Citation Nr: 19115693 Decision Date: 03/04/19 Archive Date: 03/04/19 DOCKET NO. 10-31 333 DATE: March 4, 2019 ORDER Entitlement to service connection for a right shoulder condition is denied. FINDING OF FACT The Veteran’s right shoulder condition is not etiologically linked to any in-service injury, event, or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a right shoulder condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1974 to April 1976. The Veteran reported periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) in the Army Reserves until April 1980. This matter comes before the Board of Veteran’s Appeals (Board) from a March 2009 decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) in Albuquerque. In November 2017, the Board remanded the right shoulder condition claim for further development. That development having been completed to the extent possible, the matter is again before the Board for appellate review. The November 2017 remand directives instructed the Veteran to submit the earliest treatment records regarding the shoulder; to submit missing documents with orders from ACDUTRA or INACDUTRA periods; and for the RO to schedule the Veteran a VA examination to identify the current disability underlying the Veteran’s current complaints of right shoulder pain and the likely etiology of the injury, as well as an opinion as to the likelihood of the right shoulder being a result to an injury incurred in service. All available records identified by the Veteran as relating to his claims have been obtained, to the extent possible. The Veteran has not identified, and the record does not otherwise indicate, any existing pertinent evidence that has not been obtained. The missing Army Reserves documents requested in the remand were not provided by the Veteran, and attempts to obtain the Veteran’s records were unsuccessful; further attempts to find such records would be futile. The RO made multiple attempts to obtain these records, with no success. In a June 2017 letter, VA informed the Veteran of the Reserves records they have attempted to obtain; the efforts VA undertook to obtain them; description of any further action VA will take regarding the claim, including, but not limited to, notice that VA will decide the claim based on the evidence of record unless the Veteran submits the records VA was unable to obtain; and notice that the Veteran is ultimately responsible for providing the evidence. 38 U.S.C. § 5103A(b); 28 C.F.R. § 3.159(e)(1). Finally, the Veteran had a VA examination in March 2018, to include an addendum opinion. Thus, the VA examination report in connection with the claim being decided on appeal is of record and appears adequate. The opinions expressed therein are predicated on a substantial review of the record and in consideration of the Veteran’s complaints and symptoms. As such, VA has substantially complied with the November 2017 remand directives. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Stegall v. West, 11 Vet. App. 268, 271 (1998). Given these facts, there is no further assistance that would be reasonably likely to assist the Veteran in substantiating the claim. 38 U.S.C. § 5103A(a)(2). The Board finds that VA has fulfilled its duty to assist in this regard, and will proceed to adjudicate the Veteran’s appeal. Right Shoulder Condition The Veteran claims entitlement to service connection for a right shoulder condition. Service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service; and (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may also be granted if injury or disease incurred or was aggravated during a period of ACDUTRA, 38 U.S.C. § 101(24)(B); 38 C.F.R. § 3.6(a), and for only injury incurred or aggravated during a period of INACDUTRA (injuries include acute myocardial infarction, cardiac arrest, or cerebrovascular accident). 38 U.S.C. § 101(24)(C); 38 C.F.R. § 3.6(a). First, the Veteran was afforded a VA examination in March 2018. In that examination, the Veteran was given a diagnosis for a right shoulder strain. The Board concedes there is a current diagnosis for right shoulder condition. Next, the evidence of record for an in-service event includes service treatment records (STRs), medical records, and statements from the Veteran. In the STR from March 1976, a right shoulder complaint was noted during a follow up appointment for left shoulder pain. However, in a statement in June 2010, the Veteran contends his injury began when he was injured during a period of Reserve service in August 1977 while building a bridge at Fort Lewis in Washington. He stated the injury occurred when a part of the bridge was dropped, and bounced around and hit him in the shoulder and mouth, breaking several teeth and dislocating his shoulder. The Veteran further stated he received treatment for his mouth at the time of the incident in 1977 at a hospital in Spokane, Washington, but that he never received treatment for a shoulder injury. There are no records from his Reserves service corroborating any of these allegations. The first treatment records after service regarding the Veteran’s right shoulder condition were from VA medical records in February 2005, which showed complaints of right shoulder pain, with an assessment of right shoulder acromioclavicular joint arthralgia (+/-)brachial plexopathy. VA medical records in December 2008 showed the Veteran noted a rotator cuff strain on his problem list. The Board notes that while there is evidence of treatment in service for right shoulder pain in 1976, there is no permanent residual or chronic disability shown by the STRs or service medical records, or in evidence after service until 2005. There are no records showing he dislocated or broke his right shoulder in service in 1977. As to a nexus, in March 2018, the VA examiner opined that the current diagnosis of right shoulder condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The rationale for the opinion was that there were contradictory notes in the service treatment records The examiner noted that while there was a note in the STRs on March 1, 1976 regarding the left shoulder with a follow up note March 2, 1976 which briefly addressed right shoulder pain, the examiner also noted that there was a “no” response on the Veteran’s SF-88 (a report of medical examination) in March 1976 for shoulder condition(s), and nothing was noted at separation. Additionally, according to the VA examiner, the intervening time and lack of complaint at discharge suggest no relationship to the current condition. The Board notes that the examiner evaluated the totality of the evidence, including STRs, medical records and lay statements of the Veteran, before making his opinion. Therefore, the Board finds the opinion to be probative in value, and the finding that the shoulder condition is less likely than not to be related to service is deemed to be adequate. Finally, while the Board recognizes the Veteran’s assertions that his right shoulder condition is related to service and is competent to testify as to events that occurred in military service, the Veteran is not competent to conclude that any condition he was diagnosed with in 2005, or 2018, is connected to his service. Although lay persons are competent to provide opinions on some medical issues, the specific disabilities in this case, musculoskeletal issues, fall outside the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Musculoskeletal issues require specialized training and medical diagnostic testing for a determination as to diagnosis, and they are not susceptible of lay opinions on etiology. There are many different possible musculoskeletal issues, and a layperson is not competent to diagnose among them or to provide an etiology. Therefore, the Board finds that the Veteran’s statements of record cannot be accepted as competent evidence sufficient to establish service connection for his right shoulder condition. The elements for service connection for a right shoulder condition have not been met. Accordingly, service connection for the claimed disability is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Hoy, Associate Counsel