WRIST IMPAIRMENT OF

Summary

The Veteran, who served in the United States Air Force Reserve from March 2017 to December 2017 and October 2018 to April 2019, including service in the Southwest Asia theater of operations during the Persian Gulf War, appeals the denial of service connection for a right wrist disability, claimed as secondary to a service-connected right hand burn scar. The Veteran initially reported right wrist pain in September 2022, attributing it to aircraft maintenance duties involving repetitive motions and heavy tools. In a later claim, she suggested the onset occurred during her 2017-2018 deployment, citing long hours and frequent wrench use. However, the Board found the evidence weighed against service connection. Service treatment records showed no complaints or pathology related to the right wrist, and a post-deployment health assessment reflected no injuries or generalized symptoms. Private treatment records also showed no wrist complaints or abnormalities. The Board noted the Veteran's inconsistent reporting of symptom onset, initially placing it years after service and later during service, which it found less credible and inconsistent with the lack of medical treatment sought. The Board concluded that the evidence did not persuasively establish an in-service injury or persistent post-service symptoms, and therefore, the criteria for service connection were not met. The claim was denied.

Rationale

No in-service injury, event, or disease involving the right wrist was persuasively established.; Service treatment records showed no complaints or pathology of the right wrist.; Private treatment records also showed no complaints or abnormalities of the right wrist.; Veteran's lay reports of symptoms were found less credible due to inconsistencies and lack of corroboration.

Full Decision Text

Citation Nr: A26038803
Decision Date: 04/27/26	Archive Date: 04/27/26

DOCKET NO. 250812-574090
DATE: April 27, 2026

ORDER

Service connection for right wrist disability, to include as secondary to service-connected scar, right hand, is denied. 

FINDING OF FACT

The evidence of record persuasively weighs against finding that the Veteran has a right wrist disability that began during a period of active duty service, or is otherwise related to an injury, event, disease incurred during active service or service-connected disability. 

CONCLUSION OF LAW

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, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Air Force Reserve with periods of active duty service from March 2017 to December 2017 and October 2018 to April 2019. The Veteran has qualifying service under 38 U.S.C. § 1117 and 38 U.S.C. § 1119 as a Persian Gulf veteran based on her service in the Southwest Asia (SWA) theater of operations during the Persian Gulf War. See 38 C.F.R. § 3.317(e); 38 C.F.R. § 3.320; Other (January 2023 and December 2025) (Individual Longitudinal Exposure Record verifying Veteran served in Turkey from November 8, 2018, to March 17, 2019); Other (January 2023 and December 2025) (Toxic Exposure Risk Activity (TERA) Memorandum verifies qualifying service pursuant to 38 C.F.R. §§ 3.317(e)(2), 3.320, and 38 U.S.C. §§ 1117, 1119). VA also concedes the Veteran's participation in a TERA based on her military occupational specialty (MOS) as a refuel and bomber aircraft maintenance apprentice. Id. 

In May 2024, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of entitlement to service connection for right wrist disability most recently addressed in a May 2023 rating decision. On August 22, 2024, 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 August 12, 2025, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the August 22, 2024, AOJ supplemental claim decision on appeal, as well as any evidence submitted by the Veteran, or representative, with, or within 90 days from receipt of, the August 12, 2025, VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the supplemental claim decision on appeal and prior to receipt of the VA Form 10182, or (2) more than 90 days following receipt of the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 of service connection for right wrist disability, to include as secondary to service-connected right hand burn scar, 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

Compensation may be awarded for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131. Service connection basically means that the facts, shown by evidence, establish that an injury or disease resulting in disability incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein.  38 C.F.R. § 3.303.

Service connection may be granted for any disease diagnosed after discharge, when the evidence, including that pertinent
 as secondary to service-connected right hand burn scar, 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

Compensation may be awarded for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131. Service connection basically means that the facts, shown by evidence, establish that an injury or disease resulting in disability incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein.  38 C.F.R. § 3.303.

Service connection may be granted for any disease diagnosed after discharge, when the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires: (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303(a), (d).

Service connection may be granted for a disability that is due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. A claim for secondary service connection requires medical evidence that connects the asserted secondary disability to the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). In order to establish entitlement to service connection on this secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. Id. Secondary service connection may also be established for a nonservice-connected disability which is aggravated by a service-connected disability. In such an instance, a veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995).

Entitlement to service connection for right wrist disability, to include as secondary to service-connected right hand burn scar.

