Citation Nr: 18153508 Decision Date: 11/28/18 Archive Date: 11/27/18 DOCKET NO. 16-38 430 DATE: November 28, 2018 ORDER Entitlement to an initial increased rating above 20 percent, status post gunshot wound, right shoulder, between July 1, 2007 and May 26, 2009, is denied. Entitlement to an increased rating above 20 percent, for status post gunshot wound, right shoulder, from July 1, 2009 forward, is denied. Entitlement to an initial compensable rating for, scar, right shoulder gunshot wound associated with status post gunshot wound, from May 31, 2007, is denied. Entitlement to an effective date earlier than May 31, 2007 for scar, right shoulder gunshot wound associated with status post gunshot wound, is denied. FINDINGS OF FACT 1. Between July 1, 2007 and May 26, 2009, the Veteran’s right shoulder experienced painful motion, with range of motion not limited to midway between the side and shoulder, no ankylosis, and no additional impairments. 2. From July 1, 2009, the Veteran’s right shoulder experienced painful motion, with range of motion not limited to midway between the side and shoulder, no ankylosis, and no additional impairments. 3. Throughout the appeal period, the Veteran’s scar has been shown to be linear and not painful or unstable and to not result in any disabling effects. 4. The Veteran filed his formal claim for service connection on May 31, 2007. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial increased rating above 20 percent, status post gunshot wound, right shoulder, between July 1, 2007 and May 26, 2009, have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.71a, Diagnostic Code 5203 (2017). 2. The criteria for entitlement to an increased rating above 20 percent, for status post gunshot wound, right shoulder, from July 1, 2009 forward, have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.71a, Diagnostic Code 5203 (2017). 3. The criteria for entitlement to an initial compensable rating for, scar, right shoulder gunshot wound associated with status post gunshot wound, from May 31, 2007, have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.118, Diagnostic Code 7205 (2017). 4. The criteria for entitlement to an effective date earlier than May 31, 2007 for scar, right shoulder gunshot wound associated with status post gunshot wound, have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400(o) (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1970 to February 1972 in the United States Army. He is a combat Veteran who served in the Republic of Vietnam and was awarded the Purple Heart Medal. This current appeal comes to the Board of Veterans’ Appeals (Board) from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma, that granted service connection for residuals of a gunshot wound to the right shoulder and assigned an initial rating of 100 percent for convalescence from surgery from May 31, 2009; a 10 percent initial rating from July 1, 2007, a 20 percent rating from June 24, 2008 exclusive of a period of a 100 percent rating for convalescence from surgery from May 26, 2009 to July 1, 2009. In July 2016, the RO granted an initial post-convalescent rating of 20 percent effective July 1, 2007. In the August 2015 rating decision, the RO also granted service connection for scars as a residual of the gunshot wound the to the right shoulder and assigned a noncompensable rating. In October 2015, the Board granted a total rating based on individual unemployability based in part on the impairment imposed by the right shoulder disability. In December 2015 and August 2016, the RO effected the Board decision and assigned the total disability rating based on individual unemployability, effective July 1, 2009. Duty to Notify and Assist Neither the Veteran nor his representative identified any shortcomings in fulfilling VA’s duty to notify and assist. Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015). The Board thus finds that further action is unnecessary under 38 U.S.C. § 5103A and 38 C.F.R. § 3.159. The Veteran will not be prejudiced because of the Board’s adjudication of the claims below. I. Increased Rating Disability evaluations are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. In considering the severity of a disability, it is essential to trace the medical history of the Veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole recorded history is necessary so that a rating may accurately reflect the elements of any disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Although the regulations do not give past medical reports precedence over current findings, the Board is to consider the Veteran’s medical history in determining the applicability of a higher rating for the entire period in which the appeal has been pending. Powell v. West, 13 Vet. App. 31, 34 (1999). