Citation Nr: 22019947 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 01-00 121A DATE: April 3, 2022 REMANDED Entitlement to service connection for residuals of a left hand injury is remanded. REASONS FOR REMAND The Veteran had active service from March 1968 to March 1971, to include service in the Republic of Vietnam. These matters were previously remanded by the Board of Veterans' Appeals (Board) in July 2019, November 2020, and August 2021. Service Connection Residuals of a Left Hand Injury In March 2022, the Veteran submitted a medical article which he believes indicates that his arthritis was the result of a soft tissue injury he sustained after an in-service motor vehicle accident. Consequently, the Board finds that this matter must be remanded for an addendum opinion to permit an examiner to review this evidence. Additionally, the Veteran has indicated that he believes his left hand injury to be related to "shrapnel" he received during a mortar attack in September 1969, an event attested to otherwise in buddy statements from a fellow soldier but not memorialized in the Veteran's in-service treatment record for any hand injuries. However, given that there are apparent foreign bodies visualized in the Veteran's left hand beginning with the X-rays taken in 2002, the Board requires clarification as to whether there are any medical reasons indicating that these foreign bodies are or are not objects acquired during combat as the Veteran has maintained. Accordingly, this matter is REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's left hand arthritis is at least as likely as not related to soft tissue injuries received in a motor vehicle accident during service. In providing this opinion, the clinician should consider the complete evidence of record, including the medical article submitted by the Veteran in March 2022. Alternatively, the Veteran has claimed that his left hand was injured in a mortar attack in 1969. While no records indicate a hand injury at that time, X-rays taken in 2002 document apparent foreign bodies in the Veteran's left hand, and the current clinician should opine as to whether it is at least as likely as not that the Veteran's left hand disability is a result of these foreign bodies, and, if so, whether it is at least as likely as not that this foreign bodies are a result of the mortar attack as described by the Veteran. In doing so, the clinician should comment on any medical reasons for determining that these foreign bodies were or were not acquired as described. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue 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. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran also is advised that he has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO 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.