The Veteran, when she initially filed her VA Form 21-526EZ claim for service connection for right wrist disability, reported that "right wrist gets sharp pain especially after using it all day doing maintenance on aircraft. now during normal use of the wrist i get sharp pain". See VA 21-526EZ, Fully Developed Claim (Compensation) (September 2022)

On her May 2024 VA Form 20-0995, Supplemental Claim Application, for right wrist disability, the Veteran contend that her right wrist disability is due to her military occupational specialty (MOS) duties as a crew chief and aircraft mechanic which required repetitive motions of her right wrist while using heavy tools and wrenches for hours which caused intermittent soreness. See VA Form 20-0995 (May 2024). In a separate supporting statement, the Veteran reported that: 

During my service as a crew chief; aircraft mechanic, I continuously used various tools that required repetitive notions. During my first few months there I experienced soreness from time to time but during my deployment in 017-2018 I noticed an increase in soreness and sudden sharp pain. During the deployment we were required to work at faster rates in order to produce mission ready aircrafts. Many times, we were turning wrenches, in screwing and screwing parts back on during a 12-16-hour shift 6 days a week. Not only would I notice discomfort, soreness and sharp sudden pain in my wrist while I did the above tasks but every day, multiples times day we had to drag heavy aircraft chocks in order to safely keep the aircrafts from moving.

I assumed it would go away after the workload would lessen once back from deployment, but my wrist seemed to get triggered with the same pain now with daily tasks. Such as carrying groceries, writing, cooking, etc. I usually apply pressure to the area for various seconds in order to alleviate some of the pain.
 order to produce mission ready aircrafts. Many times, we were turning wrenches, in screwing and screwing parts back on during a 12-16-hour shift 6 days a week. Not only would I notice discomfort, soreness and sharp sudden pain in my wrist while I did the above tasks but every day, multiples times day we had to drag heavy aircraft chocks in order to safely keep the aircrafts from moving.

I assumed it would go away after the workload would lessen once back from deployment, but my wrist seemed to get triggered with the same pain now with daily tasks. Such as carrying groceries, writing, cooking, etc. I usually apply pressure to the area for various seconds in order to alleviate some of the pain. During the last year of my military career, I was pregnant and was assigned to the administrative work within the unit. I had to flip through various files, staple items, or do repetitive motions with my wrist. This re triggered the pain in my wrist to be more frequent. I would constantly have to hold my wrist applying pressure in order to reduce the pain. Since then, it has not gone away, and I experience mainly the sharp sudden pains where I must apply pressure with my opposite hand in order to alleviate some of the pain.

VA 21-4138 Statement in Support of Claim (May 2024).

Alternatively, the Veteran, through her attorney, generally contends that her right wrist disability is secondary to her service-connected right hand burn scar. See VA 10182 (August 2025). 

The Board concludes that the criteria for service connection for right wrist disability, to include as secondary to service-connected right hand burn scar, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

Turning to the evidence of record, the Veteran had active duty from March 2017 to December 2017 and October 2018 to April 2019. Her service treatment records (STRs) reflect no complaints or abnormal pathology of the right wrist. Reserve STRs contemporaneous to the Veteran's discharge from her period of active duty service reveal no symptoms or injury associated with the right wrist. A March 2019 post deployment health assessment (PDHA) reflects no concern for wounds or injuries that occurred during deployment, listed no general symptoms or health concerns post-deployment, and no evidence of high generalized post-deployment physical symptoms. See STR at 35 (October 2022) 

Post-service treatment records associated with the claims file reflect no complaints, treatment, or diagnoses of the right wrist. In this regard, private treatment records, dated from September 2021 to August 2024, reveal no complaints or treatment of the right wrist and there are no abnormalities of the right wrist noted on physical examination of the musculoskeletal system. See Medical Treatment Record-Non-Government Facility (October 2024 and November 2025). 

The first indication of any right wrist condition comes on the Veteran's September 2022 VA 21-526EZ claim for service connection for right wrist condition. See VA 21-526EZ, Fully Developed Claim (Compensation) (September 2022). 

A November 2022 Scars/Disfigurement Disability Benefits Questionnaire (DBQ) reflects the Veteran's service-connected right hand burn scar is not painful or unstable, results in no limitation of function (to include limitation of motion), and there are no other pertinent physical findings, complications, conditions, signs and/or symptoms associated with the right hand burn scar. See C&P Exam at 2 and 8 (November 2022). 

