Citation Nr: 22012382 Decision Date: 03/03/22 Archive Date: 03/03/22 DOCKET NO. 18-54 637 DATE: March 3, 2022 REMANDED Entitlement to a disability rating in excess of 10 percent for the service-connected left wrist sprain, status post wrist surgery, to include whether a separate compensable disability rating is warranted for neurological impairment, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1990 to December 1993. This case is before the Board of Veterans' Appeals (Board) on appeal from an April 2016 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. In that rating decision, the RO continued a previously assigned10 percent disability rating for the service-connected left wrist sprain, status post wrist surgery (hereinafter "left wrist disability.") The Veteran's notice of disagreement was received in June 2016. The RO issued a statement of the case in October 2018. The Veteran's VA Form 9, substantive appeal to the Board, was received in December 2018. In August 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge. A transcript of the testimony is associated with the claims file. Entitlement to a disability rating in excess of 10 percent for the service-connected left wrist sprain, status post wrist surgery, to include whether a separate compensable disability rating is warranted for neurological impairment. The Veteran asserts that he has nerve damage as the result of left wrist surgery secondary to his service-connected left wrist sprain. See June 2016 NOD. August 2013 private medical records show the Veteran underwent left wrist arthroscopy to include nerve resection. The Veteran was afforded a VA wrist examination in March 2016. He reported that since his August 2013 surgery his wrist is more stiff and painful. The VA examiner noted in her remarks: During this interview and exam veteran also expressed symptomatology related to left ulnar nerve and elbow which is UNLIKELY to be related to his left wrist; he is advised to [follow up] with his [primary care provider] or orthopedic specialist about that. During the August 2021 Board hearing the Veteran testified to symptoms of nerve damage such as numbness in his pinky and ring finger, pain sensation that goes up his forearm, and chronic pain. He sincerely believes these symptoms are associated with his service-connected left wrist disability. The probative value of a medical opinion comes from its reasoning. A medical opinion that provides no rationale or an incomplete analysis is not adequate to decide a claim. The March 2016 VA examiner's opinion is a conclusory statement that does not explain how she came to her conclusion. A conclusory medical opinion that is unaccompanied by rationale is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The matter is REMANDED for the following action: Schedule the Veteran for a VA neurology examination, with a neurologist, if possible, to determine the current nature and severity of the service-connected left wrist disability, to include whether the Veteran has any related neurological impairment as a result of his prior left wrist surgery; and, whether the left wrist disability is manifested by ankylosis. The examiner should note review of this remand, and the entire claims file, and should obtain from the Veteran a full recorded history of his reported symptoms, including, but not limited to numbness in his pinky and ring finger, pain sensation that goes up his forearm, and chronic pain. Following all necessary testing, the clinician should address the following inquiry: Is the Veteran's service-connected left wrist disability manifested by ankylosis? If so, is it favorable or unfavorable, and to what degree? Does the Veteran have neurological impairment affecting his left wrist, hand, and/or forearm? If so, is it at least as likely as not (i.e., a 50 percent or greater probability) that any current neurological impairment is related to the Veteran's service-connected left wrist disability, status-post surgical repair? Why or why not? If a determination in this regard cannot be made without resorting to speculation, then the symptoms must be considered as part and parcel of the service-connected wrist disability. If the Veteran as likely as not has neurological impairment related to his service-connected left wrist disability, then what is the current extent and severity of the impairment, to include the nerve(s) involved and the extent of any motor and/or sensory deficit? L. B. CRYAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Ardalan, 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.