Citation Nr: 21072948 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 16-62 328 DATE: December 7, 2021 REMANDED Entitlement to service connection for left shoulder disability is remanded. Entitlement to service connection for right shoulder disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1977 to August 1992 and December 2003 to February 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in March 2014 by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. In September 2019, the Board remanded the Veteran's claims for additional development, and they now return for further appellate review. For the reasons below, the Board finds that another remand is warranted. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order). 1. Entitlement to service connection for left shoulder disability. 2. Entitlement to service connection for right shoulder disability. The Veteran contends that his bilateral shoulder disability is related to his service, to include carrying heavy equipment and sleeping in an M88A1 Track Recovery Vehicle while deployed. See December 2013 VA 21-4138. He noted that he was deployed to the Gulf War from December 1990 to August 1991 and began having problems with his shoulders during this period. In his March 2014 Notice of Disagreement, he reported that he received treatment for right shoulder pain in April 2004 and treatment for left shoulder pain in October 1986. The Veteran's representative further argued that "having to carry heavy equipment" during the Veteran's active service led to the development of his degenerative joint disease of the shoulders, and that the Veteran's symptoms of pain in service were early manifestations of his later-diagnosed degenerative joint disease. See July 2019 Appellate Brief. As noted in the September 2019 remand, the Veteran's Service Treatment Records (STRs) reflect that he presented for treatment during active duty for left shoulder and right shoulder pain. As to the left shoulder, the Veteran complained of a sore left shoulder in October 1986. In May 1997, he was diagnosed with left shoulder bursitis. An April 2010 record documented a left shoulder injury during a 1991 deployment. As to the right shoulder, an April 2004 record indicated a complaint of right shoulder pain. Post-separation VA treatment records also reveal right shoulder pathology in February 2013, noted as early degenerative changes with possible tendonitis. Private medical treatment records reveal bilateral shoulder degenerative changes in the AC joints. A November 2016 VA examination reflects that the Veteran's bilateral shoulder disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In support of such opinion, the examiner simply stated that, while bilateral shoulder sprains were documented in the STRs, there was no mention of an actually diagnosed acromioclavicular joint condition during service. The Board found this November 2016 VA medical opinion to be inadequate, as it was not supported by a complete rationale and did not address the specific contentions advanced in this case. Accordingly, new addendum opinions were obtained upon remand. However, despite the Board's specific directives, the VA examiner did not adequately address the relevant inquiries. Id. In this regard, the examiner offered another conclusory negative nexus opinion which simply listed the STRs reflecting treatment for right and left shoulder pain and concluded that because no diagnosis was provided upon treatment, no nexus could be established. However, in the September 2019 remand the Board directed that the examiner should offer a complete rationale for any opinion. Furthermore, the Board specifically required the examiner to address the Veteran's reports of carrying heavy equipment during active-duty service, as well as being required to sleep in a M88A1 Track Recovery Vehicle while deployed. Thus, there has not been substantial compliance with the September 2019 Board remand directives, and another opinion must be obtained. The matters are REMANDED for the following action: Forward the record, to include a copy of this remand, to an appropriate VA examiner. Following a review of the record, the examiner should address the following inquiries: (A) For each right and left shoulder disorder found, is it at least as likely as not (i.e., a 50 percent or greater probability) that such had its onset in, or is otherwise related to the Veteran's military service, to include sleeping in military vehicles or carrying heavy equipment. (B) For any arthritis of the right and/or left shoulder, did such manifest within one year of the Veteran's separation from active duty in February 2005 (i.e., by February 2006). If so, describe the manifestations. In offering such opinions, the examiner must address the Veteran's contention that carrying heavy equipment and sleeping in military vehicles on deployment led to shoulder pain in service and the development of degenerative joint disease of the shoulders. The examiner is advised that the sole basis of a negative opinion may not be the lack of complaints, treatment, or diagnosis referable to arthritis in the Veteran's STRs, or evidence of a lack of post-service treatment records demonstrating a continuity of care. A rationale for any opinion offered should be provided. JEREMY J. OLSEN Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Breckenridge 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.