Citation Nr: 18154629 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 16-58 116 DATE: December 4, 2018 ORDER Entitlement to service connection for left shoulder degenerative arthritis, bicipital tendon tear, and shoulder impingement syndrome is granted. Entitlement to service connection for right shoulder degenerative arthritis is granted. Entitlement to service connection for left knee degenerative changes is granted. REMANDED Entitlement to service connection for hypertension is remanded. Entitlement to an initial compensable rating for right ear hearing is remanded. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his left shoulder degenerative arthritis, bicipital tendon tear, and shoulder impingement syndrome are at least as likely as not related to service. 2. Resolving reasonable doubt in the Veteran’s favor, his right shoulder degenerative arthritis is at least as likely as not related to service. 3. Resolving reasonable doubt in the Veteran’s favor, his left knee degenerative changes are at least as likely as not related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for left shoulder degenerative arthritis, bicipital tendon tear, and shoulder impingement syndrome are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for right shoulder degenerative arthritis are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for service connection for left knee degenerative changes are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1983 to January 1989. 1. Entitlement to service connection for left shoulder degenerative arthritis, bicipital tendon tear, and shoulder impingement syndrome is granted. 2. Entitlement to service connection for right shoulder degenerative arthritis is granted. 3. Entitlement to service connection for left knee degenerative changes is granted. The Veteran asserts that his left knee and bilateral shoulder disabilities are related to his in-service responsibilities, including repeated parachute training. Specifically, he asserts that jerks from the parachute harness and hard landings caused his shoulder and knee problems. Resolving reasonable doubt in favor of the Veteran, the Board concludes that the Veteran’s left knee and bilateral shoulder disabilities are related to service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). October 2015 VA examination reports show the Veteran was diagnosed with bilateral degenerative arthritis of the shoulders, left shoulder bicipital tendon tear and shoulder impingement syndrome, and left knee degenerative changes. In a January 2018 report, a private physician provided an opinion based on review of the records and interview and examination of the Veteran. The private physician opined that the Veteran’s bilateral shoulder and left knee conditions are more likely than not related to service. The private physician explained that the Veteran served on airborne status as a paratrooper. The private physician explained that parachuting carries great risk of injury and exerts force on the skeletal system. The private physician noted that shoulder pain is widespread among skydivers and is linked to repeated exposure to parachute opening shock. The private physician reported that injuries to lower extremities are also common in parachuting, and that the risk of injury increases with greater parachute load as the heavier loads result in more force on ground impact. The private physician explained that the force on ground impact is felt in the feet going upwards through the leg and lower back and noted that knee problems are common. The private physician’s opinion is supported by the evidence of record. In a January 2015 letter, the Veteran’s treating physician opined that the Veteran’s left knee condition is the result of his service as a paratrooper. During an August 2014 VA examination relating to his right knee, the Veteran reported pain in both knees during hard parachute landings in service. He reported more than 80 parachute jumps with several hard landings, and reported that he has had knee pain since service. In an August 2016 statement, the Veteran reported that the majority of his jumps were with heavy equipment. He also reported that the majority of his jumps were at night which made landings more difficult due to visibility issues. He reported that he landed mostly in hard airfields or rocky ground. He also reported that he took over the counter medication during service to alleviate pain. The Veteran’s service personnel records show that he was assigned to the 82nd airborne and that he received a parachute badge. The Board notes that October 2015 VA examiners opined that the Veteran’s bilateral shoulder and left knee disabilities are less likely than not related to service. The VA examiners explained that the Veteran’s service treatment records and separation examination did not document shoulder or knee complaints, and that the first documentation of complaints in the file is in 2014. A VA examiner also explained that the Veteran’s shoulder conditions are more likely related to work as a plumber and the aging process. The other VA examiner noted in discussing the Veteran’s left knee that degenerative changes can be considered part of the aging process. However, the VA examiners did not specifically address the Veteran’s reports that he experienced pain beginning during service and his reports of more than 80 parachute jumps, including jumps with heavy loads, hard landings, and jerks from his harness. Viewing the lay and medical evidence as a whole, the Board finds that the evidence is at least in equipoise as to whether the Veteran’s bilateral shoulder and left knee disabilities are related to service. Accordingly, service connection for left shoulder degenerative arthritis, bicipital tendon tear, and shoulder impingement syndrome, right shoulder degenerative arthritis, and left knee degenerative changes is warranted. REASONS FOR REMAND 1. Entitlement to service connection for hypertension is remanded. 2. Entitlement to an initial compensable rating for right ear hearing is remanded. In a September 2016 statement, the Veteran’s sister reported that the Veteran receives disability benefits from the Social Security Administration (SSA). As SSA disability materials may be relevant to the Veteran’s claims, remand is appropriate to obtain the complete medical and administrative records related to any application for SSA disability benefits. Murincsak v. Derwinski, 2 Vet. App. 363, 369-70 (1992) (where VA has actual notice of the existence of records held by SSA which appear relevant to a pending claim, VA has a duty to assist by requesting those records from SSA). The claims file shows the Veteran has received treatment for high blood pressure, and his service treatment records note a problem with blood pressure. See March 2014 VA Treatment Record (noting active prescription for high blood pressure); November 1988 STR. The Veteran also asserted that his high blood pressure is secondary to his service-connected disabilities. Accordingly, VA medical opinion should be obtained regarding whether the Veteran has a hypertension diagnosis within the claims period and, if so, whether such disability is related to service or to a service-connected disability. While this matter is on remand, outstanding private and VA treatment records should be obtained, including VA treatment records from March 2017 to the present. The Board notes that while many documents have been translated in the Veteran’s claims file, the Veteran’s March 2015 statement and his December 2016 to March 2017 VA treatment records contain some Spanish language statements. While on remand, the AOJ should take the opportunity to review the Veteran’s claims file and translate any untranslated documents. The matters are REMANDED for the following action: 1. After securing any necessary authorization, obtain any private treatment records as the Veteran may identify relevant to his claims. 2. Obtain outstanding VA treatment records, to include any VA treatment records from March 2017 to the present. 3. Review the claims file, and translate from Spanish into English any untranslated document, to include the Veteran’s March 2015 statement and his December 2016 to March 2017 VA treatment records. 4. Contact SSA and request the Veteran’s complete SSA records, including any administrative decisions on any application for disability benefits and all underlying medical records which are in SSA’s possession. A copy of any requests sent to SSA, and any reply, to include any records obtained from SSA, must be included in the claims file. All reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records. 5. After obtaining any outstanding records, ask the appropriate examiner to review the Veteran’s file. The necessity of an in-person examination, with any appropriate testing, is left to the discretion of the examiner.   The examiner should opine as to whether the Veteran has had a hypertension disability at any time during the claim period (from September 2015 to the present). If so, the examiner should opine whether it is at least as likely as not (a 50 percent or greater probability) that the hypertension: (a) had an onset in service; (b) manifested to a compensable degree within a year of separation from service (by January 1990); (c) is otherwise related to an in-service injury, event, or disease; or (d) is caused by or aggravated by any of his service-connected disabilities (his lumbar spine, bilateral shoulder, bilateral knee, left arm, tinnitus, and right ear hearing loss disabilities). The examiner should consider all medical and lay evidence of record. The Veteran asserts that his high blood pressure is the result of his paratrooper responsibilities in service or is secondary to his service-connected disabilities. A complete rationale should be given for all opinions and conclusions expressed. 6. After the above development, and any other development deemed necessary, readjudicate the claims. If the benefits sought on appeal remain denied, the   7. Veteran and his attorney should be furnished a supplemental statement of the case and given the opportunity to respond thereto. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Purcell, Associate Counsel