Citation Nr: 18132359
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 16-05 372
DATE:	September 6, 2018
Entitlement to service connection for numbness of the right upper extremity is denied.
The record does not contain a current diagnosis for the Veteran’s complaints of numbness in the right upper extremity.
The Veteran does not have a chronic disability of the right upper extremity as a result or consequence of disease or injury incurred in or aggravated by his active military service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303.
General Statutes, Regulations and Cases Pertaining to Service Connection
The Veteran maintains that he has a chronic disability of the right upper extremity manifested by numbness and pain.  In general, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a).
Entitlement to service connection is established when the following elements are satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or “medical nexus” between the current disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); see 38 C.F.R. § 3.303 (a).
Alternatively, under 38 C.F.R. § 3.303 (b), service connection may be awarded for a “chronic” condition when (1) a chronic disease manifests itself and is identified as such in service, or within the presumptive period under 38 C.F.R. § 3.307, and the veteran presently has the same condition; or (2) a listed chronic disease (under 38 C.F.R. § 3.309 (a) manifests itself during service, or during the presumptive period, but is not identified until later, and there is a showing of continuity of related symptomatology after discharge, and medical evidence relates that symptomatology to the Veteran’s present condition. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013))).
Service Connection for Disability of the Right Upper Extremity 
As explained, the most fundamental requirement for any claim for service connection is that the Veteran must have proof she has the condition claimed. See Degmetich v. Brown, 8 Vet. App. 208 (1995); 104 F.3d 1328 (1997). Congress has specifically limited entitlement for service-connected disease or injury to cases where such incidents have resulted in disability. Brammer v. Derwinski, 3 Vet. App. 223 (1992). A current disability means a disability shown by competent medical evidence to exist. Chelte v. Brown, 10 Vet. App. 268 (1997).
Besides complaints of numbness there are no post service records showing a diagnosis of a chronic disability of the right upper extremity.  VA outpatient records dated in September 2011, show the Veteran reported a 1-2 year history of bilateral hand numbness. Nerve conduction studies were conducted in October 2011. The study was considered abnormal, but there was no electrical evidence of active right cervical radiculopathy, median neuropathy, ulnar neuropathy, or polyneuropathy.  There were chronic findings consistent with reinnervation in right C6-7-innervated muscles.   
In light of the Veteran’s claim, a QTC examination was conducted in January 2015. The Veteran reported his medical history. He stated that his symptoms began on his return from Iraq in 2005. The symptoms started in his left wrist and progressed to his right extremity in 2009.  Diagnostic testing was conducted and besides the reports of pain and numbness, there were no abnormalities, noted.  His strength was normal in the right wrist and extremity.  The diagnosis was left upper extremity with bilateral numbness.  Importantly, however, while the presence of pain and numbness were reported, these symptoms alone without an underlying diagnosis, is not a service connectable disability. Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999); Sanchez-Benitez v. Principi, 259 F.3d 1356 (Fed. Cir. 2001). While the Veteran reported that he had to make sure he had a solid grip on objects, as noted there was no objective evidence of functional loss found on examination.
The Board is grateful for the Veteran’s honorable service. However, given the record before it, the Board finds that evidence in this case does not reach the level of equipoise for service connection for a disability of the right upper extremity. See 38 U.S.C. § 5107 (a) (“[A] claimant has the responsibility to present and support a claim for benefits....”); Fagan v. Shinseki, 573 F.3d 1282, 1286 (Fed. Cir. 2009) (stating that the claimant has the burden to “present and support a claim for benefits” and noting that the benefit of the doubt standard in section 5107(b) is not applicable based on pure speculation or remote possibility); Skoczen v. Shinseki, 564 F.3d 1319, 1323-29 (Fed. Cir. 2009) (interpreting section 5107(a) to obligate a claimant to provide an evidentiary basis for his or her benefits claim, consistent with VA’s duty to assist, and recognizing that “[w]hether submitted by the claimant or VA... the evidence must rise to the requisite level set forth in section 5107(b),” requiring an approximate balance of positive and negative evidence regarding any issue material to the determination). 
As the weight of evidence of record does not rise to the level of equipoise regarding service connection for a disability of the right upper extremity and so the claim must be denied.
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. D. Jackson, Counsel 

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