Citation Nr: 21063004 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 13-21 915A DATE: October 12, 2021 ORDER Entitlement to service connection for right shoulder arthritis is denied. Entitlement to service connection for left shoulder arthritis is denied. Entitlement to service connection for left hand arthritis is denied. Entitlement to service connection for right hand arthritis is denied. Entitlement to service connection for degenerative disc disease (claimed as lower back) is denied. FINDINGS OF FACT 1. The most probative evidence does not reach the level of equipoise as to whether the Veteran's right shoulder arthritis was caused by or incurred in service. 2. The most probative evidence does not reach the level of equipoise as to whether the Veteran's left shoulder arthritis was caused by or incurred in service. 3. The most probative evidence does not reach the level of equipoise as to whether the Veteran's left hand arthritis was caused by or incurred in service. 4. The most probative evidence does not reach the level of equipoise as to whether the Veteran's right hand arthritis was caused by or incurred in service. 5. The most probative evidence does not reach the level of equipoise as to whether the Veteran's degenerative disc disease was caused by or incurred in service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for right shoulder arthritis have not been met. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 2. The criteria for entitlement service connection for to left shoulder arthritis have not been met. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 3. The criteria for entitlement to service connection for left hand arthritis have not been met. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 4. The criteria for entitlement to service connection for right hand arthritis have not been met. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309. 5. The criteria for entitlement to service connection for degenerative disc disease (claimed as lower back) have not been met. 38 U.S.C. §§ 1110, 5103; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from July 1969 to March 1972. This case comes before the Board of Veterans' Appeals (Board) on appeal of a February 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2014, the Veteran testified before the undersigned Veterans Law Judge. The Veteran passed away in May 2019, during the pendency of his appeal and the Board dismissed his appeal in order for the RO to determine in the first instance the Veteran's surviving spouse's request to substitute. The appellant, the Veteran's surviving spouse, was granted substitution in April 2020, and the case returned to the Board. When this case was last before the Board in October 2020, it was remanded for additional development. The case has now been returned to the Board for further appellate consideration. The Board finds that there has been substantial compliance with the October 2020 Board remand directives. Stegall v. West, 11 Vet. App. 268 (1998). All possible efforts were made to obtain private treatment records. The appellant has not raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (2017). The Veteran sought service connection for right and left shoulder arthritis, right and left hand arthritis, and degenerative disc disease. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing direct service connection generally requires competent evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Entitlement to service connection for right shoulder arthritis is denied. 2. Entitlement to service connection for left shoulder arthritis is denied. The Veteran sought service connection for right and left shoulder arthritis. The Veteran's service treatment records do not reflect complaints or treatment of any shoulder disability at the time of his discharge. The Veteran testified in his November 2014 Board Hearing that he had surgery on his shoulder shortly after discharge; however, he testified any medical records he had were destroyed during Hurricane Katrina. The Veteran testified that he contacted the two physicians he saw for his shoulder, Dr. W and Dr. K, however, neither had his medical records due to it being beyond the time physicians are required to maintain records. The Veteran was afforded a VA examination in September 2015. The examiner opined both the Veteran's right and left shoulder disabilities were less likely than not due to an in-service event or injury. The examiner rationalized that although the Veteran's work in service included activities which could cause repetitive motion injuries, the Veteran's service treatment records (STRs) were silent for any in-service shoulder injury. The examiner found no evidence to connect those activities to the Veteran's current disabilities. Moreover, the records first show an indication of shoulder pain in 2012, many years after discharge. An addendum opinion was obtained in June 2021. The examiner opined both the Veteran's right and left shoulder disabilities were less likely than not due to an in-service event or injury. The examiner rationalized that the Veteran's STRs were silent for any in-service shoulder injury, and his exit examination did not reflect any complaints or disabilities in the shoulders. Moreover, while the Veteran's 2015 treatment records reflect prior bilateral shoulder surgery, there is no indication of when these surgeries occurred. The Board has considered the Veteran's testimony that his shoulder disabilities began in service, his shoulders would swell up during service and that he had shoulder surgery as soon as he got out of the service. The Veteran also testified that he did not go to sickbay as long as he could continue to do his job. However, the Veteran did not have the medical knowledge required to relate his shoulder arthritis to military service. