Citation Nr: 22015978 Decision Date: 03/20/22 Archive Date: 03/20/22 DOCKET NO. 20-14 810 DATE: March 20, 2022 REMANDED Entitlement to service connection for a left wrist disability, to include as due to exposure to tactical herbicide agents and Gulf War environmental hazards is remanded. Entitlement to service connection for right wrist disability, to include as due to exposure to tactical herbicide agents and Gulf War environmental hazards is remanded. Entitlement to service connection for a left hand/fingers disability, to include as due to exposure to herbicides and Gulf War environmental hazards is remanded. Entitlement to service connection for a right hand/fingers disability, to include as due to exposure to tactical herbicide agents and Gulf War environmental hazards is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1967 to May 1969 and from November 1990 to July 1991. He served honorably in the United States Army and Army Reserve during the Vietnam and Gulf War Era, to include foreign service in the Republic of Vietnam and Southwest Asia. He was awarded numerous medals, to include the National Defense Service Medal (2 Awards), the Vietnam Service Medal, the Republic of Vietnam Campaign Medal, the Bronze Star Medal and the Southwest Asia Service Medal (1 Bronze Star). The Board thanks the Veteran and his family for his decades of service to our country. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in April 2018. These matters were previously before the Board and denied in August 2020. The denials were appealed to the United States Court of Appeals (Veterans Court) and remanded pursuant to a Joint Motion for Partial Remand (Joint Motion) in October 2021. All issues are remanded. In the October 2021 Joint Motion, the parties determined that the Board had failed to provide an adequate statement of reasons and bases for two reasons: (1) for failing to discuss the Veteran's lay statements alleging treatment for his wrist conditions (at least) and continuous symptoms from that injury; and (2) for failing to explain why the March 2018 examination was adequate given that the examiner only addressed the known etiology of the Veteran's wrist conditions, but did not address whether the pathophysiology was known. In consideration of the text of the Joint Motion, the Board finds that the best course of action is to remand these matters for an additional examination and opinion. Additionally, documents recently added to the claims file appear to indicate that the Veteran's wrist conditions were recently evaluated at a VA facility. Consequently, these additional VA treatment records should be obtained. The matters are REMANDED for the following actions: 1. Obtain the Veteran's VA treatment records for the period from January 2019 to the Present. 2. Schedule the Veteran for a VA examination for his claimed bilateral wrist and hand/finger disabilities. 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 in earning capacity, then the examiner should consider them a "disability" for the purpose of providing the requested opinions below. The examiner is asked to provide a response to the following: Are the claimed bilateral wrist and hand/finger disabilities at least as likely as not related to service, including the Veteran's described injury while taking cover? Are the claimed bilateral wrist and hand/finger disabilities at least as likely as not related to in-service exposure to herbicide agents? The examiner is advised that a negative opinion cannot be based solely on the fact that the claimed bilateral wrist and hand/finger disabilities are not on the list of diseases that are presumptively associated with exposure to herbicide agents. Are the claimed bilateral wrist and/or hand/finger disabilities manifestations of an undiagnosed illness or a chronically unexplained chronic multi-symptom illness. A medically unexplained chronic multi-symptom illness is an illness without a conclusive pathophysiology or etiology. Consequently, an adequate rationale must address whether the disabilities (if any) of the Veteran's bilateral wrists and/or hand/fingers have both a conclusive pathophysiology and etiology. Provide a rationale to support the opinions. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefit sought is not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. CLAIRE M. DAVIDOSKI Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Steven H. Johnston, 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.