Citation Nr: 18144998
Decision Date: 10/25/18	Archive Date: 10/25/18

DOCKET NO. 15-45 403
DATE:	October 25, 2018
REMANDED
Service connection for a left shoulder condition is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1998 to July 2007. This matter comes before the Board of Veteran’s Appeals (Board) on an appeal from a September 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. 
While the Board acknowledges that the Veteran submitted a RAMP opt-in election form, the appeal had already been activated at the Board and is therefore no longer eligible for the RAMP program.
The Veteran contends that his left shoulder disability is related to the duties performed in-service as a machinist. The evidence indicates that he has not been afforded a VA examination in this matter. The Veteran showed signs of mild left shoulder impingement during a private examination in February 2013. In March 2013, an MRI revealed tears of the superior, anterior and posterior aspects of the labrum, with a paralabral cyst in the spinoglenoid notch. Impingement of the infrascapular nerve could not be excluded. The Veteran showed signs of mild supraspinatus tendinosis and mild degenerative arthritis at the left acromioclavicular joint.  
VA is required to provide an examination when there is insufficient medical evidence to decide the claim, but the record otherwise contains competent evidence of a current disability or recurrent symptoms, evidence of an in-service event, and evidence of an indication of a nexus. See McLendon v. Nicholson, 20 Vet. App. 79, 83; Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010); 38 C.F.R. § 3.159 (c)(4)(i). The evidence demonstrates that the Veteran has a current disability and his credible lay statements have linked that disability to his duties performed in-service. Under the circumstances, the low threshold for determining when a VA examination must be afforded to provide diagnostic clarification has been met. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).
The matter is REMANDED for the following action:
1. Schedule the Veteran for an examination by an appropriate clinician to assess the nature and cause of any left shoulder disability. The claims file, and a copy of this remand, shall be made available to the examiner for review in conjunction with the examination. Based on review of the record and interview and examination of the Veteran, the examiner should provide an opinion that responds to the following: 
(a) Identify any left shoulder disabilities by diagnosis(es) 
(b) For each left shoulder disability diagnosed, please   opine as to whether such is AT LEAST AS LIKELY AS NOT (A 50 PERCENT PROBABILITY OR GREATER) related to the Veteran’s service. The examiner MUST CONSIDER AND DISCUSS the significance of the Veteran’s competent lay reports of an in-service left shoulder injury. 
The examiner MUST CONSIDER AND DISCUSS the significance of the specific findings of the March 2013 MRI discussed above in determining whether the Veteran has a current disability. 
(c) If the examiner concludes that any diagnosed left shoulder condition is NOT related to active service, please opine as to whether the left shoulder condition was CAUSED or AGGRAVATED by the Veteran’s service-connected right shoulder condition. 
 
VICTORIA MOSHIASHWILI
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Kyle McKone