BVA9503154 DOCKET NO. 93-21 992 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES Entitlement to service connection for a right wrist disorder. Entitlement to service connection for a neck disorder. Entitlement to service connection for lumbosacral strain. Entitlement to service connection for gastritis. entitlement to service connection for headaches. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and her husband ATTORNEY FOR THE BOARD James J. Dunphy, Counsel INTRODUCTION The veteran had active service from December 1988 to December 1992. This appeal to the Board of Veterans' Appeals (Board) arises from a January 1993 rating decision by the St. Petersburg, Florida, Department of Veterans Affairs (VA) Regional Office (RO). In September 1993, a hearing was held in St. Petersburg before a traveling member of the Board. At that time, the veteran withdrew her claims for an increased rating for a breast scar and service connection for left knee pain and a right foot disorder. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the disorders at issue are of service origin. She states that she was treated for all the disorders during her period of active duty, and that she continues to have problems to the current day. The disabilities, particularly the right wrist disorder and the headaches, limit her ability to perform at work. 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 veteran'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 evidence supports the grant of service connection for tenosynovitis of the right wrist and for migraine headaches. It is our decision, further, that the preponderance of the evidence is against the veteran's claims for service connection for a neck disorder, lumbosacral strain, and gastritis. FINDINGS OF FACT 1. The veteran was treated in service for tenosynovitis of the right wrist, which persisted subsequent to discharge from active duty. 2. The veteran currently has migraine headaches, which were first present during active duty. 3. In an automobile accident in service, the veteran sustained back and neck injuries which were acute and transitory and resolved without residuals. 4. The veteran was treated for gastritis in service, and, while she raised complaints of stomach distress after service, there was no relevant pathology. CONCLUSIONS OF LAW 1. Tenosynovitis of the right wrist and migraine headaches were incurred in service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991) 2. A neck disorder and lumbosacral strain were not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303 (1994). 3. Gastritis was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Initially, the Board notes that the veteran's claims are well grounded. By this, we mean that she has submitted claims which are plausible. The Board further concludes that the VA has met its statutory duty to assist the veteran in the development of her claim. 38 U.S.C.A. § 5107 (West 1991). I. Entitlement to service connection for a right wrist disorder When the veteran was seen in service in March 1992, she complained of right wrist pain. She retained full range of motion of the wrist and there was good strength. Nerve conduction studies were normal, and X-ray films were negative. The diagnosis was right tenosynovitis, and she was referred to occupational therapy. The pain appeared to be resolving with therapy. On VA compensation examination in January 1993, the veteran reported a history of right wrist strain. There was no deformity or swelling, and range of motion was essentially normal. The diagnosis was recurrent right wrist strain. The veteran and her husband presented testimony before a traveling member of the Board in September 1993. They testified that the veteran required a brace on the right wrist at all times. They further stated that the veteran worked as a secretary for her husband in a contracting firm, and it was only through the allowances made by her husband that she was able to retain her job. Submitted at that time were reports of outpatient treatment afforded the veteran by the VA for, among other disorders, the right wrist disability. A determination of service connection requires a finding of the existence of a current disability and a determination of a relationship between that disability and an injury or disease incurred in service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); Rabideau v. Derwinski, 2 Vet.App. 141, 143 (1992). In the veteran's case, she has met these elements, and service connection is therefore warranted. The service medical records show tenosynovitis of the right wrist, and both the outpatient treatment records and hearing testimony support the conclusion that a right wrist disorder is present currently. In view of the limited time between the symptomatology in service and the manifestations after active duty, it is logical to find an etiological relationship between the two. Accordingly, service connection for a right wrist disorder is warranted. II. Entitlement to service connection for migraine headaches The veteran was treated in service in October 1990, at which time she reported a history of occipital headaches with radiation to the frontal area. Neurological evaluation was normal. The assessment was probable tension headaches. She was hit in the head with a softball in April 1991, and complained of a headache. Neurological evaluation was unremarkable. When she was treated in September 1992, she reported a two week history of bad headaches. Follow-up treatment a week later showed the headaches (described as tension/vascular) to be improving. The veteran reported headaches when she was examined for compensation purposes by the VA in January 1993. She indicated that she took midrin to relieve the pain. Examination reveled a normal sensory, motor and reflex functions. Coordination and equilibrium were normal. The diagnosis was history of migraine headaches. The veteran and her husband presented testimony at a formal hearing in September 1993. She stated that she had to take medication for the headaches, and was bothered by light and noise. She testified that the headaches were so bad that they made her feel nauseous. As previously noted, a determination of service connection requires a finding of the existence of a current disability and a determination of a relationship between that disability and an injury or disease incurred in service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); Rabideau v. Derwinski, 2 Vet.App. 141, 143 (1992). The Board concludes that the veteran has met the requirements for a grant of service connection for migraine headaches. She was treated on repeated occasions for headaches in service, and continued to require medication for the headaches after service. Moreover, there is her testimony and that of her husband. This raises a reasonable doubt as to the etiology of the current headaches. Under the provisions of 38 U.S.C.A. § 5107 (West 1991), this doubt must be resolved in the veteran's favor. Accordingly, service connection for migraine headaches is warranted. III. Entitlement to service connection for a neck disorder and lumbosacral strain The veteran was involved in an automobile accident in July 1992. Upon treatment, she complained of soreness in the middle of her back. Physical examination was unremarkable. When seen in September 1992, it was indicated that the back pain had resolved. When the veteran was examined in January 1993 by the VA, she complained of recurrent low back and neck pain. However, examination of the back and neck showed no muscle spasm or tenderness. Range of motion of the neck and back were normal. The absence of any objective symptomatology on examination shortly after discharge, along with the limited follow-up treatment required in service, leads the Board to conclude that the injuries the veteran sustained in service were acute and transitory, resolving without residuals. Accordingly, service connection for these disorders is not appropriate. In making this determination, the Board has considered the testimony offered by the veteran at her personal hearing. We find this testimony to be sincere. However, the Board must give much greater probative weight to the contemporaneous medical evidence, which shows no residuals in the neck or back resultant from the automobile accident in service. IV. Entitlement to service connection for gastritis The veteran was treated in service on a number of occasions for complaints of digestive distress. When seen in August 1989, she reported a one week history of nausea and gas. The assessment was probable gastritis. She was seen again in June 1990, at which time the assessment was acute gastroenteritis. Examination in July 1991 showed mild epigastric tenderness. On VA compensation examination in January 1993, the veteran complained of digestive distress. However, the abdomen was soft, without tenderness, masses or guarding. While no upper gastrointestinal series was performed, the veteran indicated that a previous series had been negative. In the absence of any organic basis for the veteran's complaints of pain, the Board cannot find a basis by which to grant service connection for gastritis. Accordingly, the claim must be denied. In making this determination, the Board has considered the testimony offered by the veteran and her husband before a traveling member of the Board in September 1993. However, this testimony, while sincere, does not carry the probative weight of the specific findings on examination. As previously noted, these negative findings prevent the Board from granting the veteran's claim for service connection for gastritis. ORDER Service connection for tenosynovitis of the right wrist and migraine headaches is granted. Service connection for a neck disorder, lumbosacral strain, and gastritis is denied. CONTINUED ON NEXT PAGE J. U. JOHNSON 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. 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 which 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 which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.