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information, lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the weight of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Disability of the musculoskeletal system is primarily the inability, due to damage or infection in the parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. It is essential that the examination on which ratings are based adequately portray the anatomical damage and the functional loss with respect to all of these elements. In evaluating disabilities of the musculoskeletal system, it is necessary to consider, along with the schedular criteria, functional loss due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. DeLuca v. Brown, 8 Vet. App. 202 (1995). Functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective enervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. §§ 4.10, 4.40, 4.45. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a (musculoskeletal system) or § 4.73 (muscle injury); a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a [or 4.73] criteria.”). Separate evaluations may be assigned for separate periods of time based on the facts found. In other words, the evaluations may be staged. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, the Board has determined that a uniform evaluation is appropriate for the entire period on appeal. 1. Right Shoulder: July 1, 2007 to May 26, 2009 In a clinical record in April 2007, the Veteran’s private physician noted that the Veteran was right hand dominant and that he had been experiencing right shoulder pain for the past two years difficulty performing overhead work as a welder for the past six months. A magnetic resonance image the same month showed a full thickness rotator cuff tear. In a clinical record in May 2007, the Veteran’s private physician noted the Veteran’s report of right shoulder pain to the extent that he could not lift his hand. The Veteran subsequently underwent arthroscopic surgery to repair the tear on May 22, 2007. A post-surgical evaluation on May 31, 2007 showed continued pain and stiffness with range of flexion and abduction measured as 78 and 81 degrees respectively. The Veteran’s mother submitted a statement on July 18, 2007. She explained that the Veteran told her about being ambushed in Vietnam, and discussed his wound but did not comment on the level of post-surgery function. On August 8, 2007 the Veteran’s shoulder was doing “extremely well.” The Veteran was able to raise his arms over his head, his forward flexion was 20 degrees, he had excellent internal rotation, and had no significant pain. He was allowed to return to work at that time. Post-surgery, on October 31, 2007, the Veteran was seen by Dr. N who said He has excellent motion actively. He has excellent internal rotation and external rotation. He has slight popping anteriorly, as is commonly seen. His cuff is functioning well. He has occasional pain at night. Dr. N authorized the Veteran to return to work, with limitations on activity. On June 2, 2008, a family member noted her observations that the Veteran was unable to restore old cars and he could not raise his right arm above his head. The Veteran underwent a compensation and pension (C&P) examination of his right shoulder on February 5, 2008. His range of motion (ROM) in his right shoulder was abnormal. His flexion was 60 degrees, abduction was 50 degrees, external rotation was 80 degrees, and internal rotation was 70 degrees. Pain caused functional loss. Palpation of muscle revealed impairment of muscle tone, but no loss of deep fascia or loss of muscle substance. Signs of weakness were present, Muscle Group I had a strength of 3 out of 5. There was tendon damage due to supraspinatus; the muscle injury did not involve joint, bone, or nerve damage. The examiner found no edema, effusion, redness, heat, guarding of movement or subluxation. Imaging studies were within normal limits and there was nothing abnormal about the peripheral nerves. The overall effect of the condition was “limited.” The Veteran did not return to Dr. N until March 26, 2008. At that appointment, the Veteran was having issues with “paresthesias or pain from his shoulder radiating down into the upper part of his arm.” His occupation was noted as one in which he used a 4-pound sledgehammer daily. There was also some radiating pain down the arm, to the elbow, and into the hand. The Veteran stated that the pain tends to keep him up at night. Dr. N said that the Veteran may be experiencing nerve trouble, possibly from the neck; an MRI was recommended. On May 5, 2008, Dr. N observed the Veteran’s right shoulder. He stated, “[a]t this point in time, he is almost a year following rotator cuff repair. He has done great with the rotator cuff. He has excellent motion of the right shoulder compared to the contralateral extremity. Another examination took place on June 30, 2008. It was noted that the Veteran was gradually losing strength in his right arm, and that he was no longer able to work overhead. The Veteran explained his dysfunction as feeling more like stiffness than pain. At that time, forward flexion was 75 degrees on active and passive ROM. Abduction was 150 degrees on active and passive ROM; external rotation was 45 degrees at active and passive ROM; and internal rotation was 90 degrees at active and passive ROM. Pain was noted with all motion as