Citation Nr: 21030579
Decision Date: 05/19/21	Archive Date: 05/19/21

DOCKET NO. 16-42 244
DATE: May 19, 2021

REMANDED

Entitlement to a compensable rating for residual scars from lacerations of the left middle, ring, and little fingers is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Navy from July 1973 to April 1975. 

This matter was previously denied by the Board of Veterans' Appeals (Board) in November 2018. The Veteran appealed that decision in October 2019. In June 2020, the United States Court of Appeals for Veterans Claims (Court) issued a Memorandum Decision, in which it set aside and remanded the matter back to the Board for further development and readjudication. 

The Board finds that a remand is necessary to obtain an adequate medical opinion to comply with the Court's Order.

In the June 2020 Order, the Court found the Board erred by failing to return the January 2016 VA examination for clarification. The Court noted that the January 2016 examiner attributed the Veteran's left middle, ring and little fingers' numbness to carpal tunnel syndrome (CTS), despite the evidence of record showing the Veteran experienced pain and numbness in his fingertips since service, prior to a diagnosis of CTS, and continued to suffer from those symptoms despite his CTS surgery. The Court found the examiner's opinion to be unclear on how the appellant's numbness attributed to a median nerve condition related to CTS post-surgery. The Court found that no explanation was provided on how the median nerve would cause the appellant's finger numbness, particularly in his little finger. The Court found that the examiner noted mild incomplete paralysis of the median nerve based on Phalen's and Tinel's sign test results, but these tests do not involve the little finger. Given the nature of these tests, the Court found that it does not appear that the median nerve has any involvement with the little finger. Thus, a remand is necessary for clarification regarding the Veteran's asserted pain and numbness in his fingertips.  

Additionally, the Court concluded that the Board relied on an inadequate May 2016 VA examination to deny the Veteran a compensable rating for his service-connected hand condition. During this examination, the examiner failed to provide a rationale for the conclusion that the Veteran's fingertip numbness was due to his non-service-connected CTS. The examiner did not provide an opinion as to whether the fingertip numbness was due to the Veteran's service-connected residuals of lacerations of his left middle, ring, and little fingers. The Court indicated that the Board may not rely on the May 2016 examination report and reminded the Board that its analysis should not be limited solely to painful scars, as the Veteran is service connected for "residuals" of laceration of his left middle, ring, and little fingers.  As such, another examination is warranted which adequately addresses the Veteran's service-connected disability.

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination to determine the current nature and severity of the Veteran's service-connected residual scars from lacerations of the left middle, ring, and little fingers. The examiner is reminded that residuals are not limited to painful scars. 

The examiner is asked to describe the disorder in detail and document all symptoms necessary for rating it under the relevant criteria. 

The examiner should specifically address the Veteran's pain and numbness in the fingertips. In doing so, the examiner should review and consider the private treatment record submitted in March 2021 from G.L. discussing the Veteran's symptomatology.

2. After the above actions have been completed, and any other development deemed necessary, readjudicate the Veteran's claim. Then issue the Veteran and his attorney a Supplemental Statement of the Case. Afford him an appropriate period of time within which to respond thereto. 

 

Jenna Brant

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. Townsend, 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.