Citation Nr: 21031817 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 15-21 165 DATE: May 24, 2021 REMANDED Entitlement to service connection for a right upper extremity disability other than right hand arthritis, to include right wrist arthritis and right upper extremity carpal tunnel syndrome, and to include as secondary to a right hand disability, is remanded. Entitlement to service connection for a left upper extremity disability, to include left wrist arthritis and left upper extremity carpal tunnel syndrome, and to include as secondary to a right upper extremity disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1990 to November 1996. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2013 rating decision of an Agency of Original Jurisdiction (AOJ) of the Department of Veterans Affairs (VA), as that decision never became final and the Veteran subsequently filed a timely Notice of Disagreement. In June 2018, the Veteran testified at a videoconference hearing before the undersigned. In August 2018 and July 2020, the Board remanded this matter for additional development. The Board has broadened and recharacterized the Veteran's claim to include the relevant diagnoses of record. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). 1. Entitlement to service connection for a right upper extremity disability other than right hand arthritis, to include right wrist arthritis and right upper extremity carpal tunnel syndrome, and to include as secondary to a right hand disability, is remanded. The Board sincerely regrets the delay, but remand is necessary for additional development. The AOJ attempted to secure the medical opinion requested by the Board, and the VA examiner provided two detailed and nearly-comprehensive addendum opinions. See September 3, 2020 VA Medical Opinion; October 20, 2020 VA Medical Opinion. However, one aspect of these opinion does not comply with the Board's remand directives. Specifically, the Board directed the examiner to accept as true the Veteran's lay statements that his right wrist symptoms persisted after his cyst was drained, but provided the examiner the opportunity to address whether the evidence is medically consistent with the evidence of record. However, the examiner did not address the Veteran's reports, but instead noted that the Veteran is not competent to provide a medical diagnosis and relied on the absence of documented complaints after October 1995. On remand, an addendum opinion should be secured addressing this deficiency. The Veteran is advised that if the examiner opines that the Veteran's report of continued symptomatology following the October 1995 aspiration is medically inconsistent with the examination findings of record, the Board may rely on this evidence in making an adverse credibility determination. The Veteran may submit additional statements or other evidence in support of his claim and his testimony that symptoms persisted following the October 1995 aspiration, and the Board will consider this before reaching any decision. 2. Entitlement to service connection for a left upper extremity disability, to include left wrist arthritis and left upper extremity carpal tunnel syndrome, and to include as secondary to a right upper extremity disability, is remanded. Action on this issue is deferred pending development with respect to the Veteran's right wrist claim. The matters are REMANDED for the following action: Obtain an addendum opinion, from the October 2020 examiner if possible, addressing the etiology of the Veteran's right wrist arthritis and carpal tunnel syndrome. The claims file should be made available to and should be reviewed by the examiner. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. The examiner should address the following: (a) Please assume that the Veteran's report of unreported persistent right wrist symptoms following his October 1995 ganglion cyst aspiration are true. With this assumption in mind, is at least as likely as not (50 percent probability or higher) that the Veteran's right wrist arthritis manifested in service or within one year after separation from service? (b) Please assume that the Veteran's report of unreported persistent right wrist symptoms following his October 1995 ganglion cyst aspiration are true. With this assumption in mind, is at least as likely as not (50 percent probability or higher) that the Veteran's right wrist carpal tunnel syndrome manifested in service or within one year after separation from service? In addressing questions (b) and (c), the examiner may rely on medical principles and judgment to explain any plausible or possible causes of the reported symptoms. (c) Please state whether it the Veteran's report of unreported right wrist symptoms in service following the October 1995 aspiration is medically consistent with the examination findings of record and provide a rationale for this opinion. The Board acknowledges the lack of objective evidence. However, this opinion should be based on affirmative medical evidence and not solely based on the absence of evidence of treatment following October 1995. A complete rationale must be provided for all opinions. If the requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why an opinion would be speculative. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.M. Badaczewski, 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.