Citation Nr: 22010058 Decision Date: 02/22/22 Archive Date: 02/22/22 DOCKET NO. 13-28 761 DATE: February 22, 2022 ORDER Entitlement to service connection for carpal tunnel on the right is granted. Entitlement to service connection for carpal tunnel on the left is granted. REMANDED Entitlement to service connection for cervical spine is remanded. Entitlement to service connection for gastroenteritis is remanded. FINDINGS OF FACT 1. The Veteran's carpal tunnel on the right began during active service. 2. The Veteran's carpal tunnel on the left began during active service. CONCLUSIONS OF LAW 1. The criteria for service connection for carpal tunnel on the right are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for carpal tunnel on the left are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty from September 1980 to March 1987, from March 2005 to January 2006, from June 2009 to July 2011 and from June 2014 to July 2016. This matter comes before the Board of Veterans' Appeals (Board) from June 2010 and October 2016 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2018, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge (VLJ). This case was previously before the Board in August 2019. The issues of entitlement to service connection for a lumbar spine disability, hemorrhoids, left hip, right ankle and left ankle were all granted in a June 2020 rating decision. Therefore, they are no longer before the Board. 1. Entitlement to service connection for carpal tunnel on the right 2. Entitlement to service connection for carpal tunnel on the left The Veteran contends that his carpal tunnel on the right and left began during his military service. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The August 2016 Peripheral Nerves Conditions Disability Benefits Questionnaire (DBQ) shows that the Veteran has current diagnoses of carpal tunnel syndrome on the right and left. During service, the Veteran was diagnosed with carpal tunnel. See March 2016 treatment record. Thus, the question becomes whether the current disability is related to service. The Veteran filed his claim on July 13, 2016 for carpal tunnel. He was discharged two days later. The evidence shows that the Veteran was diagnosed during service and his disability continued after service. Upon review of the record, the Board finds the evidence shows that this carpal tunnel syndrome arose in service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for carpal tunnel on the right and left is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for cervical spine is remanded. The May 2020 examiner opined that the Veteran's cervical spine disability began between his active duty service periods. The examiner said it was less likely than not that the cervical spine incurred in or was caused by the claimed in-service injury, and it was less likely than not aggravated beyond natural progression by an in-service injury, event or illness. If an examiner finds that the disability began prior to one of the Veteran's periods of service, an opinion is needed as to whether it is clear and unmistakable that the disability pre-existed active service. Then the examiner must opine as to whether it was clear and unmistakable that the disability was not aggravated during service or clear and unmistakable that any increase was due to the natural progress. An opinion is needed in this case prior to the Board's adjudication of this issue. 2. Entitlement to service connection for gastroenteritis is remanded. The Veteran was treated for viral gastroenteritis in February 1983, a gastrointestinal infection in October 2005, a viral gastroenteritis in August 2009, all during active service. The Veteran filed a claim in November 2008 for entitlement to service connection for gastroenteritis, among other disabilities. As the Veteran has had a gastrointestinal diagnosis during service and during the claim period, an examination is needed to determine if the current treatment for gastrointestinal disorder is related to the Veteran's service as the Veteran claims. 38 C.F.R. § 3.159(c). The matters are REMANDED for the following action: 1. An addendum opinion is needed as to whether it is clear and unmistakable (obvious, manifest, and undebatable) that his cervical spine disability pre-existed active service. If so, state whether it is clear and unmistakable (obvious, manifest, and undebatable) that the pre-existing cervical spine disability WAS NOT aggravated (i.e., permanently worsened) during service or whether it is clear and unmistakable (obvious, manifest, and undebatable) that any increase was due to the natural progress. If any responses above are negative, provide an opinion as to whether the current spine disabilities, at least as likely as not (a probability of 50 percent or greater) began in or are related to active service. 2. Schedule the Veteran for a VA examination for his claimed gastrointestinal disability. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Does the Veteran have a gastrointestinal disability at any time since November 2008? Is the Veteran's current gastrointestinal disability at least as likely as not related to service, including viral gastroenteritis in February 1983, a gastrointestinal infection in October 2005, a viral gastroenteritis in August 2009? Provide a rationale to support the opinions. 3. Readjudicate the Veteran's claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case and afforded an appropriate period of time within which to respond thereto. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tahirih S. Samadani, 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.