Citation Nr: 18147220 Decision Date: 11/05/18 Archive Date: 11/02/18 DOCKET NO. 16-43 520 DATE: November 5, 2018 ORDER Entitlement to service connection for right shoulder disorder is denied. Entitlement to service connection for left shoulder disorder is denied. Entitlement to service connection for right knee disorder is denied. Entitlement to service connection for left knee disorder is denied. FINDINGS OF FACT 1. The Veteran has not had a diagnosed right shoulder disorder during the appeal period or within proximity thereto. 2. The Veteran has not had a diagnosed left shoulder disorder during the appeal period or within proximity thereto. 3. The Veteran has not had a diagnosed right knee disorder during the appeal period or within proximity thereto. 4. The Veteran has not had a diagnosed left knee disorder during the appeal period or within proximity thereto. CONCLUSIONS OF LAW 1. The criteria for service connection for a right shoulder disorder have not been met. 2. The criteria for service connection for a left shoulder disorder have not been met. 3. The criteria for service connection for a right knee disorder have not been met. 4. The criteria for service connection for a left knee disorder have not been met. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 2007 to July 2011. Service Connection 1. Right Shoulder The Veteran asserts that he experiences a right shoulder disorder, which is related to his active service. Specifically, the Veteran stated that his shoulder pain started when he performed physical activities in service. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). The question for the Board is whether the Veteran has a current diagnosis of a right shoulder disorder that either began during active service, or is etiologically related to an in-service disease or injury. After a review of the record, the Board finds that there is no competent, credible, and probative evidence that would establish that the Veteran experiences a right shoulder disorder that is etiologically related to his active service. The Veteran’s service treatment records (STRs) do not show a diagnosis of, or treatment for, a right shoulder disorder. The Veteran’s post-service VA treatment records show one complaint regarding shoulder issues, but no diagnosis of a right shoulder disorder. X-ray results showed no right shoulder abnormalities. See VA treatment records, December 10, 2013. Regarding the first element of service connection (i.e. a current disability), importantly, the Veteran’s medical records do not show a diagnosis of a right shoulder disorder. All treatment records in evidence are completely silent for a right shoulder disorder diagnosis. As such, the Veteran’s claim for entitlement to service connection for a right shoulder disorder fails. He did not have a diagnosis of a right shoulder disorder either in active service or after it. And, the best evidence of record shows that the Veteran does not have a current diagnosis of a right shoulder disorder. In the absence of proof of a present disorder (and, if so, of a nexus between that disorder and the active military service), there can be no valid claims for service connection. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). This principle has been repeatedly reaffirmed by the Federal Circuit, which has stated that “a Veteran seeking disability benefits must establish... the existence of a disability [and] a connection between the Veteran’s service and the disability.” Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). The Board has considered whether the Veteran experienced a right shoulder disorder at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, there is no evidence of a right shoulder disorder at any time during the pendency of this appeal. The Veteran also has not identified or submitted any competent evidence, to include a diagnosis of the disorder, or a medical nexus, relating his claimed disorder to active service. The Board has considered the Veteran’s lay statements in support of his claim. In multiple statements, the Veteran related that he believed that he had a right shoulder disorder that was related to his service. Although laypersons are competent to provide opinions on some medical issues, as to the specific issues in this case, diagnosing a right shoulder disorder, this issue falls outside the realm of common knowledge of a layperson. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (laypersons not competent to diagnose cancer). As a layperson, the Veteran has not been shown to possess the medical expertise to diagnose a right shoulder disorder and its etiology. The claims file does not contain any medical examinations diagnosing the Veteran with a right shoulder disorder, or linking his self-reported symptoms to his active service. In sum, there is no evidence, medical or otherwise, to support the Veteran’s statements. Thus, as previously stated, the medical evidence of record is only against the Veteran’s service connection claim. The Board acknowledges that the Veteran has not been afforded a VA examination addressing his claimed right shoulder disorder and its relationship to his active service. No such an examination is required, as the only evidence that the Veteran’s claimed disability is related to his military service are his own conclusory generalized lay statements, which are unsupported by even speculative medical evidence. See Waters v. Shinseki, 601 F.3d 1274, 1277 (Fed. Cir. 2010); Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010). Finally, the Board is cognizant of the recent holding in Saunders v. Wilkie which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. 