BVA9505790 DOCKET NO. 93-10 505 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUES 1. Entitlement to service connection for left wrist carpal tunnel syndrome, secondary to service-connected left wrist chip fracture residuals. 2. Entitlement to an increased (compensable) evaluation for left wrist chip fracture residuals. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. Siegel, Counsel INTRODUCTION The veteran served on active duty from July 1973 to July 1975. This appeal arises from a rating decision of February 1992 from the St. Louis, Missouri, Regional Office (RO). REMAND The veteran contends, in essence, that the RO was in error when it denied service connection for left wrist carpal tunnel syndrome. He specifically alleges that this disability is etiologically or causally related to his service-connected left wrist chip fracture residuals. He also, in essence, contends that the RO erred when it denied a compensable evaluation for those residuals, and he avers that he has had persistent left wrist pain and discomfort. After a review of the record, the Board of Veterans' Appeals (Board) is of the opinion that additional development of the record is requisite prior to further review of the veteran's claims. In particular, the Board notes that the report of a Department of Veterans Affairs (VA) peripheral nerve examination, conducted in November 1992, indicates an opinion that "it is possible that [the veteran's] carpal tunnel syndrom (sic) [is] proximally secondary as a long term sequelae of the fractured [left wrist]." However, the report of a VA "joints" examination, conducted by a different physician on the same day, indicates diagnoses to include "[t]he carpal tunnel I do not think is secondary to the fracture [of the left wrist]." The Board also notes that VA outpatient treatment records show that the veteran's carpal tunnel syndrome was found to be bilateral in nature. The Board believes that the report of another VA special examination would be helpful in resolving these conflicting findings and contradictory evidence. In addition, the Board notes that these November 1992 reports, while citing left hand and left wrist symptomatology, do not identify those symptoms that are specifically manifestations of the veteran's left wrist chip fracture residuals (for which service connection has been established), and those that are specifically attributable to residuals of his left wrist carpal tunnel release (for which service connection has not been established). The Board believes that the report of another examination, in which the left wrist symptomatology specifically attributable to the service-connected left wrist disability is identified, would be helpful The United States Court of Veterans Appeals (Court) has held that the duty of VA to assist veterans in the development of facts pertinent to their claims, under 38 U.S.C.A. § 5107(a) (West 1991) and 38 C.F.R. § 3.103(a) (1994), as set forth by the Court in Littke v. Derwinski, 1 Vet.App. 90 (1990), requires that VA accomplish additional development of the evidence if the record currently before it is inadequate. Accordingly, this case is REMANDED for the following: 1. The RO should request that the veteran undergo examinations of his left hand and wrist by appropriate specialists who have not previously examined him, in order to ascertain the nature and severity of any left wrist chip fracture residuals, and to determine whether his left wrist carpal tunnel syndrome is etiologically or causally related to his inservice left wrist chip fracture, or the residuals thereof. All tests indicated, to include radiographic and nerve conduction studies if appropriate, are to be conducted at this time, and all findings should be presented in a clear, comprehensive and legible manner on the examination reports. The examiners should be particularly requested to identify with specificity those symptoms that are residuals of the left wrist chip fracture, as opposed to residuals or manifestations of any other left wrist or left hand disorder. In addition, the examiners should be specifically requested to render an opinion with regard to whether the veteran's left wrist carpal tunnel syndrome is related to, or is the product of, that left wrist chip fracture or the residuals thereof. The claims folder is to be made available to the examiners prior to their evaluation of the veteran. 2. Following completion of the above, the RO should again review the veteran's claims, and determine whether service connection on a secondary basis can be granted for left carpal tunnel syndrome, and whether a compensable evaluation can be granted for left wrist chip fracture residuals. If the decision remains in whole or in part adverse to the veteran, he and his representative should be provided with a supplemental statement of the case, and with a reasonable period of time within which to respond thereto. The case should thereafter be returned to the Board for further appellate consideration, as appropriate. The veteran need take no action until he is so informed. The purposes of this REMAND are to obtain additional medical evidence and to ensure compliance with due process considerations. LAWRENCE M. SULLIVAN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1994).