Citation Nr: 18152559 Decision Date: 11/23/18 Archive Date: 11/23/18 DOCKET NO. 08-29 751A DATE: November 23, 2018 ORDER Service connection for left shoulder disabilities diagnosed as chronic rotator cuff tendonitis, biceps tendonitis, and arthritis is granted. Service connection for right great toe disabilities diagnosed as traumatic arthritis, hallux valgus surgical residuals, and chronic paronychia is granted. Service connection for left elbow arthritis is granted. Service connection for left knee arthritis is granted. FINDINGS OF FACT 1. The Board of Veterans’ Appeals (Board) finds that service connection is warranted for left shoulder disabilities including arthritis and tendonitis based on the dipositive August 2017 medical opinion from the Veteran’s treating orthopedic surgeon stating that it is more likely than not that the Veteran’s in-service left shoulder injury caused his current left shoulder conditions diagnosed as arthritis and chronic rotator cuff and biceps tendonitis. The surgeon based this opinion his treatment relationship with the Veteran as well as on a detailed review of the Veteran’s medical and military history, the Veteran’s report of symptom onset and development, and the Veteran’s remote and current treatment records. This opinion is also supported by the Veteran’s consistent, competent, and credible report that he injured his left shoulder while playing baseball during active service and by medical records dated from soon after service showing imaging and treatment consistent with the Veteran’s reported in-service injury. The Board acknowledges the negative nexus opinions of record, but assigns them less probative weight because they do not reflect a complete review of the medical evidence, are not based on a treatment relationship with the Veteran, and are not supported by as detailed explanations as is the August 2017 positive opinion. 2. The Board finds that service connection is warranted for the Veteran’s right great toe disabilities diagnosed as traumatic arthritis, hallux valgus surgical residuals, and chronic paronychia based on the dispositive August 2017 medical opinion from the Veteran’s treating orthopedic surgeon stating that it is more likely than not that the Veteran’s in-service physical activity with ill-fitting boots caused the current right toe disabilities. This opinion is supported by the Veteran’s consistent, competent, and credible reports that he first developed right great toe and toenail pain and infections during service. The Board acknowledges the negative nexus opinions of record but assigns them less probative weight because they do not reflect a complete review of the medical evidence, are not based on a treatment relationship with the Veteran (as is the August 2017 letter), and are not supported by as detailed explanations as is the August 2017 positive opinion. 3. The Board finds that service connection is warranted for the Veteran’s left elbow arthritis based on the dipositive August 2017 medical opinion from the Veteran’s treating orthopedic surgeon stating that it is more likely than not that the Veteran’s in-service left elbow injury caused the Veteran’s current left elbow arthritis. This opinion is supported by the Veteran’s consistent, competent, and credible written statements and testimony that he has had persistent left elbow symptoms and disability since injuring his left elbow playing baseball during active service. The Board acknowledges the negative nexus opinions of record, but assigns them less probative weight because they do not reflect a complete review of the medical evidence, are not based on a treatment relationship with the Veteran (as is the August 2017 letter), and are not supported by as detailed explanations as is the August 2017 positive opinion. 4. The Board finds that service connection is warranted for left knee arthritis based on the dipositive August 2017 medical opinion from the Veteran’s treating orthopedic surgeon concluding that it is more likely that not that the Veteran’s in-service left knee injury caused his current left knee arthritis. This opinion is supported by the Veteran’s consistent, competent, and credible reports of persistent left knee pain and disability since injuring his left knee during an in-service track and field event. The Board acknowledges the negative nexus opinions of record, but assigns them less probative weight because they do not reflect a complete review of the medical evidence and are not supported by as detailed explanations as is the August 2017 positive opinion. CONCLUSIONS OF LAW 1. The criteria for service connection for left shoulder disabilities diagnosed as chronic rotator cuff tendonitis, biceps tendonitis, and arthritis have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 2. The criteria for service connection for right great toe disabilities diagnosed as right hallux valgus surgical residuals including right great toe infection onychomycosis have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 3. The criteria for service connection for left elbow arthritis have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 4. The criteria for service connection for left knee arthritis have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1973 to December 1974. This matter is before the Board on appeal of a June 2007 rating decision. The Veteran appeared at a hearing before the undersigned Veterans Law Judge in July 2012. A transcript of the hearing is in the Veteran’s file. In January 2015, the Board, in part, denied the issues on appeal here. The Veteran then appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In June 2015, VA’s Office of General Counsel, representing the Secretary, filed a Motion for Remand. The Court granted the Motion in a June 2015 Order and remanded the issues back to the Board for action consistent with the Motion. In September 2015, May 2016, and May 2017, the Board remanded the case for further development for compliance with the terms of the Motion. The Board notes with appreciation that the Veteran has partnered with VA to develop (both by patiently and diligently explaining his injuries and symptoms and by searching for decades-old medical records) the evidence relied on here to grant the benefits sought. 1. Service connection for left shoulder disabilities diagnosed as chronic rotator cuff tendonitis, biceps tendonitis, and arthritis. 2. Service connection for right great toe disabilities diagnosed as traumatic arthritis, hallux valgus surgical residuals, and paronychia. 3. Service connection for left elbow arthritis. (Continued on the next page)   4. Service connection for left knee arthritis For the reasons outlined above, service connection for these disabilities is granted. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Robinson, Associate Counsel