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Accordingly, the Veteran's lay statements are not competent evidence of an etiologic relationship between the claimed arthritis and service. Based on the above, entitlement to service connection for a right and left shoulder disability is not warranted. There are no medical opinions contrary to those described above, so there is no doubt to be resolved. 3. Entitlement to service connection for left hand arthritis is denied. 4. Entitlement to service connection for right hand arthritis is denied. The Veteran sought service connection for right and left hand arthritis. The Veteran's service treatment records do not reflect complaints or treatment of any hand disability at the time of his discharge. The Veteran testified in his November 2014 Board Hearing that his hands would swell up and his knuckles would hurt; however, he did not report it as long as he could still do his job. The Veteran testified that he sought treatment with Dr. H off and on from 2002. The appellant contacted Dr. H regarding the Veteran's treatment records. Dr. H indicated he no longer worked at the clinic, and upon contacting the clinic, the appellant reported they no longer have the Veteran's records. The Veteran was afforded a VA examination in September 2015. The examiner opined both the Veteran's right and left hand disabilities were less likely than not due to an in-service event or injury. The examiner rationalized that although the Veteran's work in service included activities which could cause repetitive motion injuries, the Veteran's STRs were silent for any in-service hand injury. The examiner found no evidence to connect those activities to the Veteran's current disabilities. Moreover, the records first show a left hand surgery in March 1998, many years after discharge. Arthritis in the left and right hand were diagnosed in 2015. Additionally, the examiner stated that the Veteran worked as a mechanic from 1992 to 2000, which could also predispose someone to the development of repetitive motion injuries. The examiner noted that without information as to when the arthritis developed, an opinion cannot be rendered without resorting to mere speculation. This is a probative opinion as the examiner explained the opinion could not be made as there is a large gap of information (medical reports and evaluation) from the time after service to the present. An addendum opinion was obtained in June 2021. The examiner opined both the Veteran's right and left hand disabilities were less likely than not due to an in-service event or injury. The examiner rationalized that the Veteran's STRs were silent for any in-service hand injury, and his exit examination did not reflect any complaints or disabilities in the hands. Moreover, the Veteran's records do not indicate a hand disability or injury until a documentation of right hand pain in 2000 and an injury in 2007, many years after service. Based on the above, entitlement to service connection for a right and left hand disability is not warranted. The Veteran's statements his hand conditions were related to service do not constitute competent evidence. There are no medical opinions contrary to those described above, so there is no doubt to be resolved. 5. Entitlement to service connection for degenerative disc disease (claimed as lower back) is denied. The Veteran sought service connection for degenerative disc disease. The Veteran's service treatment records reflect that he attended sickbay one time for lower back problems; however, the Veteran's exit examination indicated no back complaints. The Veteran testified that his back was "real bad" and continued to get worse after service. The Veteran testified that he sought treatment from Dr. W and Dr. H for his back; however, as stated above, these records are unavailable. The Veteran's medical records first reflect back complaints in approximately 2008-2009, when he went through a series of injections for pain management. When he sought treatment for back pain at VA in 2009, the Veteran indicated he had experienced back pain for 40 years, and it was becoming progressively worse. A VA medical opinion was obtained in June 2021. The examiner opined the Veteran's back disability was less likely than not due to an in-service event or injury. The examiner rationalized that the Veteran's exit examination did not reflect any complaints or disabilities in the lower back. Moreover, the Veteran's records first reflect back complains in 2008, many years after service. The Board notes that while the Veteran did have one report of lower back pain in his STRs, there is no evidence of continuity to support a nexus between this report and the Veteran's current back disability. Although he reported onset of symptoms 40 years earlier in March 2009 when he established care with VA, that was contemporaneous in time to his filing of a compensation claim. Considering the timing of those statements, the allegations of continuity are not persuasive. As such, entitlement to service connection for a back disability is denied. The Veteran's statements his back condition was related to service do not constitute competent or persuasive evidence. There are no medical opinions contrary to those described above, so there is no doubt to be resolved. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Townsend, 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.