Citation Nr: 21067416 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 13-08 403 DATE: November 4, 2021 ORDER Entitlement to service connection for left shoulder degenerative arthritis is granted. Entitlement to service connection for right shoulder degenerative arthritis is granted. FINDINGS OF FACT 1. The Veteran's left shoulder degenerative arthritis is aggravated by his service-connected cervical spine condition. 2. The Veteran's right shoulder degenerative arthritis is aggravated by his service-connected cervical spine condition. CONCLUSIONS OF LAW 1. The criteria to establish service connection for left shoulder degenerative arthritis have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria to establish service connection for right shoulder degenerative arthritis have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1977 to January 1979 and May 1979 to May 1981. The Veteran also served in the Reserve and the National Guard. See service personnel records (SPRs). The Veteran appealed a December 2016 rating decision by the Agency of Original Jurisdiction (AOJ). A Board hearing was held in September 2019. A transcript is of record. In October 2020, the Board remanded the Veteran's claim to the AOJ for further action consistent with the Board's remand directives. The claim is back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). A veteran is entitled to Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability; (2) a service-connected disability; and (3) a nexus between the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1988). As to the third Wallin element, the current disability may be either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Veteran is diagnosed with bilateral shoulder degenerative arthritis. See April 2021 examination report. The Veteran is service connection for a cervical spine condition. The April 2021 examination report noted the Veteran's bilateral shoulder condition began on active duty after offloading a flatbed and that he was experiencing severe pain in the neck. The April 2021 opinions noted there is pain radiating from the cervical region into the shoulders. However, there is also separate pain in the shoulders which is not caused by any cervical condition. Although the April 2021 examiner tries to distinguish the neck and shoulder pains, the examiner ultimately stated that there is pain in the cervical spine that radiates into the shoulders. Furthermore, the aggravation opinions provided are conclusory and do not include adequate rationale. Overall, medical treatment records often note neck and shoulder pain together. See December 2009, October 2013, July 2014, January 2018 treatment records. August 2014 treatment records also noted neck pain going into the shoulder. The Veteran has consistently noted neck and shoulder pain together. See June 2018 VA Form 9. Overall, medical evidence notes shoulder pain in conjunction with neck pain. Medical evidence notes that the Veteran's cervical spine pain radiates into his shoulders. Pursuant to the medical evidence of record, the Veteran did not seek medical treatment for his shoulder condition until after he started getting treatment for his neck condition. Although the April 2021 examiner tries to make a distinction between the cervical spine and bilateral shoulder pains, medical evidence notes the Veteran's neck pain is contributing to the pain in the shoulders. This additional pain in the shoulders impacts the Veteran's shoulder functionality and overall pain. The Board finds that the evidence is at least in equipoise as to whether the Veteran's left and right shoulder condition is impacted by his service-connected cervical spine condition. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's bilateral shoulder condition is aggravated by his service-connected cervical spine condition. Accordingly, service connection for left and right shoulder degenerative arthritis is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Zheng, 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.