Citation Nr: 21075463 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 16-12 161 DATE: December 20, 2021 ORDER Service connection for immunoglobulin A nephropathy, as secondary to asthma, is granted. Service connection for a right shoulder disorder is denied. Service connection for a left shoulder disorder is denied. FINDINGS OF FACT 1. The Veteran's immunoglobulin A nephropathy is causally related to his service-connected asthma. 2. The Veteran's right and left shoulder disorders did not have their onset during service and are not otherwise related. CONCLUSIONS OF LAW 1. The criteria for service connection for immunoglobulin A nephropathy, as secondary to asthma, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for service connection for a right shoulder disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a left shoulder disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1994 to June 1998. The case is on appeal from a September 2012 rating decision. In January 2019, the Veteran testified at a Board hearing. Most recently in a November 2020 decision, the Board denied service connection for hearing loss, and higher initial ratings for a left foot disorder and asthma. At that time, the Board also remanded the claims remaining on appeal for further development. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service Connection General Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) 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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Service connection for immunoglobulin A nephropathy. The Veteran contends that his kidney disorder, diagnosed as immunoglobulin A nephropathy, was caused or aggravated by his service-connected asthma. The Veteran was afforded a January 2019 Board hearing in which he testified that his kidney condition is linked to his asthma. He stated he previously saw an endocrinologist in Texarkana who said that his asthma would have caused his kidney condition, and further, that his nephropathy was first discovered when he tried to apply for and was denied life insurance in 2000. The claim was remanded by the Board in November 2020 for further development, including a VA examination to determine whether the kidney disorder is related to his asthma. The Board also directed the RO to obtain updated treatment records related to the kidney disorder. Thereafter, the Veteran's treating physician, Dr. Matwijiw, submitted a January 2021 medical opinion in support of the claim. The physician stated following the Veteran's service, he underwent a biopsy in 2001 which revealed immunoglobulin A nephropathy. He indicated the Veteran's renal functional tests have remained fairly stable, but he has lost significant lung capacity. He opined the Veteran has ongoing lung and kidney disorders and there is an association between his chronic bronchitis or asthma and his immunoglobulin A nephropathy. The Veteran was also afforded an August 2021 VA examination in which he was diagnosed with immunoglobulin A nephropathy from 2001. The examiner indicated it is less likely as not that the Veteran's immunoglobulin A nephropathy was proximately due to or aggravated beyond the natural progression by his service-connected asthma. The examiner disagreed with the Veteran's treating physician and stated medical research does not list asthma as having a clinical association with immunoglobulin A nephropathy. He noted the Veteran does not have a condition which is associated with asthma and further, there is a genetic predisposition for his immunoglobulin A nephropathy. The Board determines service connection for immunoglobulin A nephropathy is warranted as secondary to his service-connected asthma. There is medical evidence in favor of and against the claim, with the positive nexus opinion coming from the Veteran's treating physician. While Dr. Matwijiw in his January 2021 report indicated that there is an association between the Veteran's asthma and his immunoglobulin A nephropathy, the August 2021 VA examiner reported the Veteran's kidney condition was not caused or aggravated by his asthma. At the very least, the Board determines the evidence has reached a level of equipoise. When reasonable doubt is resolved in the Veteran's favor, the Board finds that his immunoglobulin A nephropathy is casually related to his service-connected asthma. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 3.310. Accordingly, service connection for immunoglobulin A nephropathy is warranted on a secondary basis. 2. Service connection for a right shoulder disorder. 3. Service connection for a left shoulder disorder. The Veteran contends that his bilateral shoulder conditions are related to service. He testified at the Board hearing that he injured both shoulders during service replacing the leading edges of wings on "the 130's" while stationed in Little Rock. He stated since injuring his shoulders, he cannot lift his arms above his head for any length of time. He reported following service, he has not sought treatment related to his shoulders prior to the 2011 claims. The claims were remanded by the Board in June 2019 for further development, including a VA opinion to address the etiology of any diagnosed bilateral shoulder disorders. The Veteran was afforded a February 2020 VA examination in which he was diagnosed with bilateral shoulder strains. The Veteran reported that his shoulder pain began in 1996. The examiner opined the disorders were less likely than not incurred in service or within one year of separation from service. The examiner noted the Veteran's contention that his shoulder pain began during service, in 1996. However, she indicated the evidence does not support that the Veteran sought treatment during service or even following service, until 2011. She stated based on the evidence of record, the claimed disorders of bilateral shoulder strains are not related to service. The Board finds service connection for bilateral shoulder disorders is not warranted. The only relevant medical evidence of record adequately indicated that the shoulder disorders did not have their onset during service. Thus, the Board finds that the preponderance of the evidence is against the claims and such are denied. The Board accords the most probative weight to the February 2020 VA opinion in which the examiner indicated the disorders are not associated with service. The examiner thoroughly reviewed the record and addressed the Veteran's contentions. The physician accurately referenced the record, and her opinion contains well-reasoned explanations in support of her conclusions. As such, the opinion is entitled to significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board notes there are no medical opinions of record linking the Veteran's shoulder disorders with service. The Board acknowledges the Veteran's assertions during the January 2019 Board hearing. However, as a lay person the Veteran has not been shown to have specialized training sufficient to render an opinion as to the etiology of his shoulder disorders. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Therefore, the Board accords greater probative weight to the VA physician's February 2020 opinion. In sum, the Board determines the VA examination report of record is the most probative evidence of record and weighs against the shoulder claims. Thus, the preponderance of the evidence is against the claims and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As such, service connection for right and left shoulder disorders is not warranted. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Isaacs, Brandon 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.