886 F.3d 1356, 1368 (Fed. Cir. 2018). In sum, pain alone resulting in functional impairment is in fact a disability, and should not be summarily discounted as a bar to benefits based on a finding of no current diagnosis. However, the Veteran does not appear to experience any functional impairment due to his asserted right shoulder pain (pain which, in fact, he described as merely “an annoyance”). See VA treatment records, December 10, 2013. As such, Saunders is not applicable in this case. Accordingly, service connection for a right shoulder disorder is not warranted because the Veteran has not satisfied the first requirement of service connection, i.e., a current diagnosis of a disability. See 38 C.F.R. § 3.303 (2017); see again Gilpin, 155 F.3d at 1353; Brammer, 3 Vet. App. at 225. In reaching the above conclusion, the Board has considered the benefit-of- the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for a right shoulder disorder, that doctrine does not apply. 38 U.S.C. § 5107 (b) (2012). The claim of entitlement to service connection for a right shoulder disorder is denied. 2. Left Shoulder The Veteran asserts that he experiences a left shoulder disorder, which is related to his active service. Specifically, the Veteran stated that his shoulder pain started when he performed physical activities in service. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). The question for the Board is whether the Veteran has a current diagnosis of a left shoulder disorder that either began during active service, or is etiologically related to an in-service disease or injury. After a review of the record, the Board finds that there is no competent, credible, and probative evidence that would establish that the Veteran experiences a left shoulder disorder that is etiologically related to his active service. The Veteran’s STRs do not show a diagnosis of, or treatment for, a left shoulder disorder. The Veteran’s post-service VA treatment records show one complaint regarding shoulder issues, but no diagnosis of a left shoulder disorder. X-ray results showed no left shoulder abnormalities. See VA treatment records, December 10, 2013. Regarding the first element of service connection (i.e. a current disability), importantly, the Veteran’s medical records do not show a diagnosis of a left shoulder disorder. All treatment records in evidence are completely silent for a left shoulder disorder diagnosis. As such, the Veteran’s claim for entitlement to service connection for a left shoulder disorder fails. He did not have a diagnosis of a left shoulder disorder either in active service or after it. And, the best evidence of record shows that the Veteran does not have a current diagnosis of a left shoulder disorder. In the absence of proof of a present disorder (and, if so, of a nexus between that disorder and the active military service), there can be no valid claims for service connection. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). This principle has been repeatedly reaffirmed by the Federal Circuit, which has stated that “a Veteran seeking disability benefits must establish... the existence of a disability [and] a connection between the Veteran’s service and the disability.” Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). The Board has considered whether the Veteran experienced a left shoulder disorder at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, there is no evidence of a left shoulder disorder at any time during the pendency of this appeal. The Veteran also has not identified or submitted any competent evidence, to include a diagnosis of the disorder, or a medical nexus, relating his claimed disorder to active service. The Board has considered the Veteran’s lay statements in support of his claim. In multiple statements, the Veteran related that he believed that he had a left shoulder disorder that was related to his service. Although laypersons are competent to provide opinions on some medical issues, as to the specific issues in this case, diagnosing a left shoulder disorder, this issue falls outside the realm of common knowledge of a layperson. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (laypersons not competent to diagnose cancer). As a layperson, the Veteran has not been shown to possess the medical expertise to diagnose a left shoulder disorder and its etiology. The claims file does not contain any medical examinations diagnosing the Veteran with a left shoulder disorder, or linking his self-reported symptoms to his active service. In sum, there is no evidence, medical or otherwise, to support the Veteran’s statements. Thus, as previously stated, the medical evidence of record is only against the Veteran’s service connection claim. The Board acknowledges that the Veteran has not been afforded a VA examination addressing his claimed left shoulder disorder and its relationship to his active service. No such an examination is required, as the only evidence that the Veteran’s claimed disability is related to his military service are his own conclusory generalized lay statements, which are unsupported by even speculative medical evidence. See Waters v. Shinseki, 601 F.3d 1274, 1277 (Fed. Cir. 2010); Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010). Finally, the Board is cognizant of the recent holding in Saunders v. Wilkie which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. Saunders v. Wilkie, 886 F.3d at 1368. In sum, pain alone resulting in functional impairment is in fact a disability, and should not be summarily discounted as a bar to benefits based on a finding of no current diagnosis. However, the Veteran does not appear to experience any functional impairment due to his asserted left shoulder pain (pain which, in fact, he described as merely “an annoyance”). See VA treatment records, December 10, 2013. As such, Saunders is not applicable in this case. Accordingly, service connection for a left shoulder disorder is not warranted because the Veteran has not satisfied the first requirement of service connection, i.e., a current diagnosis of a disability. See 38 C.F.R. § 3.303 (2017); see again Gilpin, 155 F.3d at 1353; Brammer, 3 Vet. App. at 225. In reaching the above conclusion, the Board has considered the benefit-of- the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for a left shoulder disorder, that doctrine does not apply. 