Citation Nr: 21000723 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 16-25 528 DATE: January 6, 2021 ORDER Service connection for headaches as due to service-connected left shoulder disability is denied. REMANDED Service connection for left foot disorder is remanded. FINDING OF FACT The Veteran’s headaches are not secondary to or aggravated by service-connected left shoulder disability, and are not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for headaches due to service or service-connected left shoulder disability are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1989 to September 1989. She also had National Guard Duty service. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran attended a videoconference hearing before the undersigned in March 2019. Headaches 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. To establish service connection for a 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. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted for a disability that is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310. The Veteran contends that her current headaches are due to her service-connected left shoulder disability. For the following reasons, the Board disagrees. The Veteran has a current disability of headaches, satisfying the first element for service connection. The Veteran’s service records are silent for any complaints of headaches. She also has not alleged any in-service injury that may be the cause of her current headaches. Accordingly, the Board finds that the second element for direct service connection is not met. The Veteran is service connected for a left shoulder disability. She contends that this service-connected disability is the cause of her headaches. The Veteran has been afforded two VA examinations for her claim. Her first examination was in July 2014. The examiner opined that it was less likely than not that the Veteran’s headaches were proximately due to or the result of the Veteran’s service-connected left shoulder disability. This opinion is inadequate for service connection purposes and the Board affords it no probative weight. See El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). After remand, the Veteran underwent another VA examination in March 2020. The VA examiner opined that it was less likely than not that the Veteran’s headaches were caused by her service-connected left shoulder disability due to there being no anatomical or physiological relationship between her diagnosed headaches and service-connected left shoulder disability. In September 2020, an addendum opinion was obtained from the March 2020 examiner to opine on whether the Veteran’s service-connected left shoulder disability aggravated her headaches beyond their natural progression. The examiner found it was less likely than not that the Veteran’s service-connected left shoulder disability aggravated her headaches beyond their natural progression because there is no anatomical or physiological relationship between the Veteran’s headaches and service-connected left shoulder disability. The examiner is competent to provide this opinion, the Board finds him to be credible, and affords the opinion great probative weight. At her March 2019 hearing, the Veteran testified that a March 2014 MRI of her shoulder supports finding her service-connected left shoulder disability causes her headache. She testified that an occupational therapist told her that a tendon in her shoulder was causing her headaches, but the Veteran was unable to identify the individual. VA records do include a report of a March 2014 MRI, but the report is silent about headaches. There is also a February 2015 nurse practitioner note that commented on a January 2014 MRI, and noted that the Veteran’s left shoulder pain seems to follow along a tendon/muscle from shoulder to her neck. The February 2015 note is also silent about headaches. The only reference to a relation between the Veteran’s headaches and her left shoulder disability in her medical records is found in an April 2013 medical clerk telephone call note where the Veteran reported that she has a left shoulder injury that hurts and gives her headaches. The Board acknowledges the Veteran’s contention that her headaches are being caused by her left-shoulder disability and that there is a tendon in her left shoulder that is causing her headaches. The Veteran though has not shown that she has the requisite medical knowledge to interpret her MRI and provide a medical nexus opinion for her current disability. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board affords the Veteran’s lay statement less probative weight and affords more probative weight to the March and September 2020 VA medical opinions. Accordingly, the preponderance of the evidence is against a finding that the Veteran’s headaches are due to service or her service-connected left shoulder disability. Because the preponderance of the evidence weighs against this claim, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As such, service connection for headaches is denied. REASONS FOR REMAND Left Foot Disorder The Board cannot make a fully informed decision on the issue of service connection for left foot disorder. The Veteran is contending that her left foot disorder is due to service, or in the alternative, is related to her service-connected shin splints. The Veteran has a diagnosis of plantar fasciitis of her left foot. In March 2020, the Veteran underwent a VA examination for this claim. The examiner opined that it was less likely than not that the Veteran’s left plantar fasciitis is related to service due to there being no mention of plantar issues in her service treatment records outside of an ingrown nail. The examiner also found that plantar fasciitis is not associated with shin splints or ankle issues making secondary service connection less likely than not. The Board notes that the Veteran is service connected for left knee patellofemoral syndrome with shin splints. The opinion provided by the VA examiner is inadequate as the examiner did not opine if the Veteran’s left foot plantar fasciitis was caused or aggravated beyond its natural progression by her service-connected left knee patellofemoral syndromw with shin splints. As such, a remand is necessary to obtain an adendum opinion.   The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from September 2020 to the Present. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s left foot plantar fasciitis is at least as likely as not (50 percent or greater probability) proximately due to her service-connected left knee patellofemoral syndrome with shin splints, or aggravated beyond its natural progression by her service-connected left knee patellofemoral syndrome with shin splints. A complete rationale must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Chandeck, 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.