FINGER IMPAIRMENT OF

Summary

The Veteran, who served in the U.S. Navy from July 1983 to September 1997, appeals the denial of service connection for a right 5th finger PIP joint fusion with limitation of motion, previously claimed as a right small finger fracture. The Veteran's claim for this condition was denied by the agency of original jurisdiction in April 2021, leading to this appeal. The Board reviewed evidence of record up to the April 2021 decision, plus any evidence submitted at the March 2025 hearing or within 90 days thereafter. The Veteran's current disability and its in-service onset were conceded. The primary issue was establishing a nexus to service. Two VA examinations in February and April 2021 provided negative opinions, stating the injury occurred prior to service or that there was a significant gap in care and chronicity. However, the Board found these opinions inadequate because they failed to consider the Veteran's statements about ongoing symptoms since service and incorrectly dated the injury. A March 2025 private opinion, considered probative by the Board, linked the current finger disability directly to the in-service injuries and noted continuity of symptoms. Based on this private opinion, the Board found a nexus established. Service connection for the right 5th finger PIP joint fusion with limitation of motion is granted.

Rationale

Diagnosis of status post right 5th phalange PIP joint fusion with limitation of motion conceded.; In-service onset of right finger disability conceded.; February and April 2021 VA opinions found inadequate for failing to consider Veteran's statements and misdating injury.; March 2025 private opinion found probative, linking current disability to in-service injuries and noting continuity of symptoms.; Nexus established based on probative private opinion.

Full Decision Text

Citation Nr: A26036371
Decision Date: 04/20/26	Archive Date: 04/20/26

DOCKET NO. 210513-158896
DATE: April 20, 2026

ORDER

Entitlement to service connection for status post 5th finger PIP joint fusion with limitation of motion (previously claimed and rated as right small finger fracture) is granted.

FINDING OF FACT

The Veteran's status post 5th finger PIP joint fusion with limitation of motion is related to his military service.

CONCLUSION OF LAW

The criteria for service connection for status post 5th finger PIP joint fusion with limitation of motion (previously claimed and rated as right small finger fracture) 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 duty service in the U.S. Navy from July 6, 1983 to September 30, 1997.

In January 2021, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of the service connection claim for the small right finger disability most recently addressed in a February 2021 and September 2005 rating decisions.  In April 2021, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision.  

In the May 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 2025.

Therefore, the Board may only consider the evidence of record at the time of the April 2021 agency of original jurisdiction (AOJ) supplemental claim 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. If evidence was submitted either (1) during the period after the AOJ issued the supplemental claim 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. 

Service Connection

Generally, service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish entitlement to service-connected compensation benefits, a veteran must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

For veterans with 90 days or more of active service during a war period or after December 31, 1946, certain chronic diseases, including organic diseases of the nervous system such as sensorineural hearing loss, are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.

Pursuant to 38 C.F.R. § 3.303(b), where a chronic disease is shown as such in service, subsequent manifestations of the same chronic disease are generally service connected. If a chronic disease is noted in service but chronicity in service is not adequately supported, a showing of continuity of symptomatology after separation is required. Entitlement to service
, certain chronic diseases, including organic diseases of the nervous system such as sensorineural hearing loss, are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.

Pursuant to 38 C.F.R. § 3.303(b), where a chronic disease is shown as such in service, subsequent manifestations of the same chronic disease are generally service connected. If a chronic disease is noted in service but chronicity in service is not adequately supported, a showing of continuity of symptomatology after separation is required. Entitlement to service connection based on chronicity or continuity of symptomatology pursuant to 38 C.F.R. § 3.303(b) applies only when the disability for which the Veteran is claiming compensation is due to a disease enumerated on the list of chronic diseases in 38 U.S.C. § 1101(3) or 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury.  38 C.F.R. § 3.310.

1. Entitlement to service connection for status post 5th finger PIP joint fusion with limitation of motion (previously claimed and rated as right small finger fracture) is granted.

The Veteran contends that he has a finger disability that is related to his military service. 

At the outset, a diagnosis of status post right 5th phalange PIP joint fusion with limitation of motion is conceded. See February 2021 Hand and Finger Conditions VA examination; see also April 2021 Rating Decision.

Second, it is conceded that his right finger disability had its onset during service. See April 2021 Rating Decision.

Therefore, the only remaining issue is whether a nexus may be established. 

As to a nexus, in February 2021, the VA examiner concluded that his right finger disability was less likely than not (less than 50 percent probability) incurred in or caused by an in service of injury, event, or illness. The examiner reasoned that the right 5th finger subluxation occurred in 1985, prior to active duty. The examiner also reasoned that the Veteran was not seen for his right finger disability under 2010, a 25 year gap of chronicity since the injury occurred in 1985. Therefore, the examiner concluded that it was less likely that the Veteran's limitation of motion little finger disability incurred in service.

In April 2021, the VA examiner concluded that his right finger disability was less likely than not (less than 50 percent probability) incurred in or caused by an in-service of injury, event, or illness. The examiner reasoned that, during service, his right finger disability was acute only. There was no evidence of chronicity of care, and his symptoms were subjective only. The examiner also noted that, although the Veteran sustained an injury to his right small finger in 1985, the 1997 Separation Exam was normal. The examiner also noted that it was 15 years after service when he then required an evaluation and subsequent surgery for his right finger disability. The examiner then concluded that there was no chronicity of care documented, and, therefore, it was less likely as not that the Veteran's 1995 right finger injury resulted in his current right finger disability.

The Board finds the February 2021 and April 2021 VA opinions inadequate, as the examiners did not consider the Veteran's statements regarding ongoing symptoms of his right finger disability since service as evidence of chronicity of care. In addition, the February 2021 VA examiner was incorrect in noting that his right finger injury occurred prior to service, as the Veteran was in active duty service in 1985.

In contrast, in a March 2025 VA private opinion, the provider noted that the Veteran's right finger disability was a direct result of the injuries he sustained while on active duty in the Navy. The provider reasoned that the Veteran began experiencing issues with his right hand 5th digit in 1985 during service. The provider also reported that he has continued to experience symptoms of his right hand disability since service.

The Board finds the March 2025 private opinion probative, as the report was based on the Veteran's statements, previous in-person examination, and the provider's observations. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 30205 (2008). Given the March 2025 private opinion, a nexus has been established, and service connection for a right finger disability is warranted. 


 disability was a direct result of the injuries he sustained while on active duty in the Navy. The provider reasoned that the Veteran began experiencing issues with his right hand 5th digit in 1985 during service. The provider also reported that he has continued to experience symptoms of his right hand disability since service.

The Board finds the March 2025 private opinion probative, as the report was based on the Veteran's statements, previous in-person examination, and the provider's observations. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 30205 (2008). Given the March 2025 private opinion, a nexus has been established, and service connection for a right finger disability is warranted. 

 

Paul R. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Grossman, Christine

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.