38 U.S.C. § 5107 (b) (2012). The claim of entitlement to service connection for a left shoulder disorder is denied. 3. Right Knee The Veteran asserts that he experiences a right knee disorder, which is related to his active service. Specifically, the Veteran stated that his knee pain started when he performed physical activities in service. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). The question for the Board is whether the Veteran has a current diagnosis of a right knee disorder that either began during active service, or is etiologically related to an in-service disease or injury. After a review of the record, the Board finds that there is no competent, credible, and probative evidence that would establish that the Veteran experiences a right knee disorder that is etiologically related to his active service. The Veteran’s STRs do not show a diagnosis of, or treatment for, a right knee disorder. The Veteran’s post-service VA treatment records show one complaint regarding knee issues, but no diagnosis of a right knee disorder. X-ray results showed no right knee abnormalities. See VA treatment records, December 10, 2013. Regarding the first element of service connection (i.e. a current disability), importantly, the Veteran’s medical records do not show a diagnosis of a right knee disorder. All treatment records in evidence are completely silent for a right knee disorder diagnosis. As such, the Veteran’s claim for entitlement to service connection for a right knee disorder fails. He did not have a diagnosis of a right knee disorder either in active service or after it. And, the best evidence of record shows that the Veteran does not have a current diagnosis of a right knee disorder. In the absence of proof of a present disorder (and, if so, of a nexus between that disorder and the active military service), there can be no valid claims for service connection. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). This principle has been repeatedly reaffirmed by the Federal Circuit, which has stated that “a Veteran seeking disability benefits must establish... the existence of a disability [and] a connection between the Veteran’s service and the disability.” Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). The Board has considered whether the Veteran experienced a right knee disorder at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, there is no evidence of a right knee disorder at any time during the pendency of this appeal. The Veteran also has not identified or submitted any competent evidence, to include a diagnosis of the disorder, or a medical nexus, relating his claimed disorder to active service. The Board has considered the Veteran’s lay statements in support of his claim. In multiple statements, the Veteran related that he believed that he had a right knee disorder that was related to his service. Although laypersons are competent to provide opinions on some medical issues, as to the specific issues in this case, diagnosing a right knee disorder, this issue falls outside the realm of common knowledge of a layperson. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (laypersons not competent to diagnose cancer). As a layperson, the Veteran has not been shown to possess the medical expertise to diagnose a right knee disorder and its etiology. The claims file does not contain any medical examinations diagnosing the Veteran with a right knee disorder, or linking his self-reported symptoms to his active service. In sum, there is no evidence, medical or otherwise, to support the Veteran’s statements. Thus, as previously stated, the medical evidence of record is only against the Veteran’s service connection claim. The Board acknowledges that the Veteran has not been afforded a VA examination addressing his claimed a right knee disorder and its relationship to his active service. No such an examination is required, as the only evidence that the Veteran’s claimed disability is related to his military service are his own conclusory generalized lay statements, which are unsupported by even speculative medical evidence. See Waters v. Shinseki, 601 F.3d 1274, 1277 (Fed. Cir. 2010); Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010). Finally, the Board is cognizant of the recent holding in Saunders v. Wilkie which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. 886 F.3d at 1368. In sum, pain alone resulting in functional impairment is in fact a disability, and should not be summarily discounted as a bar to benefits based on a finding of no current diagnosis. However, the Veteran does not appear to experience any functional impairment due to his asserted right knee pain (pain which, in fact, he described being worse in the morning and afternoon, and getting better throughout the day). See VA treatment records, December 10, 2013. As such, Saunders is not applicable in this case. Accordingly, service connection for a right knee disorder is not warranted because the Veteran has not satisfied the first requirement of service connection, i.e., a current diagnosis of a disability. See 38 C.F.R. § 3.303 (2017); see again Gilpin, 155 F.3d at 1353; Brammer, 3 Vet. App. at 225. In reaching the above conclusion, the Board has considered the benefit-of- the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for a right knee disorder, that doctrine does not apply. 