Source: https://va-claim.com/2018/12/15/service-connection-for-residuals-of-cold-injury-of-the-hands-and-feet-granted-citation-nr-18132345/
Timestamp: 2019-04-19 08:54:57+00:00

Document:
The claim of service connection for residuals of cold injury on hands and feet has been reopened.
Service connection for residuals of cold injury of the hands and feet is granted.
1. Evidence received since an January 2007 rating decision, relates to a previously unestablished element of service connection for residuals of cold injury; and raises a reasonable probability of substantiating the claim.
2. The Veteran’s residuals of cold injury of the hands and feet are due to frostbite during active service.
1. New and material evidence has been received since the RO’s January 2007 rating decision sufficient to reopen the Veteran’s claim of service connection for residuals of cold injury.  38 U.S.C. §5108; 38 C.F.R. § 3.156.
2. The criteria for service connection for residuals of cold injury to the hands and feet are met.  38 U.S.C. §§ 1110, 1111, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a).
The Veteran served on active duty from April 1969 to April 1971.
This matter is before the Board of Veterans’ Appeals (Board) on appeal of a November 2012 rating decision of the Cleveland, Ohio Regional Office (RO) of the Department of Veterans Affairs (VA).
The Veteran, through his representative, withdrew his request for a hearing before a Veterans Law Judge in an April 2018 statement.
The Veteran’s original claim of entitlement to service connection for residuals of frostbite to the hands and feet was denied in January 1979 Board decision on the basis that there was no nexus between a diagnosed disorder and active service.  The Veteran attempted to reopen his claims in April 2006 and the claim was again denied in January 2007.  The January 2007 rating decision became final because the Veteran did not appeal the decision.  38 U.S.C. § 7105; 38 C.F.R. §§20.200, 20.1103.
However, a final decision shall be reopened if new and material evidence is presented.  38 U.S.C. § 5108.  New evidence means existing evidence not previously submitted to agency decision makers.  Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim.  New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim.  38 C.F.R.  § 3.156 (a).
Since the last final denials, the Veteran submitted a March 2018 letter from Dr. K. indicating the Veteran has residuals of frostbite to the fingers and toes incurred in active service.  As this evidence was submitted after the final rating decisions and relates to the lacking element of a nexus, it is new and material.  Accordingly, new and material evidence having been received, the Board finds that the claim for service connection for a skin disorder is reopened.
The Veteran contends that service connection is warranted for residuals of frostbite in the hands and feet incurred during service in Germany.
The Board concludes that the Veteran has a current diagnosis of cold injury residuals in the hands that the disability began during active 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).
Service treatment records (STRs) show complaints of nail problems in service.  September 1968 enlistment and February 1971 separation examination and associated medical history reports are negative for upper extremity abnormalities or complaints.  Prior to his service in Germany, in a December 1969 STR, the Veteran reported several years history of dry, brittle fingernails which grow slowly.  The examiner noted onychomycosis of the hands and feet.  In another December 1969 STR, the Veteran reported his mother had the same problem.
Post-service treatment records show a diagnosis of residual symptoms due to frostbite in service.  A March 1977 private treatment records indicates a diagnosis of residual symptoms of frostbite of the hands in 1970.  The examiner noted the Veteran has pain in the joints and splitting nails which caused problems while working.  The problem is worse in cold weather.
A July 1977 statement from Dr. P. indicated he has treated the Veteran since 1965.  There has been no increase in accidents since separation from service.  He has had four minor injuries since service, which were industrial related.
In a November 1977 statement, Dr. P. stated the Veteran’s mother failed to reveal significant disease of the extremities to include digits and nails of the hands.
At a hearing in March 1978, the Veteran indicated he was first treated for a skin problem during service and he was first troubled by nail problems while in service.  He testified he incurred frostbite on two separate occasions while in service.
An April 1978 examination report showed discoloration, increased thickness, and ridging of fingernails.  The feet were within normal limits.  The diagnosis was residuals of frostbite of hands.
In a June 1978 statement, D.C. stated he served with the Veteran and remembers him getting frostbite on his fingers which was treated on an emergency basis.
In an April 2006 statement, a private examiner indicated that stiffness secondary to soft tissue damage was due to frostbite in the hands and feet while in Germany.
The Veteran submitted multiple lay statement from friends indicating the Veteran had no problems with his fingers prior to service.
In a private evaluation dated March 2018, the clinician indicated the Veteran reported he was treated for frostbite in service.  The clinician reviewed the claims file including service and post-service treatment records and the lay statements.  The clinician recognized the December 1969 STR dated prior to his claimed frostbite injuries which showed a diagnosis of onychomycosis; however, the clinician indicated that the Veteran had additional issues involving his fingers and toes not related to this condition to include hypersensitivities, color changes, and fissuring of the paronychial regions.  The clinician determined that the Veteran has residuals of frostbite involving the fingers and toes bilaterally as a result of a cold exposure incident that happened during service.  The clinician based his opinion the Veteran’s reported duties during service, multiple lay witnesses to the Veteran’s hands prior to and after service, physical examination which is consistent with a remote frostbite injury, and post-service medical records showing evidence of residuals of frostbite.
Post-service private treatment records show the Veteran has a current diagnosis of residuals of frostbite of the hands and feet, and the March 2018 private examiner opined that the Veteran’s disability at least as likely as not began during active service, as competently and credibly reported by the Veteran.
Accordingly, in considering the Veteran's competent and credible lay statements as well as the pertinent medical evidence of record, and in affording the Veteran the benefit-of-the-doubt, the Board finds that it is at least as likely as not that he has residuals of cold injury to the hands and feet that were incurred due to frostbite injury in service.  The evidence is in favor of the grant of service connection for residuals of cold injury to the hands and feet is, therefore, granted.  See 38 U.S.C. § 5107.

References: §5108
 § 3
 § 7105
 § 5108
 § 3
 v. 
 § 3
 § 5107