A November 2022 Wrist Conditions DBQ reflects a diagnosis of chronic wrist sprain. See C&P Exam at 2 (November 2022). The Veteran reports, by history, onset of her wrist condition in 2021 while working with aircrafts and using heavy tools and wrenches for many hours; that it hurts from using too much, and she had overextending it a few times. 

A May 2023 VA medical opinion addressing the etiology of the Veteran's right wrist disability reflects that the claimed condition is less likely than not incurred in or caused by an in-service injury, event, or illness because the record did not show any chronicity of symptoms and no wrist pain symptoms until 3 years after active duty service.

The May 2024 Wrist Conditions DBQ reflects a diagnosis of tendinitis of the right wrist.  By history, the condition had its onset in approximately 2017 to 2018 with sharp pains on the radial side of the wrist; and that, since having her daughter in 2022, the Veteran's wrist has hurt more from carrying her child. X-ray revealed no evidence for fracture or other significant bone or soft
 medical opinion addressing the etiology of the Veteran's right wrist disability reflects that the claimed condition is less likely than not incurred in or caused by an in-service injury, event, or illness because the record did not show any chronicity of symptoms and no wrist pain symptoms until 3 years after active duty service.

The May 2024 Wrist Conditions DBQ reflects a diagnosis of tendinitis of the right wrist.  By history, the condition had its onset in approximately 2017 to 2018 with sharp pains on the radial side of the wrist; and that, since having her daughter in 2022, the Veteran's wrist has hurt more from carrying her child. X-ray revealed no evidence for fracture or other significant bone or soft tissue abnormality and no evidence of arthritis. A May 2024 medical opinion reflect that the right wrist disability is less likely than not incurred in or caused by an in-service injury, event, or illness because the record did not show any chronicity of symptoms in or since the Veteran's military service although the Veteran reported she had onset of symptom in and after service STRs were notably silent.

The Board finds that the most persuasive evidence of record weighs against finding that the Veteran's right wrist disability had its onset during her active duty service or is otherwise related to an in-service injury, disease, or a service-connected disability. 

First, there is evidence of a current right wrist disability. The November 2022 and May 2024 Wrist Conditions DBQs reflect a diagnosis of chronic right wrist sprain and right wrist tendinitis, respectively. Therefore, the first element of service connection is met. 

Second, however, there is not persuasive evidence of an injury, event, or disease involving the right wrist during the Veteran's active service from March 2017 to December 2017 and October 2018 to April 2019.

STRs include a "Medical Record" for the Veteran identifying allergies, problems, diagnosis history, medications, procedures, radiology, and clinical notes among other things. These reflect no injury to the right wrist, or that the Veteran was seen for symptoms of injury to the right wrist, or that she had persistent symptoms involving the right wrist. However, she was seen for other problems that included, for example, skin rash. A review of symptoms (ROS) dated March 2017, May 2017, and July 2017 reflects no musculoskeletal complaints to include pain. Her PDHA, dated March 2019, explicitly reflects that no injuries were incurred and her self-reported medications did not include any pain-type medications. 

The Veteran is competent to report both onset and symptoms of right wrist pain during her active duty as this is susceptible to lay observation. Layno v. Brown, 6 Vet. App. 465 (1994). However, to the extent that she reports onset of symptoms in during active duty and continuity of symptoms since service, the Board finds that this is less than credible as it is inconsistent with other evidence of record. See Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996). 

In this regard, the Veteran has been an inconsistent historian as to onset of right wrist symptoms. In connection with her original VA disability claim in September 2022, the Veteran reported at her November 2022 VA wrist examination onset of right wrist symptoms in 2021 while working on an aircraft-which was years after her release from active duty. Then, only after the claim was initially denied and in connection with her next VA disability claim, she reported at her May 2024 VA wrist examination onset of right wrist symptoms in roughly 2017 to 2018-now potentially placing onset during a period of active service; she had active duty from March 2017 to December 2017 and October 2018 to April 2019. 

