12-02 114
12-02 114
| Board of Vet. App. | Aug 31, 2016Background
- Veteran served active duty Dec 1976–Dec 1980 as a Cannon Crewman; claims bilateral hand disorders (carpal tunnel, trigger fingers, DJD) due to cold injuries and repetitive manual work in service.
- RO initially denied in Oct 2010; Board remanded in 2014; Board denied in Dec 2014; Court vacated and remanded on JMR in July 2015. Further development and examinations occurred through Jan 2016.
- Service treatment records show cold injury to feet (Jan 1980) but no treatment or complaints for hand conditions during service or within one year of discharge. Separation exam was not performed at separation by Veteran’s choice.
- Post-service medical records (1996–2016) document bilateral carpal tunnel, trigger finger, hand osteoarthritis, and related findings; earliest consistent postservice documentation begins many years after discharge.
- Multiple VA medical opinions (2012, 2014, 2015, 2016) and private records conclude it is less likely than not the hand conditions are related to in-service events; Board found these opinions adequate and found veteran’s lay assertions insufficient to establish causation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for bilateral hand disorder (carpal tunnel, trigger finger, DJD) | Veteran: onset in service from cold injuries and repetitive gun/cannon work; hand symptoms and wrist cyst in service | VA: no service records showing hand complaints/diagnoses in service or within one year; long gap to onset; competent negative medical opinions link conditions to postservice events | Denied — preponderance of evidence shows disorders not incurred in or aggravated by service |
| Continuity/manifestation within one year for arthritis presumptive service connection | Veteran: arthritis/degenerative changes began in/around service or soon after | VA: no medical evidence of manifestation to compensable degree within one year of discharge; earliest findings decades later | Not established — no presumptive entitlement under 38 C.F.R. §§ 3.307/3.309 |
| Probative weight of lay testimony vs medical opinion | Veteran: competent to report symptoms and link to service events | VA: etiology requires medical expertise; medical opinions considered veteran’s statements and still found against causation | Board gave greater weight to contemporaneous records and medical opinions; lay assertions insufficient to overcome them |
| Applicability of benefit-of-the-doubt doctrine | Veteran: ambiguous record should be resolved in his favor | VA/Board: evidence preponderates against claim | Doctrine not applied — preponderance against claim |
Key Cases Cited
- Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (VA notice/duty-to-notify precedents)
- Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (continuity of symptomatology limited to specified chronic conditions)
- McLendon v. Nicholson, 20 Vet. App. 79 (Vet. App. 2006) (VA examination/scope of duty to assist)
- Barr v. Nicholson, 21 Vet. App. 303 (Vet. App. 2007) (lay evidence as to observable symptoms; consideration by examiner)
- Bryant v. Shinseki, 23 Vet. App. 488 (Vet. App. 2010) (requirements for Board hearing and fact-finding)
- Hayes v. Brown, 5 Vet. App. 60 (Vet. App. 1993) (Board’s responsibility to weigh evidence credibility)
- Guerrieri v. Brown, 4 Vet. App. 467 (Vet. App. 1993) (probative value of medical opinions depends on analysis and expertise)
- Kahana v. Shinseki, 24 Vet. App. 428 (Vet. App. 2011) (limits of layperson competence on medical etiology)
- Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App. 1990) (benefit-of-the-doubt rule)