Citation Nr: 21069899 Decision Date: 11/22/21 Archive Date: 11/22/21 DOCKET NO. 18-10 945 DATE: November 22, 2021 ORDER The claim of entitlement to service connection for a right shoulder disability is granted. FINDING OF FACT The Veteran has experienced symptoms such as pain and lack of endurance related to his right shoulder disability since his separation from service. CONCLUSION OF LAW The criteria for entitlement to service connection for a right shoulder disability are met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active duty in the United States Air Force from May 1968 to November 1988. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in January 2017 by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2020, the Board remanded this matter for additional development. Specifically, the Board directed the RO to obtain an addendum medical opinion to determine the nature and possible relationship to service of the Veteran's right shoulder condition. The Board concludes that there has been substantial compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). This appeal has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107(a)(2) and 38 C.F.R. § 20.902(c). The claim of entitlement to service connection for a right shoulder disability. The Veteran contends that his right shoulder disability is related to his active service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102. In this case, the RO conceded that the Veteran has a current right shoulder condition, as he has been diagnosed with conditions to include glenohumeral joint osteoarthritis. See October 2020 Supplemental Statement of the Case; November 2016 VA examination; November 2015 Sutter Health treatment records. As such, the first element of service connection is met. The Board further notes that arthritis is an enumerated presumptive condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. Next, the RO conceded that the Veteran's service treatment records (STRs) show complaints of right shoulder pain in May 1979, during his active service. Specifically, the Board notes that the May 1979 primary care record includes the Veteran's report of having right shoulder pain for one year. The Veteran described having intermittent symptoms associated with heavy exertion. The Veteran had normal strength with mild tenderness to pressure on his right "AC" (acromioclavicular) joint. No history of earlier injury was reported. Initial clinical impression was recorded as, "? [sic] Bursitis vs. Tendonitis." The subsequent radiographic report again reflects the complaint of pain and symptoms for a year and reflects the impression of "prob[able] Tendonitis vs. Bursitis." While the exact diagnosis for the Veteran's symptoms may not have been conclusive, given this medical evidence and the RO's conclusions, the Board finds that the second element of service connection is also met. Lastly, the Board finds that the evidence is at least balanced as to whether the Veteran has continued to experience symptoms of his current right shoulder disability since his active service. The Board acknowledges that there are no relevant treatment records for several years following the Veteran's separation from service. Further, the Veteran declined a separation examination at his retirement in 1988. Still, the Veteran has consistently asserted that he continued to experience right shoulder pain since his service. The Veteran is competent to report that he experienced such symptoms of pain during that period and the Board finds his statements credible. The Board acknowledges that the October 2020 VA clinician opined that the Veteran's condition was less likely than not related to service; however, the Board finds this opinion to lack probative value. While the clinician conducted an extensive review of the Veteran's medical records, the clinician failed to adequately address the Veteran's lay statements regarding the chronic nature of his in-service right shoulder symptoms lasting at least one year. Contrary to the evidence, the examiner concluded that the Veteran's symptoms were part of an "acute process" and that conditions such "bursitis tendonitis" would usually resolve in six to 12 weeks. The clinician did not reconcile this opinion with the STR evidence that the Veteran's symptoms had lasted for a year. Further, the examiner did not adequately consider the Veteran's competent statements regarding continuity of symptoms following his service, as symptoms, not treatment, are the essence of any evidence of continuity of symptomatology for VA purposes. Savage v. Gober, 10 Vet. App. 488, 496 (U.S. 1997). As for the medical evidence, the examiner overlooked treatment records existing prior to 2005. For example, the examiner did not address a June 2001 record, which showed the Veteran reported a history of right shoulder pain and identified degenerative changes without acute fracture of the AC joint. Given the Veteran's competent and credible report of symptoms of right shoulder pain during and since his active service, combined with the lengthy history of medical treatment and degenerative changes of his right shoulder, the Board finds there is an adequate basis to award service connection for the Veteran's right shoulder osteoarthritis on a presumptive basis. Resolving all reasonable doubt in his favor, the Board finds the Veteran had ongoing symptoms related to his right shoulder disability since his active service, and that his claim meets the requirements of presumptive service connection under 38 C.F.R. § 3.303(b). Accordingly, the Board finds that service connection for a right shoulder disability is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The Board notes that it will not address the ultimate weight assignable to the October 2020 VA examiner's medical opinion because service connection may be granted on a presumptive basis based on a finding of continuous symptoms since service rather than on direct service connection. Because the Board is granting service connection on a presumptive basis, all other service connection theories are rendered moot. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Hart, 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.