38 U.S.C. § 5107 (b) (2012). The claim of entitlement to service connection for a right knee disorder is denied. 4. Left Knee The Veteran asserts that he experiences a left knee disorder, which is related to his active service. Specifically, the Veteran stated that his knee pain started when he performed physical activities in service. To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). The question for the Board is whether the Veteran has a current diagnosis of a left knee disorder that either began during active service, or is etiologically related to an in-service disease or injury. After a review of the record, the Board finds that there is no competent, credible, and probative evidence that would establish that the Veteran experiences a left knee disorder that is etiologically related to his active service. The Veteran’s STRs do not show a diagnosis of, or treatment for, a left knee disorder. The Veteran’s post-service VA treatment records show one complaint regarding knee issues, but no diagnosis of a left knee disorder. X-ray results showed no left knee abnormalities. See VA treatment records, December 10, 2013. Regarding the first element of service connection (i.e. a current disability), importantly, the Veteran’s medical records do not show a diagnosis of a left knee disorder. All treatment records in evidence are completely silent for a left knee disorder diagnosis. As such, the Veteran’s claim for entitlement to service connection for a left knee disorder fails. He did not have a diagnosis of a left knee disorder either in active service or after it. And, the best evidence of record shows that the Veteran does not have a current diagnosis of a left knee disorder. In the absence of proof of a present disorder (and, if so, of a nexus between that disorder and the active military service), there can be no valid claims for service connection. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). This principle has been repeatedly reaffirmed by the Federal Circuit, which has stated that “a Veteran seeking disability benefits must establish... the existence of a disability [and] a connection between the Veteran’s service and the disability.” Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). The Board has considered whether the Veteran experienced a left knee disorder at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, there is no evidence of a left knee disorder at any time during the pendency of this appeal. The Veteran also has not identified or submitted any competent evidence, to include a diagnosis of the disorder, or a medical nexus, relating his claimed disorder to active service. The Board has considered the Veteran’s lay statements in support of his claim. In multiple statements, the Veteran related that he believed that he had a left knee disorder that was related to his service. Although laypersons are competent to provide opinions on some medical issues, as to the specific issues in this case, diagnosing a left knee disorder, this issue falls outside the realm of common knowledge of a layperson. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (laypersons not competent to diagnose cancer). As a layperson, the Veteran has not been shown to possess the medical expertise to diagnose a left knee disorder and its etiology. The claims file does not contain any medical examinations diagnosing the Veteran with a left knee disorder, or linking his self-reported symptoms to his active service. In sum, there is no evidence, medical or otherwise, to support the Veteran’s statements. Thus, as previously stated, the medical evidence of record is only against the Veteran’s service connection claim. The Board acknowledges that the Veteran has not been afforded a VA examination addressing his claimed a left knee disorder and its relationship to his active service. No such an examination is required, as the only evidence that the Veteran’s claimed disability is related to his military service are his own conclusory generalized lay statements, which are unsupported by even speculative medical evidence. See Waters v. Shinseki, 601 F.3d 1274, 1277 (Fed. Cir. 2010); Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010). Finally, the Board is cognizant of the recent holding in Saunders v. Wilkie which stated that where pain causes functional impairment, a disability for VA compensation purposes exists, even if there is no underlying diagnosis. 886 F.3d at 1368. In sum, pain alone resulting in functional impairment is in fact a disability, and should not be summarily discounted as a bar to benefits based on a finding of no current diagnosis. However, the Veteran does not appear to experience any functional impairment due to his asserted left knee pain (pain which, in fact, he described being worse in the morning and afternoon, and getting better throughout the day). See VA treatment records, December 10, 2013. As such, Saunders is not applicable in this case. Accordingly, service connection for a left knee disorder is not warranted because the Veteran has not satisfied the first requirement of service connection, i.e., a current diagnosis of a disability. See 38 C.F.R. § 3.303 (2017); see again Gilpin, 155 F.3d at 1353; Brammer, 3 Vet. App. at 225. In reaching the above conclusion, the Board has considered the benefit-of- the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for a left knee disorder, that doctrine does not apply. 38 U.S.C. § 5107 (b) (2012). The claim of entitlement to service connection for a left knee disorder is denied. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Lech, Counsel