Veteran attempted to opt into the Appeals Modernization Act (AMA) review system by submitting a Rapid Appeals Modernization Program (RAMP) election form, which was received in April 2018. Since the Veteran's claim was certified to the Board in June 2017, the Veteran's action was untimely, and the Board will proceed with adjudicating the claim under the Legacy Appeals System. After a thorough review of the record, the Board finds that more development is necessary prior to final adjudication of the claim on appeal. The Veteran's DD 214 indicated her military occupational specialty (MOS) was as a medical specialist. She contends her Raynaud's disease is due to a cold weather injury she sustained in service. She reported a three-year tour in Germany from 1976 to 1979. She was a medical specialist, which required one to three weeks living in tents in the field. During an exercise in the field she sustained a cold weather injury to her hands. She developed a tingling sensation, numbness, discoloration, and brief periods of loss of use in both hands. She indicated that medics rarely went to sick call and often treated each other for minor things. The Veteran reported receiving a profile to wear gloves and a restriction to temperatures of at least 50 degrees. Since she separated from service in the summer of 1983, she did not exhibit signs of Raynaud's during examination. Additionally, she contends the examination was hurried. The Veteran's service treatment records show a March 1981 letter of admonition, which noted she was restricted from subjecting herself to temperatures less than 50 degrees Fahrenheit. Due to concerns she would be unable to perform her duties, she was counseled to seek a definite diagnosis and treatment for the conditions that restricted her ability to control her normal bodily functions, perform daily unit activities, or otherwise be mission ready. The medical conditions limiting her were not identified in the letter. A December 1981 gynecological note indicated suspected Raynaud's disease. In May 2016, the Veteran underwent a VA examination for her Raynaud's disease. The examiner opined it was less likely than not that her Raynaud's disease was incurred in or caused while she was in military service by the mere fact that there was no diagnosis of Raynaud's disease in service. The examiner's rationale noted the 1981 note of suspected Raynaud's but appeared to rely on a lack of subsequent medical evidence confirming the condition in opining to a negative nexus. Specifically, the examiner stated there were no medical records confirming the condition after the 1981 note and there was no mention of Raynaud's in her separation physical. The May 2016 examiner's rationale failed to address the Veteran's reports of cold weather injury to her hands in service. While the Veteran's service treatment records did not show an assessment of cold weather injury, she is competent to report on factual matters of which she has first-hand knowledge and experiences through her senses. Barr v. Nicholson, 21 Vet. App. 303 (2007); Washington v. Nicholson, 19 Vet. App. 362 (2005). For example, she is competent to report tingling, numbness, pain, and discoloration in her hands since 1979. Her MOS of medical specialist also made her competent to self-diagnose certain injuries such as cold weather injury to her hands. Additionally, the examiner's rationale did not address the restriction noted in March 1981 prohibiting her from being subjected to temperatures less than 50 degrees Fahrenheit. Where the VA undertakes to provide the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The May 2016 VA examiner's opinion does not provide an adequate rationale regarding whether the Veteran's Raynaud's disease was related to service. The Board finds an addendum opinion from the May 2016 examiner should be requested regarding the Veteran's service connection claim. The matters are REMANDED for the following actions: 1. Obtain and associate all outstanding VA and non-VA treatment records with the claims file. 2. Once the above development is complete obtain an addendum opinion from the May 2016 VA examiner regarding the Veteran's service connection claim for Raynaud's disease of the bilateral upper extremities. If the May 2016 VA examiner is not available, the requested opinion with rationale should be rendered by another qualified clinician. If the examiner determines that a new examination is necessary, the AOJ should schedule one for the Veteran. (a.) The examiner is asked to opine on the following: If it is at least as likely as not that the Veteran's Raynaud's disease of the bilateral upper extremities had its onset in service or was otherwise etiologically related to any event or circumstance of her service, to include cold weather injury to her hands while serving as a medical specialist in the field. The complete record, to include a copy of this remand and the claims folder, must be made available to and reviewed by the examiner in conjunction with the examination. The examination report must include a notation that this record review took place. 3. After completion of the above and any additional development deemed necessary, the issues on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran and his representative should be furnished with a supplemental statement of the case and afforded the opportunity to respond. Thereafter, the case should be returned to the Board for further consideration. Saudiee Brown Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.L. Byers 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.