Citation Nr: 21040918 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 16-63 520 DATE: July 7, 2021 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a sciatic nerve disorder, to include on a secondary basis, is remanded. Entitlement to service connection for a right-hand disability is remanded. Entitlement to service connection for a hiatal hernia is remanded. REASONS FOR REMAND The Veteran had active service from January 2002 to October 2009. These matters come to the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2020, the Veteran appeared at Board hearing before the undersigned. Although the Veteran's representative was not present during this hearing, the Veteran agreed to continue with the proceeding. The transcript is of record. VA's duty to assist includes providing a medical examination or obtaining a medical opinion when such is necessary to make a decision on the claim. 38 U.S.C. § 5103A(d). VA is obligated to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service, and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d) (2012); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Veteran contends that he has a back disability, sciatic nerve disorder, right hand disability, and hiatal hernia that are related to active service. The Veteran also asserts that the sciatic nerve disorder is related to his back disability. The Veteran's service treatment records (STRs) contain various complaints related to each of these claimed disorders. Specifically, an April 2005 STR notes that the Veteran reported having an intermittent, non-reproducible bulge for the last two years on the left rib line, which was painful; the assessment notes possible hernia, which could not be reproduced or tested. An April 2007 record notes that the Veteran received treatment for a right-hand injury resulting in swelling, bruising, a small laceration, and tenderness at the fourth and fifth metacarpal. A July 2007 STR notes pain in the thoracic spine, severe upper back pain, and a pinched nerve, lasting approximately one week; a June 2009 post-deployment assessment also notes complaints of back pain. At his Board hearing, the Veteran testified that these disorders began during active service and that he has continued to experience symptoms since service. In this regard, the Veteran described experiencing ongoing back pain with a shooting pain and/or numbness in his extremities, right hand pain, and an intermittent bulge in presents in his chest when laying in certain positions. The Board notes that the Veteran has not been afforded a VA examination for his claimed disorders and finds that the documentation of complaints and treatment in his STRs and the lay statement provided by the Veteran regarding continuity of symptoms of since service, which the Board finds both competent and credible, are sufficient to trigger the VA's duty to assist. As such, the Board finds that prior to adjudication, a remand for VA examinations is necessary to determine if the Veteran has a current back disability, nerve disorder, right hand disability, and hiatal hernia or related disorder manifested by an intermittent bulge in the chest, and if so, to address whether it is etiologically related to his active service, and, in the case of a nerve disorder, whether it is alternatively related to a service-connected disability. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination with an appropriate medical professional with respect to the nature and etiology of his claimed back disability. The electronic claims file must be made accessible to the examiner for review, and such review should be noted in the examination report. The VA examiner must offer an opinion as to the following: (a.) Does the Veteran have a current back disability? If so, the examiner should address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's current back disability is etiologically related to military service. (b.) The examiner must provide reasons for each opinion expressed with consideration given to all evidence of record, including the Veteran's lay statements and service treatment records, which note complaints of back pain in July 2007 and June 2009. 2. Schedule the Veteran for a VA examination with an appropriate medical professional with respect to the nature and etiology of his claimed sciatic nerve disorder. The electronic claims file must be made accessible to the examiner for review, and such review should be noted in the examination report. The VA examiner must offer an opinion as to the following: (a.) Does the Veteran have a nerve disorder, to include sciatic involvement? If so, the examiner should address the following: i. Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's nerve disorder is etiologically related to military service. ii. Additionally, if a back disability is found to be related to service, the examiner should also opine as to whether it is at least as likely as not (50 percent or greater probability) that the nerve disorder is proximately due to or the result of a service-connected disability. (b.) The examiner must provide reasons for each opinion expressed with consideration given to all evidence of record, including the Veteran's lay statements and service treatment records, which note complaints of a pinched nerve along with complaints of back pain. 3. Schedule the Veteran for a VA examination with an appropriate medical professional with respect to the nature and etiology of his claimed right-hand disability. The electronic claims file must be made accessible to the examiner for review, and such review should be noted in the examination report. The VA examiner must offer an opinion as to the following: (a.) Does the Veteran have a current right-hand disability? If so, the examiner should address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's current right-hand disability is etiologically related to military service. (b.) The examiner must provide reasons for each opinion expressed with consideration given to all evidence of record, including the Veteran's lay statements and service treatment records, which note a right-hand injury in April 2007. 4. Schedule the Veteran for a VA examination with an appropriate medical professional with respect to the nature and etiology of his claimed hiatal hernia. The electronic claims file must be made accessible to the examiner for review, and such review should be noted in the examination report. The VA examiner must offer an opinion as to the following: (a.) Does the Veteran have a current hiatal hernia or related disability manifested by an intermittent bulge in the chest? If so, the examiner should address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's hiatal hernia or related disability is etiologically related to military service. (Continued on the next page) (b.) The examiner must provide reasons for each opinion expressed with consideration given to all evidence of record, including the Veteran's lay statements and service treatment records, which note complaints and treatment for a possible hernia in April 2005. Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Hite, 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.