Citation Nr: 19150950 Decision Date: 07/01/19 Archive Date: 07/01/19 DOCKET NO. 18-11 056 DATE: July 1, 2019 REMANDED Entitlement to service connection, to include on a secondary basis, for right shoulder disorder, to include right shoulder pain, is remanded. Entitlement to service connection, to include on a secondary basis, for right arm disorder, to include right arm pain, is remanded. Entitlement to service connection, to include on a secondary basis, for neck disorder, to include neck pain, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1979 to October 1980. These matters come before the Board of Veterans’ Appeals (Board) on appeal from September 2017 and October 2017 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection, to include on a secondary basis, for right shoulder disorder, to include right shoulder pain, is remanded. The Veteran contends that his right shoulder disorder, to include right shoulder pain is caused or aggravated by his service-connected residuals from removal of a chest tumor. He was afforded a VA examination for his right shoulder in October 2017, where he reported constant pain in his right shoulder and limited range of motion. The examiner diagnosed the Veteran with right shoulder arthritis and opined that it is less likely than not that the Veteran’s right shoulder disability is related to service, as his service treatment records only contain one mention of right shoulder bursitis, and post-service treatment records are silent for nearly 37 years after separation from service for further right shoulder treatment. However, the October 2017 VA examiner did not provide a medical opinion as to secondary service connection. The U.S. Court of Appeals for the Federal Circuit recently found that the term “disability,” as used in 38 U.S.C. § 1110, “refers to the functional impairment of earning capacity, not the underlying cause of said disability,” and held that “pain alone can serve as a functional impairment and therefore qualify as a disability.” Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). The October 2017 VA examiner found pain with regard to the Veteran’s right shoulder upon examination. The Board finds that, in light of Saunders, the Veteran should be afforded a new VA examination to determine whether his right shoulder pain presents a functional impairment of earning capacity, and if so, whether that impairment is related directly to service or to his service-connected residuals from removal of a chest tumor. 2. The claims of entitlement to service connection, to include on a secondary basis, for right arm disorder, to include right arm pain, and neck disorder, to include neck pain, are remanded. The Veteran contends that his right arm pain and neck pain are caused or aggravated by his service-connected residuals from removal of a chest tumor. Post-service private treatment records confirm reports of right arm and neck pain. To date, the Veteran has not been afforded VA examinations to determine the nature and etiology of any diagnosed right arm disorder or neck disorder, to include right arm pain and neck pain. The Board finds that, in light of Saunders, the Veteran should be afforded VA examinations to determine whether his right arm pain and neck pain present functional impairments of earning capacity, and if so, whether these impairments are related directly to service or to his service-connected residuals from removal of a chest tumor. The matters are REMANDED for the following action: 1. With any necessary identification of sources and authorization by the Veteran, request all VA and private treatment records for the Veteran not already associated with the file. Copies of any outstanding VA and private treatment records should be added to the Veteran's electronic claims file. 2. Thereafter, schedule the Veteran for a VA examination to determine the nature and etiology of any diagnosed right shoulder disorder, to include right shoulder pain. The Veteran’s electronic claims file must be accessible for review by the VA examination in conjunction with the examination. A complete history from the Veteran should be obtained and recorded. All testing deemed necessary by the examiner should be performed and the results reported in detail. A detailed rationale for all opinions should be provided. Following the review of the claims file and examination of the Veteran, the examiner is then requested to respond to the following: a) Is it as least as likely as not (a 50 percent probability or greater) that the Veteran’s reported right shoulder pain results in a functional impairment of earning capacity, i.e., a disability for VA purposes? b) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right shoulder disability had its onset in service or is otherwise directly related to service? c) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right shoulder disability is proximately due to or caused by the Veteran’s service-connected residuals from removal of a chest tumor? d) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right shoulder disability is aggravated (made worse beyond its natural progression) by the Veteran’s service-connected residuals from removal of a chest tumor? If aggravation is found, the examiner should attempt to quantify the degree of additional disability resulting from the aggravation. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of any diagnosed right arm disorder, to include right arm pain. The Veteran’s electronic claims file must be accessible for review by the VA examination in conjunction with the examination. A complete history from the Veteran should be obtained and recorded. All testing deemed necessary by the examiner should be performed and the results reported in detail. A detailed rationale for all opinions should be provided. Following the review of the claims file and examination of the Veteran, the examiner is then requested to respond to the following: a) Is it as least as likely as not (a 50 percent probability or greater) that the Veteran’s reported right arm pain results in a functional impairment of earning capacity, i.e., a disability for VA purposes? b) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right arm disability had its onset in service or is otherwise directly related to service? c) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right arm disability is proximately due to or caused by the Veteran’s service-connected residuals from removal of a chest tumor? d) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed right arm disability is aggravated (made worse beyond its natural progression) by the Veteran’s service-connected residuals from removal of a chest tumor? If aggravation is found, the examiner should attempt to quantify the degree of additional disability resulting from the aggravation. 4. Schedule the Veteran for a VA examination to determine the nature and etiology of any diagnosed neck disorder, to include neck pain. The Veteran’s electronic claims file must be accessible for review by the VA examination in conjunction with the examination. A complete history from the Veteran should be obtained and recorded. All testing deemed necessary by the examiner should be performed and the results reported in detail. A detailed rationale for all opinions should be provided. Following the review of the claims file and examination of the Veteran, the examiner is then requested to respond to the following: a) Is it as least as likely as not (a 50 percent probability or greater) that the Veteran’s reported neck pain results in a functional impairment of earning capacity, i.e., a disability for VA purposes? b) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed neck disability had its onset in service or is otherwise directly related to service? c) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed neck disability is proximately due to or caused by the Veteran’s service-connected residuals from removal of a chest tumor? d) Is it at least as likely as not (a 50 percent probability or greater) that any diagnosed neck disability is aggravated (made worse beyond its natural progression) by the Veteran’s service-connected residuals from removal of a chest tumor? If aggravation is found, the examiner should attempt to quantify the degree of additional disability resulting from the aggravation. 5. After completing all indicated development, the Agency of Original Jurisdiction should readjudicate the Veteran’s claims. If the benefits sought on appeal remain denied, the Veteran should be furnished with a supplemental statement of the case, given the opportunity to respond, and the case should thereafter be returned to the Board for further appellate review, if warranted. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Houle, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.