the primary reason for the limited ROM. There was no bone loss, no inflammatory arthritis, and no ankylosis. The right shoulder disability’s effect on occupational functioning was “significant” as there were issues with lifting, carrying, reaching, and manual dexterity. Daily activities such as chores, shopping, exercising, bathing, dressing, and grooming suffered mild effect. Muscle Group 4 was found to be injured due to supraspinatus with a strength of 3. All other muscle groups were normal. Overall muscle function was noted as normal and sufficient to perform activities of daily living (ADLs). The surgical scars were observed as 1cm, linear wounds; there were 5 in total. They were not painful or tender to the touch, and not adherent. There were no residuals of: nerve damage, tendon damage, bone damage, or muscle herniation; there was no loss of deep fascia or muscle substance. By March 4, 2009, the Veteran was again having pain and issues raising his arm over his head. The pain was noted as “a significant change in the last couple of months.” There was pain with forward flexion, abduction, and weakness with lifting. His issues were tied to a possible rotator cuff tear, and an MRI was ordered. Analysis The Veteran is in receipt of a 20 percent evaluation for residuals of a right shoulder injury under Diagnostic Code 5203. See 38 C.F.R. §§ 4.20, 4.71a. The Veteran filed his claim for service connection on May 31, 2007. As a preliminary matter, the evidence shows that the Veteran’s right shoulder is his dominant shoulder. Despite the Veteran currently being rated under Diagnostic Code 5203 the RO actually rated him at 20 percent for painful motion under 38 C.F.R. § 4.59, during this period on appeal. Diagnostic Code 5203 provides ratings for other impairment of the clavicle or scapula. Malunion of the clavicle or scapula is rated as 10 percent for the major shoulder. Nonunion of the clavicle or scapula without loose movement is rated as 10 percent for the major shoulder; nonunion of the clavicle or scapula with loose movement is rated as 20 percent for the major shoulder. Dislocation of the clavicle or scapula with loose movement is rated as 20 percent for the major shoulder and 20 percent for the minor shoulder. Diagnostic Code 5203 provides an alternative rating based on impairment of function of the contiguous joint. 38 C.F.R. § 4.71a. The terms “major” and “minor” are used in the rating criteria to refer to the dominant or non-dominant upper extremity. See 38 C.F.R. § 4.69 (2016). The evidence demonstrates that the Veteran’s right arm is his dominant upper extremity. The Board does not find that the Veteran is entitled to a rating higher than 20 percent for his right shoulder disability. Under the current diagnostic code, he is receiving the highest possible evaluation. 38 C.F.R. § 4.71a, Diagnostic Code 5203. To receive a 30 percent evaluation, or higher, other diagnostic codes would need to be considered. Diagnostic Code 5200 provides that ankylosis of the scapulohumeral articulation is to be rated as follows: favorable ankylosis, with abduction to 60 degrees, can reach mouth and head, 30 percent for the major shoulder and 20 percent for the minor shoulder; intermediate ankylosis, between favorable and unfavorable, 40 percent for the major shoulder and 30 percent for the minor shoulder; unfavorable ankylosis, abduction limited to 25 degrees from side, 50 percent for the major shoulder and 40 percent for the minor shoulder. A Note provides that the scapula and humerus move as one piece. 38 C.F.R. § 4.71a. Diagnostic Code 5201 provides that limitation of motion of the arm at the shoulder level is rated 20 percent for the major shoulder; limitation of motion of the arm midway between the side and shoulder level is rated as 30 percent for the major shoulder; limitation of motion of the arm to 25 degrees from the side is rated as 40 percent for the major shoulder. 38 C.F.R. § 4.71a. Diagnostic Code 5202 provides ratings for other impairment of the humerus. Malunion of the humerus with moderate deformity is rated as 20 percent for the major shoulder; malunion of the humerus with marked deformity is rated as 30 percent for the major shoulder. Recurrent dislocations of the humerus at the scapulohumeral joint, with infrequent episodes, and guarding of movement only at the shoulder level, are rated as 20 percent for the major shoulder; recurrent dislocations of the humerus at the scapulohumeral joint, with frequent episodes and guarding of all arm movements, are rated as 30 percent for the major shoulder. Fibrous union of the humerus is rated as 50 percent for the major shoulder. Nonunion of humerus (false flail joint) is rated as 60 percent for the major shoulder and 50 percent for the minor shoulder. Loss of head of the humerus (flail shoulder) is rated as 80 percent for the major shoulder. 