FINGER(S) AMPUTATION OF ONE OR MORE

Summary

The Veteran served from February 1987 to August 1991. He appeals the denial of service connection for a dislocated right 5th finger, and the remand of claims for a low back condition, left lower extremity radiculopathy, and a right knee condition. The Veteran reported an in-service injury to his right 5th finger from a basketball incident, with brief splinting during service. A fellow service member corroborated the injury circumstances. While service treatment records did not document the injury, and VA C&P examiners provided negative opinions, the Board found the evidence to be in equipoise. Resolving doubt in the Veteran's favor, the Board granted service connection for the dislocated right 5th finger. The claims for the low back, left lower extremity radiculopathy, and right knee conditions were remanded. The Board found that the negative opinions for these remanded conditions were inadequately reasoned, as they relied too heavily on the length of time between service and diagnosis without sufficient explanation. The Board requires addendum opinions that provide a more complete rationale, explaining why a remote etiology is unlikely, rather than solely relying on the time lapse.

Rationale

Evidence in equipoise; Benefit of doubt resolved in Veteran's favor; Corroborating statement from fellow service member

Full Decision Text

Citation Nr: 26002628
Decision Date: 02/25/26	Archive Date: 02/25/26

DOCKET NO. 18-36 453
DATE: February 25, 2026

ORDER

Entitlement to service connection for a dislocated 5th finger of the right hand is granted.

REMANDED

Entitlement to service connection for a low back condition is remanded.

Entitlement to service connection for radiculopathy of the left lower extremity is remanded.

Entitlement to service connection for a right knee condition is remanded.

FINDING OF FACT

Resolving reasonable doubt in favor of the claim, the Veteran's dislocated right 5th finger condition began during active service.

CONCLUSION OF LAW

The criteria for service connection for a dislocated right 5th finger are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from February 1987 to August 1991.

These matters come before the Board of Veterans' Appeals (Board) on appeal from rating decisions issued in December 2017 and February 2018.

During the course of this appeal, the Veteran testified via live video conference before the undersigned Veterans Law Judge (VLJ) at a hearing in July 2023. A transcript of the hearing is associated with the claims file.

These matters were previously before the Board in January 2024.

1. Entitlement to service connection for a dislocated right 5th finger

The Veteran seeks entitlement to a condition he characterizes as a dislocated right 5th finger with arthritis of the hand. This "dislocated" finger is described in a February 2024 Compensation and Pension (C&P) examination report that documents that the Veteran's right fifth finger is always bent 30 degrees at the 5th distal interphalangeal joint, and the distance between the 4th and 5th metacarpophalangeal joints is increased. While the joints are not fixed, and they can be manually straightened by another person's hand (or the Veteran's left hand), the 5th finger immediately returns to this other position when the pressure is removed.

By history, the Veteran reports that this condition began after his hand was hit by a basketball during service. He reports that he received treatment for this condition during service, and the finger was briefly splinted during service. The Veteran's fellow service-member submitted a written statement dated February 2024, corroborating the circumstances of the Veteran's injury. 

The Board concludes that the Veteran has a current disability that is related to the Veteran's in-service basketball injury. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

As discussed above, the Veteran's right 5th finger is dislocated or permanently bent while at rest. Thus, the question becomes whether the current disability is related to service.

The evidence against the claim includes the fact that the Veteran's described injury is not recorded in his service treatment records. Additionally, the opinions of the C&P examiners in February and November 2024 are negative opinions. The February 2024 C&P opinion is a negative opinion based on the lack of any documentation of the treatment records during service or until the advent of the claim.

However, the November 2024 addendum opinion, which focused on the question of the Veteran's right hand arthritis, a condition with which he has not been diagnosed, the clinician appears to have accepted the history of the Veteran's right little finger in-service injury.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current right 5th finger condition is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for the right 5th finger dislocation or deformity condition is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

REASONS FOR REMAND

1. The matters of (1) Entitlement to service connection for a low back condition; (2) Entitlement to service connection for radiculopathy of the left lower extremity radiculopathy condition; and (3) Entitlement to service connection for a right knee condition are remanded.

These matters arise from the same legal and factual circumstances and can be treated adequately and efficiently together.

Unfortunately,
 to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for the right 5th finger dislocation or deformity condition is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

REASONS FOR REMAND

1. The matters of (1) Entitlement to service connection for a low back condition; (2) Entitlement to service connection for radiculopathy of the left lower extremity radiculopathy condition; and (3) Entitlement to service connection for a right knee condition are remanded.

These matters arise from the same legal and factual circumstances and can be treated adequately and efficiently together.

Unfortunately, the negative opinions provided regarding these conditions are all entirely or primarily based on the length of time between the Veteran's service and the date of his diagnosis with the conditions of the low back, left lower extremity nerve, and right knee. While this is a persuasive rationale with regard to a claim based on chronic diseases or conditions, the length of time between the Veteran's claimed injuries and his later diagnosis is not sufficient by itself to provide an adequate rationale for the Board to determine that the Veteran's subsequently diagnosed conditions are not related to the Veteran's service. To be sure, the length of time between a claimed injury and the subsequent identification of a disability is informative and may be used along with other factors, e.g. the developmental process of the disease or condition is known to generally proceed more quickly, indicating a more recent injury. Consequently, the Board finds that these matters must be remanded opinions that provide a more complete rationale regarding these conditions.

The matters are REMANDED for the following action:

1. Obtain addendum opinions from an appropriate clinician regarding whether the Veteran's claimed low back, left lower extremity radiculopathy, and right knee conditions are at least as likely as not (the evidence is approximately balanced or nearly equal, if not greater) related to the Veteran being required to carry, wear, and use heavy equipment as a firefighter during his period of service? The opinions should be accompanied by an adequate rationale. In the event of a negative opinion, the rationale should not be based solely on the length of time between the Veteran's service and the subsequent diagnosis of these conditions. If the examiner believes that the length of time makes an in-service etiology unlikely, the examiner should explain why this is so, by explaining the typical length of the disease process, the relative severity or lack thereof of symptoms or medical findings, or other circumstances which would make such a temporarily remote etiology atypical.

2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefit sought is not granted to the Veteran's satisfaction, send the Veteran and representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. 

 

Paul R. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Steven H. Johnston, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.