FINGER IMPAIRMENT OF

THOMAS H. O'SHAY · 2026 · Case ID: A26034752

DENIED

Summary

The veteran, who served from September 1992 to September 1996, appeals the denial of service connection for bilateral finger, bilateral shoulder, bilateral elbow, and bilateral wrist disabilities. The veteran contends these conditions are due to overuse in service and result in a limitation of range of motion. The Board found that the veteran failed to establish the first element of service connection: a current disability. While the veteran reported some joint pain and requested lidocaine patches for his shoulder and elbow in a December 2024 treatment record, the Board found this insufficient to establish a current disability or functional impairment of earning capacity, distinguishing the case from Saunders v. Wilkie. The Board also noted that the veteran's lay statements did not demonstrate continuity of symptomatology or functional impairment. The Board concluded that a VA examination was not required as the claim fell under an exception for non-presumptive claims based on physical trauma, and the threshold for duty to assist was not met due to the lack of evidence for a current disability. The Board afforded no probative weight to the veteran's self-diagnosis and gave more weight to the competent medical evidence of record, which did not show a current diagnosis of the claimed conditions. The evidence persuasively weighed against finding a current disability, thus the benefit of the doubt doctrine did not apply. Service connection for all claimed conditions was denied.

Rationale

No current disability established; No continuity of symptomatology; No functional impairment of earning capacity

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250429-539042

Full Decision Text

Citation Nr: A26034752
Decision Date: 04/15/26 Archive Date: 04/15/26

DOCKET NO. 250429-539042
DATE: April 15, 2026

ORDER

Service connection for right-hand finger disability is denied.

Service connection for left-hand finger disability is denied.

Service connection for right wrist disability is denied.

Service connection for left wrist disability is denied.

Service connection for right elbow disability is denied.

Service connection for left elbow disability is denied.

Service connection for right shoulder disability is denied.

Service connection for left shoulder disability is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had right-hand finger disability at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has had left-hand finger disability at any time during or approximate to the pendency of the claim.

3. The evidence of record persuasively weighs against finding that the Veteran has had a right wrist disability at any time during or approximate to the pendency of the claim.

4. The evidence of record persuasively weighs against finding that the Veteran has had a left wrist disability at any time during or approximate to the pendency of the claim.

5. The evidence of record persuasively weighs against finding that the Veteran has had a right elbow disability at any time during or approximate to the pendency of the claim.

6. The evidence of record persuasively weighs against finding that the Veteran has had a left elbow disability at any time during or approximate to the pendency of the claim.

7. The evidence of record persuasively weighs against finding that the Veteran has had a right shoulder disability at any time during or approximate to the pendency of the claim.

8. The evidence of record persuasively weighs against finding that the Veteran has had a left shoulder disability at any time during or approximate to the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for right-hand finger disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for left-hand finger disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for right wrist disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for left wrist disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for right elbow disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for service connection for left elbow disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

7. The criteria for service connection for a right shoulder disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

8. The criteria for service connection for a left shoulder disability are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 1992 to September 1996. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the April 2015 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the April 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider
on appeal from an April 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the April 2015 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

1. Service connection for right-hand finger disability is denied.

2. Service connection for left-hand finger disability is denied.

3. Service connection for right wrist disability is denied.

4. Service connection for left wrist disability is denied.

5. Service connection for right elbow disability is denied.

6. Service connection for left elbow disability is denied.

7. Service connection for right shoulder disability is denied.

8. Service connection for left shoulder disability is denied.

The Veteran contends that bilateral finger, bilateral shoulder, bilateral elbow, and bilateral wrist disabilities are due to service. He contends that he suffers from a limitation of range of motion due to overuse in service.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

The presence of a current disability is the cornerstone of any service connection claim. Service connection is not warranted when there is no current disability. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Current means near the time a claim is filed or at any time during its pendency. Romanowsky v. Shinseki, 26 Vet. App. 289 (2013); McClain v. Nicholson, 21 Vet. App. 319 (2007). Disability "refers to the functional impairment of earning capacity." Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that pain can constitute a current disability, even without an underlying diagnosis, if it causes sufficient functional impairment). Evidence must show that the Veteran currently has the disability for which benefits are being claimed. Coburn v. Nicholson, 19 Vet. App. 427, 431 (2006) (the absence of any one element will result in denial-of-service connection).

The term "disability" refers to a functional impairment that reduces earning capacity. See Saunders, 886 F.3d at 1363. To establish a disability, the claimant's symptoms must result in a "level of a functional impairment of earning capacity." Id. at 1367-68 (noting that the policy underlying veterans' compensation is to compensate veterans whose ability to earn a living is impaired as a result of their military service). Service connection cannot be granted for injuries or diseases that are acute and transitory in nature, and do not result in residual functional impairment, because such injuries or diseases by definition would not reduce earning capacity.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of bilateral finger, shoulder, elbow, and wrist disabilities and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Service treatment records indicate that in
, because such injuries or diseases by definition would not reduce earning capacity.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

Service treatment records indicate that in March 1995, the Veteran was treated for a blister on the left palm and thumb. In March 1996, he was treated for a laceration to the right hand.

On his July 1996 separation report of medical history, the Veteran denied painful or trick shoulders or elbows and noted that "overall health was good except for the knee". The separation examination noted normal upper extremities.

Post active service, a July 2012 VA knee and leg conditions examination note that the Veteran reported that he had been in two motorcycle accidents, the first one was in 1998, and the second accident was in March 2000, at which time he sustained fractured fingers and toes, requiring lacerations.

