Citation Nr: 21004028 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 17-17 671 DATE: January 25, 2021 ORDER Entitlement to service connection for a right shoulder bursitis, claimed as rotator cuff with numbness right hand, triceps bicep is denied. FINDING OF FACT The Veteran’s right shoulder condition did not begin during active service, or is otherwise related to an in-service injury, event, or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for a right shoulder bursitis, claimed as rotator cuff with numbness right hand, triceps bicep have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service with the Army from November 1983 to December 1984. This case comes before the Board of Veteran’s Appeals (Board) on appeal from a November 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran had a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is of record. A December 2019 Board decision reopened the previously denied claim, and remanded the underlying claim on the merits for adjudication. It is now returned to the Board. VA has a duty to notify and assist claimants in substantiating a claim for VA benefits.  38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.159, 3.326(a).  These duties have been satisfied in this case; appropriate notice was included in the May 2016 21-526EZ claim form used to initiate the current claim. The RO associated the Veteran’s service and VA and private outpatient treatment records with the claims file. All released or submitted private treatment records have been associated with the claims file.  No other relevant records have been identified and are outstanding.  Appropriate and necessary examinations were afforded the Veteran, and are adequate for evaluation, as they include needed findings to permit application of the rating schedule and identification of current disability. Such includes the examinations ordered in the December 2019 Board remand. Stegall v. West, 11 Vet. App. 268, 271 (1998). As such, VA has satisfied its duty to assist.  38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016). Service connection may be granted for a disability resulting from a 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 entitlement to service-connected compensation benefits, 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. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). For secondary service connection, it must be shown that the disability for which the claim is made is proximately due to or aggravated by a service-connected disability. See 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). Some chronic diseases may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA’s policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a). The Veteran contends that her right shoulder condition was related to her military service. Specifically, she claimed that her condition was related to her shooting a rifle during basic training. Service treatment records (STRs) demonstrated that the Veteran was diagnosed and treated for a right shoulder condition in service. A July 1982 treatment record noted that the Veteran complained of right shoulder pain. The Veteran was diagnosed with bursitis. On November 1987 treatment record, the Veteran marked “yes” for swollen or painful joints and for arthritis, rheumatism, or bursitis. However, she marked “no” for painful or trick shoulder or elbow. The examiner noted that the Veteran had acute left shoulder bursitis. Post service treatment records documented that the Veteran continued to complain of right shoulder pain. A September 1998 private treatment note documented that the Veteran was diagnosed with right shoulder bursitis. She complained of tingling in her lower right arm. She reported that her pain had been present off and on for a couple of years. In July 2005 and September 2016, the Veteran was afforded VA shoulder examinations. However, both VA examiners were not able to provide a medical opinion without resorting mere to speculation. In August 2019, the Veteran testified that she injured her shoulder during basic training while firing a rifle. She reported that her shoulder had always been inflamed or hurting to some degree since service. In February 2020, the Veteran was afforded a VA examination. The Veteran was diagnosed with right shoulder degenerative disease. The Veteran reported that she first had a shoulder condition in 1984. She indicated that her condition was related to her military training and duties. She noted that her condition never completely resolved. The examiner opined that the Veteran’s 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 examiner explained that the Veteran’s symptoms reported in July 1984 did not have a specific right shoulder condition diagnosed at the that time, and it was possibly a chest condition. The examiner noted that there was no shoulder condition of a severity likely that would result in chronicity diagnosed. He further indicated that there were no records while that Veteran was in-service demonstrating that her condition reoccurred or remained chronic; she was not treated further, nor did she complain. He noted that the Veteran’s December 1984 examination was marked negative for a shoulder condition, with an addendum stating that a left [sic] shoulder acute bursitis was resolved and making no mention of any shoulder condition. He indicated that the November 1987 examination was negative for any shoulder condition and the Veteran denied any current health problems. There was no mention of a right shoulder condition until July 1991. It was not possible either on a pathophysiologic basis or on the basis of an historical clinical nexus to relate the in-service should condition of 1984 with the later condition in 1991 and after. In other words, the 1984 injury was minor, acute, transitory, and resolved fully. Although laypersons, such as the Veteran, are sometimes competent to provide opinions on certain medical questions, the specific issue in this case falls outside the realm of common knowledge of a lay person as it involves making a definitive clinical determination of the nature and etiology of the Veteran’s right shoulder condition. See Kahuna v. Shinseki, 24 Vet. App. 428, 435 (2011). While the Veteran can describe that she experiences a right shoulder condition, she is not able to provide competent evidence as to the etiology of her condition. The Veteran was not diagnosed with arthritis in her right shoulder until many years after her separation from service. While she now reports continuous symptoms since service, contemporaneous STRs and post service records fail to show such. The STRs in fact contradict her current allegations. There is no competent and credible evidence linking the Veteran’s right shoulder condition with service. In the absence of such, service connection on a direct basis is not warranted. Further, there was no diagnosis of arthritis for many years after service, and allegations of continuity are not credible. Presumptive service connection is not warranted. Accordingly, the Board finds that the claim of entitlement to service connection for a right shoulder bursitis, claimed as rotator cuff with numbness right hand, triceps bicep must be denied. 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 Veteran’s claim of entitlement to service connection, that doctrine is not applicable. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Baxter 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.