BVA9500621 DOCKET NO. 93-07 935 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUE Entitlement to service connection for chronic residual disability from an injury to the right hand. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD C. S. Freret, Counsel INTRODUCTION The appellant had active military service from June 1989 to August 1991. This appeal comes before the Board of Veterans' Appeals (Board) from a January 1992 rating decision by the Department of Veterans Affairs (VA) Phoenix, Arizona, Regional Office (RO), which denied entitlement to service connection for residual disability from an injury to the right hand. CONTENTIONS OF APPELLANT ON APPEAL The appellant asserts that he sustained an injury to his right hand in service that has left him with residual disability in the fourth and fifth knuckles of that hand. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the appellant's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the appellant's claim of entitlement to service connection for residual disability from an injury to the right hand. FINDINGS OF FACT 1. An injury to the fourth and fifth knuckles of the right hand in service is shown to have been acute and transitory and to have resolved without residuals. 2. Residual disability from a right hand injury is not shown at the present time. CONCLUSION OF LAW Chronic residual disability from a right hand injury was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303(b) (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The provisions of 38 U.S.C.A. § 5107(a) (West 1991) have been met, in that the appellant's claim is well-grounded and adequately developed. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131 (West 1991). For a showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (1994). Service medical records show that the appellant was treated in September 1990 for a complaint of pain in the fourth and fifth knuckles of the right hand, . He gave a history of catching his right hand between two desks at work. Swelling at the fourth and fifth right metacarpophalangeal joints, with decreased range of motion, was noted. An assessment of possible fracture of the right fourth and fifth metacarpals at the metacarpophalangeal joints was reported. General Services Administration Standard Form (GSASF) 600, chronological record of medical care, dated September 24, 1990. X-ray examination of the right hand in September 1990 revealed only soft tissue swelling with no fracture. GSASF 519-A, Radiologic Consultation Request/Report, dated September 24, 1990. A subsequent entry in an October 1990 service medical record indicates that the appellant reported that his right hand had healed well except for some continued swelling in the right fifth knuckle (metacarpophalangeal joint). Examination revealed that the right fifth metacarpophalangeal joint was swollen but had full range of motion, except for the appellant's inability to fully extend the joint. The assessment was a sprain of the right fifth metacarpophalangeal joint with incomplete healing. GSASF 600, chronological record of medical care, dated October 29, 1990. Subsequently dated service medical records, including an examination conducted in March 1991 for a Physical Evaluation Board, show no further complaints, findings, or treatment pertaining to the right hand. A VA medical examination was conducted in October 1991. At that time, the appellant complained of minimal pain in the right hand, worse in cold weather or when he hits the hand against a solid object. Range of motion in the right hand was full, with minimal pain elicited. The examiner's diagnoses of the appellant's disabilities included injury to the right hand in the past, with residual mild pain in cold weather or on striking a solid object, full range of motion, and minimal tenderness. VA Form 10-9034a, report of rating examination conducted on October 23, 1991. X- ray examination of the right hand at the October 1991 VA medical examination did not reveal any remarkable degenerative changes. Report of a VA X-ray of the right hand taken October 23, 1991. Although the appellant sustained an injury to his right hand in service when he got the hand caught between two desks, resulting in soft tissue swelling to the fourth and fifth right metacarpophalangeal joints, X-ray examination at the time of the injury in September 1990 failed to reveal any fracture. Nor did X-ray examination of the right hand in October 1991 reveal any remarkable degenerative changes or any other discernible residual disability in the hand. We note that while the appellant currently experiences occasional pain in the right hand (in cold weather and on striking the hand on a solid object) and has some mild tenderness in the hand, he has full range of movements in the hand. In essence, the medical evidence does not demonstrate that he has an identifiable disability associated with his right hand at this time. Therefore, the Board finds the evidence establishes that the right hand injury in service was an acute and transitory injury that resolved without any residual disability. Absent manifestation of an identifiable disability in the right hand at the present time, service connection is not warranted for chronic residual disability from an injury to the right hand. ORDER Service connection is denied for chronic residual disability from an injury to the right hand. BETTINA S. CALLAWAY 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 so assigned. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue that was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date that appears on the face of this decision constitutes the date of mailing and the copy of this decision that you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.