Further, the Veteran's suggestion of frequent, persistent symptoms of right wrist pain during active duty as well as since her active duty appears incongruent with STRs showing she denied musculoskeletal problems on ROS and the absence of any post service treatment. While treatment is not required to establish a claim for service connection, the Board has considered her report of symptoms during active duty and since active duty.  She reports that during active duty she had soreness and sudden sharp pain; she reports that since active duty she has had symptoms frequently interfering with work and an inability to "shoot with her right hand with a shotgun during qualifications because her hand gets too shaky." The Board finds the nature and severity of symptoms reported are simply incongruent with not seeking medical evaluation or treatment in service and after release from active duty. The Board acknowledges that the Veteran reported during her 2024 VA wrist examination that she had had a visit with her health care provider,
 on ROS and the absence of any post service treatment. While treatment is not required to establish a claim for service connection, the Board has considered her report of symptoms during active duty and since active duty.  She reports that during active duty she had soreness and sudden sharp pain; she reports that since active duty she has had symptoms frequently interfering with work and an inability to "shoot with her right hand with a shotgun during qualifications because her hand gets too shaky." The Board finds the nature and severity of symptoms reported are simply incongruent with not seeking medical evaluation or treatment in service and after release from active duty. The Board acknowledges that the Veteran reported during her 2024 VA wrist examination that she had had a visit with her health care provider, Kaiser-Permanente. However, after the rating decision on appeal, the Veteran provided VA with copies of Kaiser-Permanente treatment records; but, these records reflect no complaints, findings, or abnormal pathology of her right wrist-or any history of injury during her active duty service. See Medical Treatment Record-Non-Government Facility (October 2024 and November 2025). 

The foregoing, coupled with the nearly three year period from the Veteran's discharge from active duty service to VA's receipt of her September 2022 VA 21-526EZ, tends to weigh against the credibility of symptoms in service as well as persistent symptoms of disability since her active service. An absence of corroborating evidence and personal interest may factor into the Board's credibility analysis, so long as it is not the sole basis for a credibility finding. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Therefore, the Veteran's lay report of symptoms in service and persistent symptoms since service have no probative or persuasive value. Thus, the second element of the claim for service connection is not met.

The Board acknowledges the Veteran's belief that she has right wrist disability related to her MOS duties involving her right wrist. However, the etiology of her current disability, shown years after her active duty, is not susceptible to lay observation. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, the Veteran's medical opinion has no probative or persuasive value.

Because there is not persuasive evidence supporting the incurrence of an injury to the right wrist during the Veteran's active service, or persistent symptoms of a right wrist disability since her active duty service, the AOJ had no duty to obtain a medical opinion addressing the Veteran's theory that he condition was related to her MOS duties with repetitive motion/use. See McLendon v. Nicholson, 20 Vet. App. 79 (2006) (a VA examination and/or opinion is warranted when there is an indication in the record that a current disability is related to military service). Indeed, it is difficult to imagine that VA could obtain an adequate medical opinion when there is not competent, credible evidence of record indicating the incurrence of an injury or symptoms of an injury during active service, or persistent symptoms since active service-as here. 

As to the Veteran's newly raised  theory that her right wrist disability is secondary to service-connected right hand burn scar, the Board observes this was raised for the first time on the Veteran's August 2025 VA Form 10182. Neither the Veteran nor her attorney have provided nor identified any relevant information supporting that theory. Furthermore, the AOJ had no duty to obtain a medical opinion addressing this theory as this theory because there was no evidence to suggest a relationship between the Veteran's right wrist tendonitis or sprain and her service-connected scar apart from her attorney's generalized assertion, which is not sufficient on its own to trigger VA's duty to obtain a VA examination under McLendon v. Nicholson, 20 Vet. App. 79, 84 (2006). See Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010). Here, a November 2022 Scars/Disfigurement DBQ reflects no functional impact on the right wrist due the scar, right hand. The Veteran's attorney volleys at the Board the general assertion that VA is compelled generally to investigate the possibility of secondary service connection, citing to DeLisio v. Shinseki, 25, Vet. App. 45 (2011). However, he misses that there must still be evidence that reasonably indicates the nonservice-connected condition is due to the service-connected disability. As before, neither the Veteran nor her attorney provided nor identified any relevant information supporting that theory and, thus, VA had no duty to investigate secondary service connection.

On balance, there is persuasive evidence supporting onset of a right wrist disability during a period of active service or that it is etiologically related to an
 on the right wrist due the scar, right hand. The Veteran's attorney volleys at the Board the general assertion that VA is compelled generally to investigate the possibility of secondary service connection, citing to DeLisio v. Shinseki, 25, Vet. App. 45 (2011). However, he misses that there must still be evidence that reasonably indicates the nonservice-connected condition is due to the service-connected disability. As before, neither the Veteran nor her attorney provided nor identified any relevant information supporting that theory and, thus, VA had no duty to investigate secondary service connection.

On balance, there is persuasive evidence supporting onset of a right wrist disability during a period of active service or that it is etiologically related to an injury incurred during a period of active service. 

Accordingly, the claim is denied. As the evidence of record persuasively weighs against the claim, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

 

 

C.A. SKOW

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Kenney, K.A.

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.