THUMB IMPAIRMENT OF

Summary

The Veteran, who served from December 1979 to December 1992, appeals the denial of service connection for a right thumb disability. The Veteran contends that current right thumb arthritis is related to repetitive administrative and technical duties performed during service, including typing, calculator use, and ledger writing, and that she experienced right thumb pain continually since service. The Board reviewed evidence of record up to the March 2021 AOJ decision, excluding evidence submitted after the April 2025 hearing or more than 90 days following it. The evidence against the claim included a February 2021 VA examiner's opinion stating it was less likely than not that the arthritis was incurred in service, noting insufficient medical records to confirm arthritis during service but failing to address post-service pain reports. In favor of the claim, a June 2025 private medical opinion from Dr. R.P. found it at least as likely as not that the degeneration is related to cumulative biomechanical strain from in-service duties, referencing medical literature and the Veteran's testimony. The Board found the evidence in equipoise, resolving doubt in the Veteran's favor, and granted service connection for a right thumb disability.

Rationale

Favorable finding from March 2021 rating decision regarding current disability and in-service complaints.; Private medical opinion found condition at least as likely as not related to cumulative biomechanical strain from in-service duties.; Evidence found to be in equipoise, resolving doubt in Veteran's favor.

Full Decision Text

Citation Nr: A26031597
Decision Date: 04/07/26	Archive Date: 04/07/26

DOCKET NO. 210701-169751
DATE: April 7, 2026

ORDER

Entitlement to service connection for a right thumb disability is granted.

FINDING OF FACT

Resolving reasonable doubt in the Veteran's favor, the Veteran's right thumb arthritis is at least as likely as not related to repetitive administrative and technical duties during active duty service.  

CONCLUSION OF LAW

The criteria for entitlement to service connection for a right thumb disability 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 served on active duty from December 1979 to December 1992.

In the July 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket.  A Board hearing was held on April 2, 2025.  Therefore, the Board may only consider the evidence of record at the time of the March 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision. 

VA Forms 10182 were also received in October and November 2021, for which Board hearings were held in April 2025.  Those appeals will be subject to separate Board decisions.

Entitlement to service connection for a right thumb disability

The Veteran contends that her current right thumb disability is related to repeated typing and writing activities throughout active duty service, and that she experienced right thumb pain during and continually since service.  See April 2025 hearing transcript; December 2020 Veteran statement.

The Board concludes that the Veteran has a current right thumb disability that is related to active duty service.  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).

The March 2021 rating decision found the Veteran has a current disability of right thumb arthritis, and that she was seen for complaints of right thumb pain during service.  These favorable findings are binding on the Board.  38 C.F.R. § 3.104(c).

Thus, the question Before the Board is whether the current disability is related to service.  

The evidence against the claim includes a February 2021 VA examiner's opinion that it was less likely than not that the Veteran's right thumb arthritis was incurred in or caused by service.  The examiner noted the Veteran's complaint of right thumb pain in the service treatment records, but stated there were insufficient medical records to confirm the presence of arthritis during service.  However, the VA examiner did not address the Veteran's reports of right thumb pain since service.

The evidence in favor of the claim includes a June 2025 letter opinion by Dr. R.P., who noted the Veteran's reports regarding her in-service duties and her right thumb symptoms since service, and discussed relevant medical literature.  Dr. R.P. opined that it is at least as likely as not the Veteran's right thumb joint degeneration is directly related to the cumulative biomechanical strain sustained during active duty service, specifically repetitive administrative and technical duties she performed throughout her service - sustained typing, calculator use, and ledger writing.  See also DD Form 214 (confirming the Veteran's specialties during service); April 2025 hearing testimony.

Accordingly, the Board finds the evidence to at least be in equipoise as to whether the Veteran's
 of the claim includes a June 2025 letter opinion by Dr. R.P., who noted the Veteran's reports regarding her in-service duties and her right thumb symptoms since service, and discussed relevant medical literature.  Dr. R.P. opined that it is at least as likely as not the Veteran's right thumb joint degeneration is directly related to the cumulative biomechanical strain sustained during active duty service, specifically repetitive administrative and technical duties she performed throughout her service - sustained typing, calculator use, and ledger writing.  See also DD Form 214 (confirming the Veteran's specialties during service); April 2025 hearing testimony.

Accordingly, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current right thumb disability is related to service.  Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a right thumb disability is warranted.  38 U.S.C. § 5107; 38 C.F.R. § 3.102.

 

 

David Gratz

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. M. Cooney, 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.