A December 2024 VA treatment record notes the Veteran's report of joint pains in the morning. He requested lidocaine patches for the shoulder and elbow joints.

At the outset, the Board finds that there was not a pre-decisional duty to assist error in not providing the Veteran a VA examination in support of his claim. Under the holding of McLendon v. Nicholson, the VA is obliged to provide an examination or obtain a medical opinion in a claim of service connection when the record contains competent lay or medical evidence of (1) a current diagnosed disability or persistent or recurrent symptoms of disability; (2) evidence establishing that the veteran suffered an event, injury or disease in-service; and (3) an indication that the claimed disability or symptoms may be associated with the established event, injury, or disease in-service or with another service-connected disability; and (4) insufficient competent medical evidence for VA to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81-83 (2006); see also 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4).

The threshold for finding a link between current disability and service is low. McLendon, 20 Vet. App. at 83. The Veteran's reports of a continuity of symptomatology can satisfy the requirement for evidence that the claimed disability may be related to service. Id. The Veteran is competent to report his observable symptoms and history, including the onset and timing of symptoms, and such reports must be considered. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

Here, the Veteran has not submitted any medical treatment records or lay statements within the period on appeal when evidence may be accepted that would tend to show a current bilateral shoulder, bilateral wrist, bilateral elbow, or bilateral finger disability. VA treatment records that have been associated with the file do not show any diagnosis of a current disability.

The Board has also reviewed the record to see if the Veteran has made statements about the claimed conditions. However, no statements of recurrent symptomatology, pain, or functional impairment were made, such that the Board could find that his lay statements would meet the current disability element under McLendon. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4).

The Board also acknowledges that the U.S. Court of Appeals for the Federal Circuit found that pain alone can constitute a "disability" under § 1110, because pain can cause functional impairment. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). However, even in light of Saunders, the Veteran still has not submitted any evidence, lay or otherwise, of bilateral fingers, bilateral elbow, bilateral shoulder, and bilateral wrist disability. The Board acknowledges that in December 2024, the Veteran requested lidocaine patches for bilateral elbow and shoulder pain. The Board considered Saunders but the Veteran has not made any specific contentions regarding how any current, subjective bilateral elbow and shoulder symptoms, such as pain, have resulted in specific functional impairments. Here, neither the Veteran nor the record indicates that any bilateral shoulder
can cause functional impairment. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). However, even in light of Saunders, the Veteran still has not submitted any evidence, lay or otherwise, of bilateral fingers, bilateral elbow, bilateral shoulder, and bilateral wrist disability. The Board acknowledges that in December 2024, the Veteran requested lidocaine patches for bilateral elbow and shoulder pain. The Board considered Saunders but the Veteran has not made any specific contentions regarding how any current, subjective bilateral elbow and shoulder symptoms, such as pain, have resulted in specific functional impairments. Here, neither the Veteran nor the record indicates that any bilateral shoulder and elbow symptoms affect his earning capacity. Thus, the Board finds that this case is distinguished from Saunders.

The Board has also considered whether a VA examination was required pursuant to 38 U.S.C. § 1168(a). Pursuant to the PACT Act, unless an exception applies, VA is required to provide an examination when a veteran submits a claim for service connection and has, 1) evidence of a disability, 2) participation in a toxic exposure risk activity (TERA) in service; and 3) the evidence is not sufficient to grant service connection. The requirement for an examination does not apply if the Secretary determines there is no indication of an associated between the disability claimed by a veteran and the TERA for which a veteran submitted evidence. 38 U.S.C. § 1186(b). The Secretary has determined that the exception applies for non-presumptive claims based on physical trauma, mental disorders, conditions determined to have no positive association with herbicide agent exposure, and claims for disabilities that manifested during service or with an etiology not associated with toxic exposure.

Here, the Veteran has claimed service connection for a musculoskeletal disability which he contends is due to overuse in service. The Board finds that this falls under the exception of non-presumptive claims based on physical trauma. A VA examination pursuant to 38 U.S.C. § 1168(a) was therefore not required.

After reviewing the available evidence of record, the Board finds that the record does not show and the Veteran did not provide evidence of a current disability of the bilateral shoulder, bilateral finger, bilateral wrist, and bilateral elbow disability. Therefore, the RO was not required to provide him with a VA examination for any of the sought conditions. McLendon v. Nicholson, 20 Vet. App. 79, 81-83 (2006). As such, the Board finds that the RO did not make a pre-decisional duty to assist error by not providing him with a VA examination. 38 C.F.R. § 20.802 (a). As the initial element of any service connection claim (a current disability) has not been met, further analysis of the claim is not necessary. See Brammer v. Derwinski, 3 Vet. App. 223 (1992).

While the Veteran believes he has a current diagnosis of all eight above disabilities, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, at 1377 (Fed. Cir. 2007). Consequently, the Board affords the Veteran's assertions that he has bilateral finger, bilateral wrist, bilateral elbow, and bilateral shoulder disability no probative weight and gives more probative weight to the competent medical evidence of record.

(Continued on the next page)

Based on the foregoing, the Board finds that the competent and credible evidence is neither evenly nor approximately balanced as to whether service connection for bilateral fingers, bilateral wrist, bilateral elbow, and bilateral shoulder disability is warranted. Rather, the evidence persuasively weighs against finding a current disability. The benefit of the doubt doctrine does not apply. 38 U.S.C. §5107 (b), Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). The claims are denied.

Thomas H. O'Shay

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Asare, Ama K.

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.

Analyze in VA Law Explorer