Wrist & hand decisions — 2019

The Board denied payment or reimbursement for unauthorized medical expenses incurred at Moberly Regional Medical Center on January 2, 2018 due to the lack of pre-authorization and failure to meet the criteria for emergency treatment under 38 U.S.C. § 1725.

The Board denied the claim of clear and unmistakable error (CUE) in the April 1972 rating decision that granted service connection for residuals of shrapnel wound and fracture of the right wrist, as reasonable minds could disagree about whether the disability was moderately severe or severe.

The Veteran's bilateral hand numbness and tingling, including his carpal tunnel syndrome, are remanded for further examination. The issue of an increased rating for peripheral nerve damage and numbness in the left lower extremity is also remanded due to a lack of clarity regarding whether it is separate from service-connected radiculopathy. The lumbar spine condition remains remanded.

The Veteran's right knee disability, including degenerative joint disease of the right knee, is granted as service-connected. Other conditions are denied.

The Veteran's service-connected right elbow condition is found to be the proximate cause of his painful right wrist motion. Service connection for this condition is granted.

The Board has determined that the Veteran's left wrist tendinitis is related to her military service and grants service connection for this condition.

The Board has dismissed the Veteran's appeal for an initial rating in excess of 10 percent for tinnitus. The claims for increased ratings for bilateral hearing loss, generalized anxiety disorder with major depression prior to April 11, 2016, sleep apnea, GERD, right wrist sprain with avascular necrosis, status post removal of necrotic bone, psoriasis, diabetes, right ankle sprain, right knee disorder, right foot disorder, bilateral leg disorder, chest disorder, residuals of head injury including scar, and vocal chords disorder are all remanded for further development.

The Board denied service connection for a left wrist disorder and granted service connection for bilateral hearing loss with an initial rating of 20 percent, effective February 3, 2014. The decision also found that the Veteran's current left wrist disability is not related to service.

The Veteran's service-connected disabilities have made him unable to secure and follow substantially gainful employment, thus the Board has granted his claim for total disability rating based on individual unemployability (TDIU).

The Board has granted service connection for bilateral carpal tunnel syndrome, finding that the condition was shown as such in service and manifested after service.

The Board has remanded the Veteran's claims for left and right ankle disorders, foot disorders, asthma (respiratory disorder), right shoulder disorder, right wrist disorder, left-hand disorder, right-hand disorder, lumbar spine disorder, cervical spine disorder, right hip disorder, left hip disorder, left knee disorder, and right knee disorder due to outstanding VA treatment records and the need for additional medical examinations.

The appeal of the issue of entitlement to service connection for diabetes mellitus, type II is dismissed. The appeals for increased disability evaluation in excess of 10 percent for left-wrist disorder, service connection for left-hand numbness (to include carpal tunnel syndrome), service connection for an acquired psychiatric disorder, to include PTSD, service connection for kidney disorder, to include as secondary to medications prescribed for hypertension and/or an acquired psychiatric disorder, to include PTSD, and service connection for obstructive sleep apnea, to include as secondary to an acquired psychiatric disorder, to include PTSD are all remanded.

The Board has denied the Veteran's claim for a compensable rating for bilateral hearing loss. The issues of service connection for various conditions, including right rotator cuff condition, back condition, asbestosis, and knee conditions are remanded due to outstanding records.

The Veteran's right wrist disability is rated at 40 percent, but the Board denied a higher rating and TDIU due to lack of ankylosis outside favorable or loss of use.

The Board has remanded several service connection claims due to the need for additional examinations and development of evidence. The appellant's left knee osteoarthritis claim remains in appellate status, while his generalized anxiety disorder claim requires a new examination.

The Board has remanded the Veteran's claims due to inadequate medical examinations and development needs.

The Board has dismissed the claim of service connection for depression and is remanding the Veteran's right wrist rating claim. The issue of a separate compensable rating for neurologic abnormalities associated with a right wrist disability is also being remanded.

The Veteran's chronic tension headaches are granted service connection. The other issues on appeal are remanded for further development.

The Veteran's bilateral carpal tunnel syndrome is rated at 20 percent for the left hand and 30 percent for the right hand, reflecting moderate incomplete paralysis.

The Veteran's claim for an increased rating of his service-connected right wrist disability is remanded due to the need for a new VA examination and notification regarding a scheduled examination.