38 C.F.R. § 4.71a. The requirements for ratings higher than 20 percent, under Diagnostic Codes 5200, 5201, and 5202 were not found at any examination during this rating period. While a June 2008 examination found that the subjective limits of function was “significant,” limitation this limitation is accounted for under the applicable diagnostic codes and regulations. The medical evidence during the rating period demonstrated that painful motion alone limited the Veteran’s ability to use his right shoulder, but it did not show there were additional issues contemplated by other rating codes. The Veteran has not experienced ankylosis, his ROM is not limited to midway between his side and shoulder level, and he does not have an impairment of his humerus. Because his disability did not display any of these symptoms a higher rating is not warranted between July 1, 2007 and May 26, 2009. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). 2. Right Shoulder: from July 1, 2009 A Travel Board hearing took place on November 18, 2011 that addressed service connection for his right shoulder disability. The Veteran testified that after service he experienced some stiffness and pain, but did not seek treatment until roughly 2006 and did not further address the severity of his shoulder disability at that time. On August 4, 2014 and April 22, 2015 the Veteran reported constant right shoulder pain. He said it had been occurring for a while, and the pain was normally about a 5 or 6 out of 10. At the July 22, 2015 C&P examination the Veteran was diagnosed with: shoulder impingement syndrome, AC joint osteoarthritis, rotator cuff tear, labral tear including superior labral anterior-posterior lesion (SLAP), and degenerative arthritis. The Veteran reported that flare-ups prevented him from lifting his arms over his head. His ROM was 80 degrees of flexion, 80 degrees of abduction, 20 degrees of external rotation, and 90 degrees of internal rotation. Repetitive use did not reveal any more limited ROM, and the examiner predicted that there would not be additional loss of function during flare-ups described by the Veteran. The exam was being conducted during a flare-up, and flare-ups were found to limit function by pain, fatigue, and lack of endurance. Muscle strength was 4 out of 5 in forward flexion and abduction. There was no atrophy or ankylosis; a suspected rotator cuff condition was positive on the Hawkins’ impingement test, empty-can test, external rotation/infraspinatus strength test, and lift-off subscapularis test. Instability, dislocation or labral pathology was suspected due to a history of mechanical symptoms. There was no history of recurrent dislocation, and the crank apprehension test was negative. There was no condition or impairment of the clavicle, scapula, or AC joint, but there was palpation of the AC joint. There was no loss of flail shoulder, no false flail shoulder (nonunion), or fibrous union of the humerus. Also, no malunion of the humerus with moderate or marked deformity was found. The examiner concluded, It is at least as likely as not that the gunshot injury to right shoulder with injury to Muscle Group 1 altered the biomechanics of normal shoulder function, changing the way he used his shoulder and contributed to onset of DJD (degenerative joint disease), shoulder impingement and increased susceptibility to rotator cuff injury. Analysis After his second rotator cuff surgery and period of convalescence, from July 1, 2009, the Veteran has received a 20 percent evaluation for painful motion under 38 C.F.R. § 4.59. While the July 22, 2015 examination demonstrated additional issues with the shoulder (arthritis, osteoarthritis, shoulder impingement, AC joint palpation, etc.) the additional issues are contemplated in that they cause painful motion. They do not, however, cause additional function loss, loss of ROM, or any of the symptoms listed under Diagnostic Codes 5200, 5201, or 5202. Additionally, Diagnostic Codes 5003 and 5010 were considered for ratings purposes, but since these diagnostic codes would not provide the Veteran with a rating above 20 percent, evaluating him under the arthritic diagnostic codes is not necessary since they provide a maximum rating of 20 percent. The Veteran’s symptoms cause painful motion and issues with performing the physically demanding job he once held. The symptoms that cause painful motion have been considered and properly rated, they do not create such impairment or symptoms that could be rated under another diagnostic code. ROM is not limited to a higher compensable rating, there is no evidence of ankylosis, an injury to the humerus, or other symptoms that require evaluation under another diagnostic code for this period. Since the Veteran’s second shoulder surgery he has been properly rated and the Board does not find that a rating above 20 percent is warranted. As noted, the Veteran was granted a total disability rating based on individual unemployability, effective July 1, 2009, in part in contemplation of the impairment caused by the right shoulder disability. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). 