Citation Nr: A24042829 Decision Date: 08/01/24 Archive Date: 08/01/24 DOCKET NO. 220427-240902 DATE: August 1, 2024 ORDER Entitlement to service connection for a right wrist disability is denied. FINDING OF FACT The evidence of record persuasively weighs against finding that the Veteran's right wrist disability onset during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a right wrist disability not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from August 1997 to August 2017. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2021 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), which is the Agency of Original Jurisdiction (AOJ). In his April 2022 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence submission docket. Therefore, the Board may only consider the evidence of record at the time of the August 2021 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Entitlement to service connection for a right wrist disability The Veteran seeks entitlement to service connection for a right wrist disability. He states that "[l]ifting of heavy ordnance in 500 pounds or more over the 20 years of service has aggravated [his] wrist to point of extreme discomfort." June 2021 VA 21-526EZ. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). In this case, the Veteran has a diagnosis of status post acute sprain in his right wrist, as noted in his July 2021 VA examination. As such, the first prong of service connection, a current disability, is met. With respect to the next two elements of service connection-an in-service event or incurrence of injury and its causal relationship to the Veteran's current disability-the Veteran's service treatment records reflect that the Veteran suffered an injury to his right wrist in 2009 after falling on an outstretched hand. Additionally, the Veteran states, and the service treatment records also reflect, that while in service, the Veteran was responsible for ordnance handling. Service treatment records indicate that the Veteran reported wrist pain in the weeks following his fall, specifically when pressure was applied to his wrist. X-rays taken in September 2009 showed no fractures. The Veteran did not report any wrist pain at subsequent doctor's appointments or on medical screening forms while in service. Though unspecified wrist joint point is noted in the problems list. On his 2017 report of medical history at service retirement, the Veteran checked "no" under "painful shoulder, elbow, or wrist." No abnormalities of the wrist were found on retirement examination. At his July 2021 VA examination, the Veteran told the examiner that his wrist pain started while in service, that he experienced "sharp pain," and was recommended to use warm and cold compresses. He reported intermittent popping of the wrist during regular rotation, wrist pain when rotating counterclockwise, and a limited range of motion. He said that he was unable to perform workouts with applied pressure and medium to heavy lifting is limited. He also reported flare ups that are alleviated by brace support. X-rays showed no "acute osseous abnormality" and no "acute fracture or dislocation." The examiner also noted a small decrease in dorsiflexion range of motion of the right wrist and that there was no evidence of pain. After reviewing the VA examination and the Veteran's file, the VA examiner concluded in an August 2021 opinion that the Veteran's wrist condition was less likely than not (less than a 50 percent probability) incurred or caused by his in-service injury. In support of her conclusion, the examiner observed that the Veteran's service treatment records and post-service treatment records lacked mention or treatment of continuing right wrist symptoms or impairment after the 2009 fall. The examiner wrote that the diagnosis of status post acute right wrist sprain indicated that "the previous right wrist pain in service had resolved." Finally, the examiner indicated that "[t]reatment records in service [do] not support a chronic right wrist condition that is related to the Veteran's current complaints of right wrist pain." The Board finds the VA examination and opinion credible and affords it probative weight. Importantly, the VA examination and opinion are largely consistent with the record. Though the Veteran reported at the July 2021 VA examination that his pain started in service, and many service treatment records list "wrist joint pain" as a "problem" that the Veteran has, the Veteran did not report any pain or symptoms or receive treatment specific to his right wrist after his fall in 2009. On the 2017 retirement examination, and at medical appointments during service, the Veteran reported that he was not having any pain in his wrists, and no abnormalities were noted on examination. Thus, the only credible, probative opinion of record weigh against the claim, and the Veteran has not presented or identified any medical opinion or other competent evidence that, in fact, supports his claim for service connection. The Board has considered the Veteran's statements regarding his in-service duties and the right wrist symptoms he noted in service. The Veteran is competent to testify to observations and symptoms; however, this testimony must be weighed against the other evidence of record. As noted above, continued right wrist treatment/complaints, beyond occasional notation of unspecified wrist pain, were not noted after 2009, to include at service discharge. The VA examiner also reviewed these records and the Veteran's statement and concluded that the disability did not likely onset in service. On the question as to whether the Veteran's right wrist disability had its onset in service, or is otherwise related to service, the specific, reasoned opinion of the VA examiner is of greater probative weight than the more general assertions of the Veteran, even assuming the Veteran's competence to opine on this medical question. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Kahana v. Shinseki, 24 Vet. App. 428, 433, n. 4 (2011). In sum, the Board finds that the weight of the evidence is persuasively against finding that the Veteran's right wrist disability is related to service, and the ben. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. The benefit of the doubt doctrine is therefore not for application. Lynch v. McDonough, 21 F.4th 776, 781-2 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). Therefore, entitlement to service connection is denied. G. E. Wilkerson Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Romberger, 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.