Citation Nr: A25093063 Decision Date: 10/28/25 Archive Date: 10/28/25 DOCKET NO. 230901-375294 DATE: October 28, 2025 ORDER Entitlement to service connection for left wrist carpal tunnel syndrome is granted. Entitlement to service connection for right wrist carpal tunnel syndrome is granted. FINDINGS OF FACT 1. The left wrist carpal tunnel syndrome was caused by the Veteran's active duty service. 2. The right wrist carpal tunnel syndrome was caused by the Veteran's active duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for left wrist carpal tunnel syndrome have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for service connection for right wrist carpal tunnel syndrome have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Army from August 1973 to November 1976. These matters are before the Board of Veterans' Appeals (Board) on appeal from an August 2023 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2023, the Veteran filed a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), requesting a hearing with a Veterans Law Judge. In August 2025, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the transcript is of record. As the Veteran's case is proceeding on the hearing docket, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his attorney at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). Although the evidentiary window has not closed, this does not prejudice the Veteran given the full grant below. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). Entitlement to service connection for left wrist carpal tunnel syndrome and right wrist carpal tunnel syndrome In May 2023, the Veteran filed a claim for service connection for carpal tunnel syndrome of the bilateral wrists. The RO denied that claim in an August 2023 rating decision, and the Veteran appeals that decision. Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Turning to the evidence, the Veteran's service treatment records are silent for complaint, diagnosis, or treatment for carpal tunnel or radiculopathy. In a separation medical examination completed in June 1976, the Veteran's upper extremities, spine, and neurologic symptoms were found to be normal. See STR - Medical, October 18, 1974, p24. In August 2005, the Veteran reported neurologic impairment in his right forearm. A VA clinician assessed probable median nerve entrapment syndrome in the proximal forearm instead of carpal tunnel syndrome, but treatment records from at least May 2009 forward listed carpal tunnel syndrome listed as an active problem. See CAPRI, October 4, 2021, p278. In March 2023, the Veteran wrote a letter to VA stating that he had pain in his hands and wrist and that the symptoms onset during military service when he had to use old-style typewriters for extended periods. He said that at first the pain was very mild, but it worsened over time and after military service. See Correspondence, March 14, 2023. A private doctor prepared a letter in April 2023 which described the Veteran's symptoms and stated that the Veteran felt that his symptoms were due to his military service. See Medical Treatment Record - Non-Government Facility, April 6, 2023. In August 2023, VA completed a Disability Benefits Questionnaire (DBQ) for Peripheral Nerve Conditions. Based on an in-person examination and a review of the VA e-folder, the examiner diagnosed carpal tunnel syndrome of the right and left hands. In terms of medical history, the Veteran said that his symptoms onset during service in 1974 when he was required to use an old-style typewriter. See C&P Exam, August 14, 2023. The August 2023 examiner issued a medical opinion which concluded that the bilateral carpal tunnel syndrome was at least as likely as not incurred in or caused by the claimed in-service injury, event, or illness. The opinion included a summary of the medical evidence and cited medical literature in support of its conclusion. The examiner's rationale for this conclusion was that the Veteran's duties required him to make "frequent, repetitive, small movements with his hands while typing and frequent, repetitive, grasping movements with the hands when he moved the typewriter around by grasping and holding its small handles" and that such movements were likely to cause carpal tunnel syndrome according to medical literature. See C&P Exam, August 14, 2023. At the hearing before the Board in August 2025, the Veteran testified that, as a radio operator, he operated the teletype and was responsible for encryption. He was required to operate a small box for encryption, and, in combination with typing on the teletype, "it was like constant use of my hands all the time." The Veteran waived the 90 day period for evidence submission. See Hearing Transcript, August 20, 2025. Applying the criteria for direct service connection, the Veteran has a current diagnosis of bilateral carpal tunnel syndrome from the August 2023 examination. His testimony at the hearing stated that during active duty, his bilateral hands and wrists were under strain operating the teletype and encryption equipment; his testimony is credible and consistent with the duties of a Radio Operator. See Certificate of Release or Discharge From Active Duty (e.g. DD 214, NOAA 56-16, PHS 1867), October 18, 1974. The first and second requirements have been met. See Saunders, supra. The third requirement for direct service connection is evidence of a link or causal relationship between the current disability and the in-service disease or injury. See 38 C.F.R. § 3.303(a). The August 2023 VA medical opinion concluded that the bilateral carpal tunnel syndrome was at least as likely as not incurred in or caused by the claimed in-service injury, event, or illness. The opinion was supported by a rationale and cited medical literature to support its conclusion. There is no medical evidence stating otherwise. Therefore, the evidence supports a finding that the bilateral carpal tunnel syndrome was caused by the Veteran's active duty service, and service connection is warranted. J. NICHOLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Dean, Robert 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.