Citation Nr: 22010670 Decision Date: 02/24/22 Archive Date: 02/24/22 DOCKET NO. 17-09 268 DATE: February 24, 2022 ORDER Entitlement to service connection for right wrist triangular fibrocartilage complex (TFCC) tear is denied. FINDING OF FACT The weight of the evidence is against a finding that the Veteran's right wrist TFCC tear is etiologically related to service. CONCLUSION OF LAW The criteria for service connection for right wrist TFCC tear have not been met. See 38 U.S.C. §§ 501, 1111; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably in the Army from July 2006 to September 2011. This matter comes before 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 May 2020, the Board remanded the matter for an addendum opinion. In June 2020 and September 2020, an addendum opinion was provided. Upon review, of the medical opinions the Board finds that there has been substantial compliance with the Board remand instructions. In February 2020, the Veteran testified before the undersigned Veterans Law Judge (VLJ) during a videoconference. A transcript is associated with the claims file. SERVICE CONNECTION Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active-duty service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to establish service connection a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. See 38 C.F.R. § 3.303 (d). The standard of proof to be applied in decisions on claims for veterans' benefits is outlined in 38 U.S.C. § 5107. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. See 38 C.F.R. § 3.102. When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. Entitlement to service connection for right wrist TFCC tear is denied. The Veteran has a diagnosis of right wrist TFCC tear. See June 2020 VA medical opinion. The first element of Shedden is met. Regarding the second element of Shedden, in-service incurrence, service treatment records (STRs) show a diagnosis of right wrist ganglion cyst in 2010 and tendonitis in 2011. The Veteran asserts that her right wrist was injured while in Afghanistan and she was told she had tendonitis. She adds that she found out she had a torn cartilage after service discharge and that the in-service diagnosis of tendonitis was in error. In any event, the second element of Shedden is met. As to the third prong of Shedden, a VA examiner determined that it was less likely than not that the Veteran's right wrist TFCC tear was related to service. See September 2020 VA examination report. The VA examiner reasoned that the Veteran's single episode of tendonitis in early 2011 was not the causal factor involved in her TFCC injury. The condition was acute and resolved. The examiner added that there was no clinical evidence that this condition was misdiagnosed as her clinical history, symptoms, and examination at the time are consistent with that diagnosis. The VA examiner also reasoned that there was no objective evidence that the ganglion cyst diagnosed in 2010 was misdiagnosed. The examiner emphasized that the in-service description of the wrist nodule and medical history are consistent with a ganglion cyst. The in-service ganglion cyst was observed to have resolved and to be unrelated to the Veteran's TFCC tear. The VA examiner added that the causal analysis was based on medical principles anchored by clinical evidence. The VA examiner used the subject history of pain to provide a narrative or framework for which one may place the medical data within and attempt to reconstruct the possible etiology or development of the disease/illness in question. The Board finds this opinion to be highly probative, as it was based on a thorough review of the Veteran's claim file and an adequate rationale was provided to support the conclusion. See Bloom v. West, 12 Vet. App. 185, 187 (1999). The medical opinion is afforded substantial probative weight. See Nieves-Rodriquez v. Peake, 22 Vet. App. 295, 304 (2008). There are no competent medical opinions to the contrary. The Board acknowledges that lay individuals are competent to report symptoms observable to a layperson i.e., wrist pain. Nevertheless, lay individuals are not competent to opine as to the specific etiology of this condition. Consequently, the lay assertions of etiology cannot constitute evidence upon which to grant the claim for service connection, and the Board affords these statements little probative value. See Latham v. Brown, 7 Vet. App. 359, 365 (1995). The Board is mindful that all reasonable doubt is to be resolved in the Veteran's favor. However, as the persuasive evidence is against the claim, the claim must be denied. See 38 U.S.C. § 5107 (b); see also Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Smith, 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.