BVA9500475 DOCKET NO. 93-20 404 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUE Entitlement to service connection for bilateral carpal tunnel syndrome. REPRESENTATION Appellant represented by: Alabama Department of Veterans Affairs ATTORNEY FOR THE BOARD Theresa M. Catino, Associate Counsel INTRODUCTION The veteran served on active duty from June 1970 to April 1991. This appeal arises from a May 1992 rating decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama (RO) which denied the veteran's claim of entitlement to service connection for bilateral carpal tunnel syndrome. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his present carpal tunnel syndrome originated in service. In particular, he asserts that this disability resulted from an in-service injury to his shoulder. He also asserts that, because his bilateral carpal tunnel syndrome was diagnosed within one year after his separation from active military duty, he should be granted service connection for this disability. 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 preponderance of the evidence is against the claim of entitlement to service connection for bilateral carpal tunnel syndrome. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained. 2. The veteran did not have carpal tunnel syndrome in service. 3. Carpal tunnel syndrome began after service. CONCLUSION OF LAW Bilateral carpal tunnel syndrome was not incurred in or aggravated by military service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is well-grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, the Board finds that the veteran has presented a claim which is plausible. The Board is also satisfied that all relevant facts have been properly developed. No further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a). According to the applicable law and regulations, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (1994). Furthermore, the regulations provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1994). In the substantive appeal, the veteran contended that his bilateral carpal tunnel syndrome first became manifested during service. The service medical records, however, fail to show findings of bilateral carpal tunnel syndrome. Significantly, the retirement examination demonstrated that the veteran's upper extremities (in particular, the strength and range of motion of the upper extremities) were normal. Carpal tunnel syndrome was not found at this examination. Furthermore, according to the report of medical history, which the veteran completed at the time of the retirement examination, he did not relate that he had swollen or painful joints or any bone, joint, or other deformity. He did not report having had any problems with either of his upper extremities, including his wrists and hands. In November 1991, when the veteran was treated at a service department facility for numbness in both of his hands, he was diagnosed to have bilateral carpal tunnel syndrome. In the substantive appeal, the veteran also contended that his present bilateral carpal tunnel syndrome resulted from a shoulder injury he incurred during service. Specifically, the veteran asserted that in May 1986 he injured his right shoulder and right arm and that thereafter he began experiencing numbness in his right arm. Furthermore, he maintained that his duties for approximately 10 of the years that he was in service, which included writing assignments, required him to use his hands and wrists a great deal. He contended in the substantive appeal that these duties contributed to the development of bilateral carpal tunnel syndrome, which began as a result of the shoulder injury. The service medical records do show that in May 1986 the veteran was treated for a shoulder injury he incurred while working. Significantly, no injury to the veteran's wrists or hands was noted. Moreover, none of the physicians who treated the veteran for bilateral carpal tunnel syndrome after his separation from service has related this disability to the shoulder injury in service or to service in general. Consequently, despite the veteran's contention that his bilateral carpal tunnel syndrome was caused by the in-service injury to his shoulder, there is no medical evidence to substantiate this contention. Moreover, there is no medical evidence placing the onset of carpal tunnel syndrome in service. The United States Court of Veterans Appeals (Court) has held that, where the determinative issue involves medical causation or a medical diagnosis, only competent medical evidence will serve to make a claim plausible or possible. Espiritu v. Derwinski, 2 Vet.App. 492, 494-495 (1992); Grottviet v. Brown, 5 Vet.App. 91, 93 (1994). Recently, the Court explained that competent lay testimony is limited to statements which the witness actually observed (e.g., symptoms or facts that he or she observed) and which are within the realm of his or her personal knowledge. Lay testimony is not competent to prove that which would require specialized knowledge or training (e.g., medical expertise). Layno v. Brown, 6 Vet.App. 465, 469-470 (1994). Therefore, although the veteran is competent to provide an account of his symptoms, he is not competent to offer evidence which requires medical knowledge. Accordingly, his opinion that carpal tunnel syndrome was caused by the shoulder injury is not to be given evidentiary weight. In the substantive appeal, the veteran also asserted that, because his bilateral carpal tunnel syndrome was diagnosed within the same year as his discharge from service in 1991, he should be presumed to have this disability as a result of his active military service. However, the law and regulations clearly state which diseases and disabilities are applicable to the provisions of presumptive service connection. Carpal tunnel syndrome is not listed. 38 U.S.C.A. § 1101 (West 1991); 38 C.F.R. § 3.309(1994). ORDER Service connection for bilateral carpal tunnel syndrome is denied. ____________________________ JOHN E. ORMOND 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.