Citation Nr: A26030833 Decision Date: 04/03/26 Archive Date: 04/03/26 DOCKET NO. 210322-148125 DATE: April 3, 2026 REMANDED Entitlement to a compensable disability rating for residuals of an open reduction and internal fixation of the left little finger (left little finger disorder) is remanded. REASONS FOR REMAND The Veteran served on active duty from March 2003 to March 2008. This matter comes to the Board of Veterans' Appeals (Board) from a November 2020 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In the March 22, 2021, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on December 4, 2024 before the undersigned Veterans Law Judge; a hearing transcript has been added to the record. Therefore, the Board may only consider the evidence of record at the time of the November 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. However, because the Board is remanding the claim, any evidence the Board could not consider will be considered by the AOJ in the adjudication of the claim. 38 C.F.R. § 3.103(c)(2)(ii). Increased rating for residuals of an open reduction and internal fixation of the left little finger (left little finger disorder) is remanded. The Board finds that remand is required to remedy a pre-decisional omission in VA's duty to assist the Veteran. 38 C.F.R. § 20.802(a). Pursuant to Jones v. Shinseki, 26 Vet. App. 56 (2012), VA may not consider the ameliorative effects of medication where such effects are not explicitly contemplated by the rating criteria. Stated another way, VA "must discount beneficial medication effects when assigning an evaluation" when the applicable diagnostic code does not consider them. Ingram v. Collins, 38 Vet. App. 130 (2025). VA provided an examination for the Veteran's left little finger in November 2020. The examination report documents that the Veteran treats his musculoskeletal disorder with various medications, including Tylenol and arthritis cream. However, the report does not clearly delineate the ameliorative effects of medication when describing the impact of the Veteran's condition. The relevant diagnostic codes used to evaluate the Veteran's left little finger condition do not consider the beneficial effects of medication. Therefore, under Jones and Ingram, the Board must discount their effects. On remand, a corrective examination should be provided. The matter is REMANDED for the following action: Provide the Veteran with an appropriate examination to determine the severity of the service-connected residuals of an open reduction and internal fixation of the left little finger. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The relevant Disability Benefits Questionnaire must be utilized. To comply with Jones and Ingram, the examiner must discount the beneficial effects of medication on the severity of the Veteran's left little finger disorder. A complete rationale must be given for all opinions and conclusions expressed. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). S. CHARLES NEILL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board SG, 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.