Citation Nr: 21004041 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 14-34 474A DATE: January 25, 2021 REMANDED Entitlement to service connection for status post left shoulder total replacement is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1975 to June 1979. In April 2017, the Veteran had a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the Veteran’s claims file. Although the Board regrets the additional delay, a remand is necessary to obtain an adequate nexus opinion. The Veteran underwent a VA examination in June 2019 at which time a VA clinician offered a negative nexus opinion based on an absence of treatment records for a left shoulder condition in service and in the years following service. See June 2019 VA Examination, pp.1-2. Because the June 2019 clinician did not provide a reason for rejecting the Veteran’s reports of continuing pain from the time of his in-service fall to when he first sought treatment, the claim was remanded. In March 2020, the Agency of Original Jurisdiction (AOJ) obtained a second nexus opinion that cited a lack of treatment records as the basis for the negative opinion but failed to provide a reason for rejecting the Veteran’s reports. See March 2020 VA Examination, p. 2. The claim was once again remanded for an adequate opinion. Most recently, the AOJ obtained a third opinion in October 2020. Unfortunately, this opinion contains the same deficiencies as the prior two opinions. The October 2020 clinician offered a negative nexus opinion and the supporting rationale stated that there is no chronicity of care documented in the available records. See October 2020 VA Examination, pp. 2-3. The clinician did not provide an explanation for why the Veteran’s left shoulder pain, that he maintains he has experienced since his service, is not etiologically related to his in-service fall. See December 2017 Hearing Transcript, pp. 3-7. The Board, therefore, finds that a new opinion is needed that considers the Veteran’s reports. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[w]ithout a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991)”). The matter is REMANDED for the following action: Obtain a VA opinion that addresses the etiology of the Veteran’s left shoulder disability. If deemed necessary by the examiner designated to provide the opinion, schedule the Veteran for an examination. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished. The entire claims file, to include a complete copy of this REMAND, should be made available to the examiner designated to provide an opinion, and the examination report should include a discussion of the Veteran’s documented medical history and assertions. The examiner should offer comments, an opinion and a supporting rationale that address whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s current left shoulder disability was incurred in, aggravated by or is otherwise etiologically related to his active duty service. In providing this opinion, the examiner must address the Veteran’s left shoulder pain that he first experienced during his active duty service and that has continued in varying degrees since his service. See May 2015 STRs, p. 70; December 2017 Hearing Transcript, pp. 3-7; May 2015 STR, p. 70. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered. If the examiner rejects the Veteran’s reports, the examiner must provide a reason for doing so. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board W.V. Walker, 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.