Citation Nr: 18142591 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 08-24 417 DATE: October 16, 2018 ORDER Entitlement to service connection for a left shoulder condition, to include as secondary to service-connected disabilities is granted. Entitlement to service connection for a right elbow condition, to include as secondary to service-connected disabilities is granted. FINDINGS OF FACT 1. The Veteran’s left shoulder condition is proximately due to his service-connected right knee medial meniscal injury. 2. The Veteran’s right elbow condition is proximately due to his service-connected right knee medial meniscal injury. CONCLUSIONS OF LAW 1. The criteria for secondary service connection for a left shoulder condition are met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). 2. The criteria for secondary service connection for a right elbow condition are met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty from October 1984 to June 1985 and from February 2003 to August 2003. The Board acknowledges that the Veteran submitted a RAMP opt-in election form on September 10, 2018. However, the two issues addressed in this decision were activated at the Board on August 28, 2018. These two issues are therefore no longer eligible for the RAMP program. In any event, both claims are being granted in full, so there can be no prejudice caused to the Veteran by issuing this decision. This decision does not address the issues of entitlement to an increased rating for an acquired psychiatric condition or entitlement to a total disability rating due to individual unemployability (TDIU) because those issues are still on remand to the agency of original jurisdiction for further development. This decision also makes no finding as to the Veteran’s ability to opt-in to the RAMP for those issues. Service Connection 1. Entitlement to service connection for a left shoulder condition, to include as secondary to service-connected disabilities The January 2017 VA examination shows the Veteran has a current diagnosis of left shoulder subacromial/subdeltoid bursitis, and a November 2010 private examiner opined that this was caused by prolonged use of crutches to ambulate for years after the accident that caused the Veterans service-connected right knee meniscal tear. While the January 2017 VA examiner ultimately opined that the Veteran’s left shoulder condition was less likely than not proximately due to or aggravated by a service connected condition, the only condition considered was service-connected left elbow epicondylitis. The January 2017 VA examiner mentioned that the Veteran’s use of crutches was a likely contributor to his left shoulder condition, but incorrectly stated that the Veteran’s use of crutches was caused by an August 2015 back surgery for a non-service-connected condition. The November 2010 opinion mentioning years of crutch use makes it clear that the January 2017 VA examiner’s opinion was based on an inaccurate understanding of the Veteran’s medical history. When applied to the accurate record, the rationale of the January 2017 examiner’s opinion actually supports the conclusion reached by the November 2010 private examiner. Because the balance of the evidence shows that the Veteran’s left shoulder condition is proximately due to his use of crutches to treat his service-connected right knee meniscal tear, service connection for his left shoulder condition is warranted on a secondary basis. 2. Entitlement to service connection for a right elbow condition, to include as secondary to service-connected disabilities The January 2017 VA examination shows the Veteran has a current diagnosis of right elbow epicondylitis, and a November 2010 private examiner opined that this was caused by prolonged use of crutches to ambulate for years after the accident that caused the Veterans service-connected right knee meniscal tear. While the January 2017 VA examiner ultimately opined that the Veteran’s right elbow condition was less likely than not proximately due to or aggravated by a service connected condition, the only condition considered was service-connected left elbow epicondylitis. The January 2017 VA examiner mentioned that the Veteran’s use of crutches was a likely contributor to his right elbow condition, but incorrectly stated that the Veteran’s use of crutches was caused by an August 2015 back surgery for a non-service-connected condition. The November 2010 opinion mentioning years of crutch use makes it clear that the January 2017 VA examiner’s opinion was based on an inaccurate understanding of the Veteran’s medical history. When applied to the accurate record, the rationale of the January 2017 examiner’s opinion actually supports the conclusion reached by the November 2010 private examiner. Because the balance of the evidence shows that the Veteran’s right elbow condition is proximately due to his use of crutches to treat his service-connected right knee meniscal tear, service connection for his right elbow condition is warranted on a secondary basis. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Zimmerman, Associate Counsel