3. Scars Scars were noted at the February 5, 2008 examination. The scars were observed at the anterior and posterior right shoulder, both were 1 cm by 0.3 cm. The examiner said of the scars, There is no tenderness, disfigurement, ulceration, adherence, instability, tissue loss, inflammation, edema, keloid formation, hypopigmentation, hyperpigmentation and abnormal texture. Another examination took place on June 24, 2008. The scars were noted again on this exam. They were not separate or adherent. There were 5 scars in total, they were 1 cm by .1 cm, there was no tenderness, no functional loss, no soft tissue damage, or breakdown over the scar. The July 22, 2015 examination found three scars. One was .9 cm by .9 cm, the other was 2 cm by 2.1 cm, and the third was 1.5 cm by .2 cm. The examiner noted that the scars were not painful or unstable. Analysis The Veteran is rated under Diagnostic Code 7805, which instructs the Board to “[e]valuate any disabling effect(s) not considered in a rating provided under diagnostic codes 7800-04 under an appropriate diagnostic code.” The Board has considered whether a compensable disability rating is warranted under any other Diagnostic Code. In this regard, Diagnostic Code 7804 (Scar(s), unstable or painful) provides, as relevant, a 10 percent disability rating based on one or two scars that are unstable or painful. Note (2) states that “[s]cars evaluated under diagnostic codes 7800, 7801, 7802, or 7805 may also receive an evaluation under this diagnostic code, when applicable.” While Diagnostic Code 7804 is potentially applicable, the evidence of record indicated that the Veteran’s scar was not painful or unstable. With respect to other potentially applicable Diagnostic Codes, Diagnostic Code 7800 relates to scars of the head, face or neck and is therefore not applicable to the Veteran’s scars, which are due to right shoulder surgery and located on the right upper extremity. Diagnostic Code 7801 relates to burn scars or scars due to other causes not of the head, face, or neck that are deep and nonlinear and is therefore not applicable to the Veteran’s scar, which was noted by the VA examinations to be a linear scar and to not be due to burns. See Melson v. Derwinski, 1 Vet. App. 334 (1991) (holding that the use of the conjunctive “and” in a statutory provision meant that all of the conditions listed in the provision must be met). Diagnostic Code 7802 relates to scars not of the head, face, or neck, that are superficial and nonlinear and is therefore not applicable to the Veteran’s scars. As such, a compensable disability rating is not warranted under these Diagnostic Codes, and no others Diagnostic Codes are applicable. In addition, the Board notes that the United States Court of Appeals for Veterans Claims (Court) has held that “when a condition is specifically listed in the [rating] Schedule, it may not be rated by analogy” and that “VA must...apply the [Diagnostic Codes] that specifically pertain to the listed conditions and determine the appropriate disability ratings.” See Ulysses Copeland v. McDonald, 27 Vet. App. 333 (2015); see also 38 C.F.R. § 4.20 (2017) (titled “Analogous ratings” and stating that “[w]hen an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury”). In this case, the VA examinations found the scars to be linear, not painful or unstable, not on the head, face, or neck, and without any additional tissue or functional damage. As noted, Diagnostic Code 7805 is titled “Scars, other (including linear scars)” and therefore linear scars are specifically listed in the rating schedule under Diagnostic Code 7805. As such, rating the Veteran’s scar by analogy is not appropriate and the appropriate Diagnostic Code for the scar to be rated under is 7805. As outlined above, a compensable disability rating is not warranted under this Diagnostic Code. II. Earlier Effective Date Generally, the effective date is the date of receipt of the claim or the date entitlement arose, whichever is later, unless otherwise provided. 38 U.S.C. § 5110(a); 38 C.F.R. 3.400. Entitlement arises on the date the claimant meets the basic eligibility criteria. For direct service connection claims, if the claim is received within one year of separation, the date of entitlement will be the day after separation commenced. 38 U.S.C. § 5110(b)(1); 38 C.F.R. § 3.400(b)(2)(i). The Veteran contended that an effective date earlier than May 31, 2007 for the scars on his right shoulder. Presumably, he refers to the scars from the gunshot wound rather than the surgical scars, as the surgical scars could not have been present prior to surgery—which first took place on May 22, 2007. However, the effective date for service connection is the latter of the receipt of the claim for service connection, or the date on which entitlement arose. Id. In this instance, the RO received the Veteran’s claim for service connection on May 31, 2007. Entitlement may have arisen prior, but the file does not contain a formal or informal claim for service connection at an earlier date. VA regulations provide that an effective date is given based on the receipt of the claim; therefore, an effective date earlier than May 31, 2007 is denied. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Harner, Associate Counsel