Citation Nr: 21029693 Decision Date: 05/14/21 Archive Date: 05/14/21 DOCKET NO. 15-06 754A DATE: May 14, 2021 ORDER Service connection for bilateral carpal tunnel syndrome is denied. FINDING OF FACT The preponderance of the evidence is against finding that bilateral carpal tunnel syndrome began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for bilateral carpal tunnel syndrome are not met. 38 U.S.C. §§ 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the U.S. Air Force from November 1977 to August 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision. The Veteran testified before the undersigned Veterans Law Judge in January 2021. Service connection for bilateral carpal tunnel syndrome Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. The Veteran contends that his bilateral carpal tunnel syndrome had its onset during his period of active service. In a November 2014 written statement, and again during his January 2021 hearing, he described how his duties included using a typewriter for up to 8 hours with little or no breaks. He stated that he developed carpal tunnel syndrome as a result. Notably, the Veteran has not shown the relevant medical knowledge or expertise to diagnose a specific condition like carpal tunnel syndrome. Rather, the Board infers from his statements that he developed symptoms during service which he believed to be carpal tunnel syndrome. This is consistent with his August 2015 VA treatment records when he reported a history of bilateral numbness since 1980. Unfortunately, the Board must conclude that, while the Veteran has a current medical diagnosis of bilateral carpal tunnel syndrome, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. Service treatment records are negative for any complaints, treatment, or diagnoses associated with carpal tunnel syndrome or neurologic symptoms of the arms or hands. His July 1981 separation examination was normal, and he denied the presence of any relevant symptoms on the accompanying medical history report. During his Board hearing, the Veteran testified that he did not report his symptoms at the time because "you didn't tell people that you were hurting," and that it seemed like "you would actually get kicked out of the service if you showed weakness." In sum, he indicated that his military career would be adversely affected by reporting health problems. However, a review of the Veteran's service treatment records shows that he sought treatment for a right earache and two separate upper respiratory infections during his period of service. More significantly, as part of the medical history report for his July 1981 separation examination, he described having left knee pain and decreased hearing in his left ear. He also acknowledged a history of chest pain during service for which he was not seen. In other words, he actively reported a variety of different health conditions without mention of numbness or other symptoms in his arms or hands. This strongly suggests that no such symptoms were present. See AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013) (recognizing the widely-held view that the absence of an entry in a record may be considered evidence that the fact did not occur if it appears that the fact would have been recorded if present). In sum, while the Veteran believes his carpal tunnel syndrome had its onset during service, the Board reiterates that the preponderance of the evidence weighs against findings that a relevant in-service injury or disease occurred. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Shamil Patel, 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.