Citation Nr: 21004691 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 15-27 338A DATE: January 27, 2021 ORDER Entitlement to service connection for a right shoulder disorder is denied. Entitlement to service connection for a left shoulder disorder is denied. FINDING OF FACT A current shoulder disorder was not present until years after active service, is not etiologically related to active service, and is not secondary to a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for service connection for a right shoulder disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137; 38 C.F.R. §§ 3.303, 3.307 3.309, 3.310. 2. The criteria for service connection for a left shoulder disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137; 38 C.F.R. §§ 3.303, 3.307 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from July 1969 to March 1980 and from March 1982 to October 1991. A videoconference hearing before the undersigned Veterans Law Judge was held in September 2017. The hearing transcript has been associated with the claims file. This matter was previously before the Board, most recently in May 2020 when it was remanded for development pursuant to a Joint Motion for Partial Remand (JMR). Service Connection Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests arthritis to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as opposed to merely isolated findings or a diagnosis including the word “chronic.” When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). The term “chronic disease” refers to those diseases, such as arthritis, listed under section 1101(3) of the statute and section 3.309(a) of VA regulations. 38 U.S.C. § 1101(3); 38 C.F.R. § 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Veteran is a Persian Gulf Veteran. Service connection may be granted to a Persian Gulf Veteran who exhibits objective indications of chronic disability resulting from an undiagnosed illness or a medically unexplained chronic multisymptom illness (such as chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders) that is defined by a cluster of signs or symptoms, or resulting from an illness or combination of illnesses manifested by one or more signs or symptoms. The symptoms must be manifest to a degree of 10 percent or more. By history, physical examination, and laboratory tests, the disability cannot be attributed to any known clinical diagnosis. Objective indications of chronic disability include both “signs” in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification. Disabilities that have existed for 6 months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a 6-month period will be considered chronic. 38 U.S.C. §§ 1117, 1118 (2012); 38 C.F.R. § 3.317. Bilateral shoulder disorder The Board finds service connection is not warranted for a shoulder disorder, diagnosed as osteoarthritis of each shoulder and right rotator cuff tear. Initially, the Board finds that the evidence shows that a current shoulder disorder was not present until years after the Veteran’s discharge from service. Service treatment records reveal no history of a shoulder disorder. A February 1986 record does reveal a history of stiffness of the neck that was thought possibly due to shoulder pain, but the diagnosis was acute myositis of the cervical and thoracic spine and subsequent treatment records only reveal findings and diagnoses related to the spine, not the shoulder. Service examination records, including the April 1991 retirement examination record, reveal normal clinical findings for the upper extremities and negative histories of painful or “trick” shoulder. Post-service records reveal histories of injury to the right shoulder in March 1999 and left shoulder in Fall 2006, with symptoms that began with those injuries. See, e.g., November 2002 and August 2007 private treatment records. A May 2009 private treatment record adds the Veteran’s history that he had no significant right shoulder problem after a rotator cuff repair until he had to use a walker after hip replacement surgery in December 2008. The Veteran reported symptoms that began around the time of discharge from service at the May 2015 VA examination and during combat control school at the September 2017 hearing before the Board. Although the Veteran is competent to report a symptomatic history, including when the symptoms began, the Board finds the history of symptoms during and since service is not credible because it is contradicted by the earlier histories provided by the Veteran, notably the histories provided in conjunction with initial medical treatment for the shoulders, which report a post-service onset of the symptoms, associated with post-service injuries. In light of the foregoing, the Board finds the Veteran’s history of chronic symptoms since active service is not probative evidence that a current disorder began in service. In sum, the Board finds the preponderance of the evidence establishes that the shoulder disorders were not present until years after the Veteran’s discharge from service. The Board further finds the probative evidence does not suggest that a currently diagnosed shoulder disorder is related to service. There is no medical evidence of record linking a current shoulder disorder to service and no probative lay evidence, and the May 2015 VA examiner determined it was less likely than not that a shoulder disorder was related to service. The examiner explained that there was no evidence of a shoulder disorder in the service treatment records or within a year of discharge, including in the records associated with the 1978 parachute accident. The examiner added that the current osteoarthritis was no worse than anticipated based on age alone. Finally, the Board finds a shoulder disorder is not secondary to a service-connected disability. A May 2015 VA examiner determined the osteoarthritis is consistent with the Veteran’s age. A June 2020 VA medical opinion reports that a shoulder disorder was not caused or aggravated by a service-connected disability. The medical professional reported that there was no credible medical evidence to support a causal link between the service-connected disabilities (cervical strain with degenerative disc disease, right ankle fracture, left knee condition, left hip replacement, or arthritis of the thoracic spine) and the diagnosed shoulder conditions. The medical professional explained that research failed to show that an injury or disease of one extremity would have any significant impact on another extremity and failed to show that any injury to the spine would impact the shoulders. The medical professional reported that there was no human pathophysiology to support a mechanism for the claimed aggravation. The medical professional added that the Veteran’s shoulder conditions were the result of trauma to the shoulder joints specifically and were not in any way related to the cervical spine condition. There is no medical evidence in support of a secondary relationship. Although the Veteran may believe his shoulder disorder is secondary to the service-connected cervical spine disability, he has not provided competent lay evidence in support of that belief, such as an explanation as to how the conditions could be related, and the record does not suggest he is competent to provide an opinion as to the etiology of the shoulder disorders. Accordingly, the claim must be denied. In reaching this decision, the Board has considered the doctrine of reasonable doubt but has determined that it is not applicable because the preponderance of the evidence is against the claim. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Snyder, 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.