How the Board ruled on wrist claims, 2021–2025

Wrist (direct service connection)

Direct (began in or was caused by service), or theory not stated in the Board order

31.1% granted of 1,373 decided cases (margin of error 28.7–33.6%). 427 granted, 946 denied, 2,071 sent back to VA (remanded, not decided), 269 dismissed.

What convinced the Board in granted cases

• VA examiner opinions against the claim lost weight when they ignored in-service records of chronic wrist pain, wrongly said there was no current condition, or did not address the veteran's hand-heavy service duties. (3 of 12 decisions read; e.g. 21017495, A24033373, 22001795)
• The Board credited favorable medical opinions, including a treating hand surgeon who knew the veteran's history and ruled out other risk factors, and a VA examiner who linked carpal tunnel to work as a mechanic. (4 of 12 decisions read; e.g. A24032251, A24033373, 22001795)
• The most common basis was a wrist injury or complaint documented in service records plus the veteran's credible account of wrist pain continuing since service. (7 of 12 decisions read; e.g. 23052914, 21031594, 21072019)

Common reasons in denied cases

• No competent medical evidence linked the wrist to service, and the veteran's own belief about cause was not competent medical evidence. (4 of 14 decisions read; e.g. A24021352, 23025554, A25006987)
• The Board relied on thorough VA opinions that went unrebutted, sometimes pointing to a normal separation exam or no treatment for many years after service. (4 of 14 decisions read; e.g. 23029420, A24021352, A24021235)
• Many denials found no current diagnosable wrist condition during the claim period. (5 of 14 decisions read; e.g. A24061923, A25036114, 22050340)

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Wrist secondary to any service-connected condition

Secondary (caused or worsened by a service-connected condition)

27.6% granted of 76 decided cases (margin of error 18.8–38.6%). 21 granted, 55 denied, 183 sent back to VA (remanded, not decided), 5 dismissed.

What convinced the Board in granted cases

• The Board gave strong weight to a favorable opinion, private or VA, that reviewed all the facts and explained how the service-connected condition led to the wrist problem, sometimes citing medical literature. (6 of 12 decisions read; e.g. A22005750, A22015511, A25036166)
• Negative VA opinions lost weight when they overlooked diagnoses or treatment records, skipped the secondary question, gave no opinion, or could only speculate. (6 of 12 decisions read; e.g. A24001732, 21027622, A25027537)
• Grants often involved a clear chain, such as wrist strain from crutches used for service-connected knees, or a body-wide condition like lupus, gout, Hashimoto's, or diabetes reaching the wrist. (5 of 12 decisions read; e.g. 22004934, A25036166, A25027537)

Common reasons in denied cases

• The Board denied when a VA examiner gave a reasoned opinion, based on an accurate history, that the service-connected condition did not cause or worsen the wrist, and no contrary opinion existed. (4 of 11 decisions read; e.g. 24000928, 21056656, 21006465)
• The veteran's own belief that the wrist problem came from service or another condition was not competent medical evidence, since the cause was medically complex. (6 of 11 decisions read; e.g. A22015769, A21000994, 22015121)
• Some claims failed because there was no current wrist disability or no functional impairment, or because another cause, such as a post-service accident, was more likely. (5 of 11 decisions read; e.g. 23031333, 24001933, A21000994)

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Wrist secondary to the other wrist

Secondary (caused or worsened by a service-connected condition)

Small sample: 11 decided cases, too few for a reliable percentage. 7 granted, 4 denied, 21 sent back to VA (remanded, not decided), 0 dismissed.

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