Citation Nr: 19106944 Decision Date: 01/29/19 Archive Date: 01/29/19 DOCKET NO. 18-52 259 DATE: January 29, 2019 ORDER Entitlement to service connection for a right shoulder disorder is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has a right shoulder disorder that manifested during service, within one year of separation, or that is otherwise due to a disease or injury in service. CONCLUSION OF LAW The criteria for service connection for a right shoulder disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from August 1953 to August 1956. Entitlement to service connection for a right shoulder disorder. The Veteran asserts that he is entitled to service connection for a right shoulder disorder on a direct basis. However, as outlined below, the preponderance of the evidence of record demonstrates that the Veteran’s right shoulder disorder did not manifest during, within the year following, or a result of active service. As such, connection cannot be established on a direct basis. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, service connection for certain chronic diseases, including arthritis, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert. v. Derwinski, 1 Vet. App. 49, 55 (1990). The Veteran’s service treatment records (STRs) are unavailable for review. VA treatment records show that the first treatment for the right shoulder was sought in February 2000 for a skin nodule. The Veteran underwent surgery to remove the skin nodule in May 2000. The Veteran’s first treatment for the right shoulder was over 40 years after separation from service. In a July 2017 statement, the Veteran stated that service was a contributing factor to the pain and mobility loss of his right shoulder. He stated that the disorder began in service and worsened over the past 60 years. He stated that he is no longer able to use a firearm because of the pain in his right shoulder. On the November 2018 substantive appeal, the Veteran asserted that he believed his right shoulder disorder was caused by the recurring shock to his right shoulder while practicing on the shooting team and as a squad leader in the infantry firing rifles. The Veteran asserts that this is the early onset of the right shoulder disorder. Based on the foregoing, there is no evidence that the Veteran’s right shoulder disorder was manifested in service or to a compensable degree in the first year following his separation from service. Consequently, service connection for a right shoulder disorder on the basis that such became manifest in service and persisted, or on a presumptive basis (as a chronic disease under 38 U.S.C. § 1112), is not warranted. Notably, the Veteran has not claimed, nor has he submitted competent evidence to show, that he has suffered from the right shoulder disorder continuously since service. See 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 495-96 (1997). There is also no evidence that the Veteran’s right shoulder disorder is otherwise related to service. The Veteran’s VA treatment records and private treatment records are silent for an opinion relating his right shoulder disorder to service. The Board acknowledges that the Veteran has not been afforded a VA examination with respect to this claim, but finds no such examination was required because the evidence does not indicate that the claimed disability, or symptoms thereof, may be associated with the Veteran’s active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Although the Veteran currently experiences pain in the right shoulder, there is no competent and credible evidence of an in-service event, injury or disease, or a nexus between any of his diagnosed disabilities and service. As such, the Board finds that a VA examination was not required. Further, the Veteran’s own statements relating his right shoulder disorder to service are not competent evidence, as he is a layperson and lacks the training to provide adequate opinion regarding medical etiology. Specifically, the Veteran lacks the training to opine whether right shoulder pain, in the absence of credible evidence of continuity, as here, is related to an incident in service. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007) (Whether lay evidence is competent and sufficient in a particular case is a fact issue to be addressed by the Board rather than a legal issue to be addressed by the Veterans Court). Also, right shoulder pain is a symptom of the musculoskeletal system, and the record does not show that the Veteran has training or education in this medical field; therefore, lay evidence of the etiology is not competent nexus evidence as it is not capable of lay observation. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007); Layno v. Brown, 6 Vet. App. 465, 469-70. Thus, the Veteran is not competent or qualified, as a layperson, to render an opinion on medical causation. In light of the foregoing, the Board concludes that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a right shoulder disorder. Accordingly, it must be denied. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Thompson, Associate Counsel