Citation Nr: 21004073 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 10-39 245 DATE: January 25, 2021 ORDER Entitlement to service connection for a back disability is denied. Entitlement to service connection for a left shoulder disability is denied. FINDINGS OF FACT 1. The Veteran’s back disability is not related to his military service. 2. The Veteran’s left shoulder disability is not related to his military service. CONCLUSIONS OF LAW 1. The criteria for service connection for a back disability have not been satisfied. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a left shoulder disability have not been satisfied. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1970 to August 1972. This matter comes before the Board of Veterans’ Appeals (Board) from an April 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). These issues were previously remanded by the Board in February 2018 and has since been returned for further adjudication. In October 2020, the Veteran submitted a letter stating that he never appealed regarding his left shoulder or back disabilities, but was appealing service connection for a right knee disability and an increased rating for his right shoulder disability. The RO recently granted service connection for his right knee disability, so that issue is no longer on appeal. As for the right shoulder, the Veteran has not perfected an appeal to the Board regarding that issue. The Veteran has perfected an appeal as to service connection for left shoulder and back disabilities. As these issues have not been withdrawn, they will be addressed by the Board at this time. Service Connection Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an 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. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Back disability The Veteran contends that he injured his back during a motor vehicle accident in service. Service treatment records are silent for any complaints, treatment, or diagnosis for any back condition. At separation, evaluation of the spine and musculoskeletal system was normal. In July 2008, the Veteran’s siblings reported that, upon his return from service, the Veteran was in a lot of pain. In January 2009, the Veteran reported to his treating physician that he injured his back when he fell off a jeep in service. The Veteran underwent a VA examination in November 2014. The examiner opined that it was less likely than not that his back was related to his military service. The examiner stated that the medical evidence does not support a fall causing arthritis. There is no record of back evaluation and treatment in the service treatment records during active service to provide an alternative diagnosis. In March 2016, the Veteran underwent a second VA examination. The examiner again opined that it was less likely than not that his back disability was related to his military service. According to the examiner, the Veteran’s service records do not document a chronic on-going treatment or condition for the back. His discharge examination was normal for the back. There is no documentation of a motor vehicle accident causing a permanent chronic back disability. Finally, the Veteran underwent a VA examination in September 2020. Again, the examiner opined that it was less likely than not that his back disability was related to his military service. According to the examiner, there are no records that support the condition of lumbar degenerative disc disease or arthritis of the spine occurred following a motor vehicle accident while on active duty. The evidence at separation shows that the Veteran’s spine was within normal limits. The lay evidence from the Veteran and his relatives which indicates that the Veteran has experienced a continuity of symptoms since discharge is subjective and not consistent with the Veteran’s reports of an accident. There is a lack of objective evidence in the records to demonstrate a chronic back condition related to an in-service injury. Although the Board sympathizes with the Veteran’s contentions, the evidence is against a finding that his back disability is related to his military service. After a review of the records contemporaneous to service, all three examiners stated that the Veteran’s back was normal in service. Further, the objective medical records do not document a chronic condition since service, and an examiner opined that a fall or motor vehicle accident would not cause degenerative disc disease or arthritis. Moreover, the most recent examiner to offer an opinion indicated that the objective findings at separation showing no back abnormality were more probative to the question of nexus than subjective lay statements about pain. The Board has considered the lay statements, to include the Veteran’s assertions that he suffered from back pain since service and his sisters’ observation that he was in pain. As none of the declarants is not shown to have medical education or experience, they are lay persons and competent to report (1) symptoms that are observable to a layperson, e.g., pain; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). They are not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, the lay assertions do not constitute evidence upon which service connection can be granted. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include opinions rendered by trained medical professionals based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale, to include consideration of the subjective reports of pain. Service connection for a back disability is denied. 2. Left shoulder disability The Veteran contends that he injured his left shoulder during a motor vehicle accident in service. Service treatment records are silent for any complaints, treatment, or diagnosis for any left shoulder condition. At separation, evaluation of the upper extremities was normal. In July 2008, the Veteran’s siblings reported that, upon his return from service, the Veteran was in a lot of pain. In November 2014, the Veteran underwent a VA examination. The examiner opined that it was less likely than not that his left shoulder was related to his military service as there was no chronicity of care. The Veteran underwent a second VA examination in March 2016. Again, the examiner opined that it was less likely than not that his left shoulder was related to his military service. According to the examiner, the Veteran’s service records do not document a chronic on-going treatment or condition for the left shoulder. His discharge examination was normal for the left shoulder. There is no documentation of a motor vehicle accident causing a permanent chronic left shoulder disability. Finally, the Veteran underwent a VA examination in September 2020. During this examination, the Veteran reported that he did not have a left shoulder condition. Further, the examiner noted the separation examination showed clinical evaluation that the Veteran’s musculoskeletal system was within normal limits, and the lay evidence which indicates that the Veteran has experienced a continuity of symptoms since discharge from service is subjective and not consistent with the Veteran’s reports of an accident related injury. There is a lack of objective evidence in the records to demonstrate a chronic shoulder condition relate to an in-service injury. The evidence demonstrates that the Veteran’s left shoulder disability is not related to his military service. Initially, at the Veteran’s most recent VA examination, the Veteran reported that he did not have a left shoulder disability. This goes against a finding of continuity of symptomatology. Further, the evidence in service does not demonstrate that he suffered from a left shoulder disability or injury, and post-service treatment records do not demonstrate a continuity of care. These facts were found significant by the VA examiners who offered opinions against the claim. There is no competent evidence in significant conflict with those opinions. The Board has considered the lay statements, but again notes the declarants are not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, the lay assertions do not constitute evidence upon which service connection can be granted. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include opinions rendered by trained medical professionals based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale, to include consideration of the subjective reports of pain. Service connection for a left shoulder disability is denied. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Hofmeister, Attorney Advisor 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.