Citation Nr: 20005983 Decision Date: 01/24/20 Archive Date: 01/23/20 DOCKET NO. 11-27 919 DATE: January 24, 2020 ORDER Entitlement to service connection for a left shoulder disability is denied. FINDING OF FACT The Veteran’s left shoulder disability, to include arthritis, was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a left shoulder disability are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1978 to August 1992. This case comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2010 Agency of Original Jurisdiction (AOJ) decision that in pertinent part, determined that new and material evidence had not been received to reopen a previously denied claim of service connection for a left shoulder disability. In March 2017, the Board remanded this case to the AOJ for scheduling of a Board videoconference hearing. In January 2018, the Veteran withdrew her hearing request. In an April 2018 decision, the Board reopened the claim, and remanded it for additional development. The case was subsequently returned to the Board. 1. Entitlement to service connection for a left shoulder disability The Veteran contends that she incurred a left shoulder disability in service while performing push-ups. See January 2019 VA examination. In her October 2011 substantive appeal, she asserted that her condition was not properly diagnosed in service. In a July 2010 VA outpatient treatment record, the Veteran complained of bilateral shoulder and knee pain, and said her pain developed in service while exercising and running, and there was no specific event, just an accumulation of repeated traumas. She asserts that she had trouble with both shoulders in service, and they worsened since then. See her December 2019 statement. Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The Veteran has a current diagnosis of osteoarthritis of the left shoulder, as evidenced by a March 2008 VA outpatient treatment record showing that an X-ray study showed mild bilateral acromioclavicular joint and acromial osteophytes, and a July 2010 diagnosis of osteoarthritis in the shoulders. Arthritis is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. However, the disability was not shown as chronic in service, did not manifest to a compensable degree within a presumptive period, and was not noted in service with attributable continuity of symptomatology. VA treatment records show the Veteran was not diagnosed with arthritis of the left shoulder until March 2008, decades after her separation from service and decades outside of the applicable presumptive period. The Veteran’s service treatment records are negative for complaints, treatment, or diagnosis of a left shoulder injury or disability, and on separation examination in June 1992, her upper extremities were clinically normal. While the Veteran is competent to report experiencing symptoms of left shoulder pain since service and consistently since service, the Board finds the reports of continuity of symptomatology not credible. The Veteran’s reports are internally inconsistent with her reports in contemporaneous treatment records, which show that she denied experiencing a painful or “trick” shoulder at the time of her separation medical examination in June 1992. Although she filed a claim for service connection for right and left shoulder conditions in November 1992, on VA examination in March 1993, she reported that her right shoulder was the one that was painful. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). VA physical therapy notes in 2012 and 2013 reflect that although the Veteran complained of bilateral knee pain and right shoulder pain, she did not complain of left shoulder pain. Further, while the Veteran asserts that the reported left shoulder symptoms are manifestations of left shoulder arthritis, she is not competent to determine that these symptoms were manifestations of left shoulder arthritis as the Veteran has not demonstrated the necessary medical expertise. The issue is medically complex, as it requires specialized medical education, and the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Board gives more probative weight to competent medical evidence. The preponderance of the evidence is against finding that a medical nexus exists between the Veteran’s left shoulder disability, to include arthritis, and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303. In a January and September 2019 medical opinions, the VA examiner reviewed the claims file, including the Veteran’s lay statements, and opined that the Veteran’s left shoulder disability is not at least as likely as not related to an in-service injury, event, or disease, including the Veteran's reported shoulder injuries during exercises in service. The rationale was that left shoulder pain and arthritis were first diagnosed and treated approximately 16 years after service, and the medical records do not show in-service treatment of a left shoulder injury or a chronic condition. The Board also finds that the preponderance of the evidence is against finding that the Veteran’s left shoulder disability is proximately due to or the result of, or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). The January and September 2019 VA examiner opined that the left shoulder disability is less likely than not proximately due to or aggravated beyond its natural progression by the Veteran's service-connected right shoulder or bilateral knee conditions. The rationale was that the medical records do not support a correlation between these conditions, and the left shoulder condition is a separate condition. There is no competent evidence linking the current left shoulder disability with service or a service-connected disability. While the Veteran believes her left shoulder disability is related to an in-service injury, event, or disease, including exercising, she is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. L. Wasser, 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.